Becoming Urologist: Starter’s kit

     As I started my Urology Residency journey, there was a little chaos in my mind and also in my heart. Well… who am I lying?! It was a big one… It is so much to learn and hard to find the optimal way to do it, adapted to day to day life at work. Urology especially, is very diverse and even the starting point may be confusing. Confusion brings numbness and it could blur the exciting challenge ahead…

     Surgery can be overwhelming and as young doctors, we really need mentors and smart tools to learn so we can level up our game. Learning in the surgical field is also about surgical skills and hands-on training, an exciting and appealing aspect that spices the beautiful clinical mindset and the fulfilling doctor-patient relationship. During my learning process, I have discovered helpful tools (resources) and I am sharing them in case you also struggle to upgrade. This is written targeting my fellow Urologists, but for sure there is some inspiration for colleagues from other medical specialties.

     So, here you have it, my friends: a SHOULD DO list to navigate Urology, from my perspective:

• Take notes. If you don’t have an iPad, a laptop or a plain old paper notebook with you… you are not pushing yourself forward. Take advantage of dead time to learn through reading, writing, listening to podcasts. It doesn’t really matter how you do it, just be wired to Urology daily! Summarize, draw, read and learn in as many different ways as possible about the disease and treatment management that you encounter every day. Start studying the main surgeries that are made into your hospital so that you can optimize understanding/ learning from every intra-operatory opportunity. Uptodate is a great tool to have an overview of recent studies and the pocket EAU guidelines should be on your desk (extended Pdf has great selected references for you to read).

• EAU Membership is mandatory to have access to the European guidelines, Webinars, Online Courses, Hands on Trainings, significant discounts to congresses and find out about Research grants, Internship opportunities that are available in the Urologic community.

• Even so, the Guidelines just pave the way to disease and patient management, as understanding the why and the how it is a whole new story. You have to follow the references, read the studies, get friendly with PubMed, Researchgate and Sci-Hub. You can learn more in these blogposts about Journals, Scientific articles, Writing/ publishing  and other resources.

• A refresh on statistics is needed to be able to evaluate/ compare the studies you access. Even with all this work, the why and how are still hard to fully get. You have to read Campbell-Walsh and really understand embryology, anatomy, pathophysiology, pharmacology, genetics… and actually all other medical subjects/ branches that help diagnose and treat the pathology covered by your specialty, to be able to integrate them in your surgical approaches and treatments. The act of refreshing these processes cements your learning and improves it, making it easier to understand, to assimilate and to gain ideas for your own research project.

• Get a movie editor and learn how to edit surgeries, watch and read a lot about them. Send a case report to a video Journal. Make a list with what surgical steps you have learned so far and what you want to learn next. Share it with your mentor and design together your learning journey. Seek elegance, precision and efficiency in surgery. Learn how to communicate, create, inspire and motivate a team. Learn how to manage stressful situations, emotions and resources. Learn to be a leader and a team player.

  • Invest in a relationship with your mentor. He/ She will guide you for optimal ways of gaining knowledge. Observe and ask questions. Cultivate learning opportunities with work colleagues. Learn from each other and rise the level of the team. Each member is ahead of the game in something, invest in a nurturing environment for your team and you will all win. Compete only with yourself, learn from those around you. There is a place and a moment for each of us as we all shine differently. Be attentive to patients and learn about communication and emotional intelligence. Many times our surgical results depend on post operatory care and follow-up which depends on how the patient understands the disease and trusts in you.

       Online learning resources:
  – UROONCO Edu platform (from EAU, short useful videos to run in the background), Surgery in Motion School of EAU (video-based mentorship in surgical training), SIU Academy, Websurg (surgeries explained), WRSE (Worldwide 24/7 Robotic Surgical Education event), Invivox (trainings for the medical community), BJU International podcasts,  InTouch Health (Webinars, case studies).

       Some of my favourite congresses/ events:
  – EAU (The biggest one in Europe, an amazing learning and motivational experience), CEM Central European Meeting of EAU (here I had my first posters), ESUT (perfect for a marathon of Live Surgeries), CLERU International Laparoscopy Course (Live Surgery, HOT and the opportunity to get your E-BLUS certificate in my beautiful city Cluj) and International Robotic surgery Course (Live surgery & Dry lab training), ERUS (EAU Robotic Urology Section), Progress in Uro-Oncology (Robotic Surgery), MRi-US fusion prostate biopsy Course in Cluj, National Urology Congress, Urogyn, International Semirigid and Flexible Ureteroscopy Course Timisoara, ESUR (EAU Section of Urological Research), FEDURO (uro-oncology courses in Bucharest with the opportunity of winning a participation to an international congress/ conference or Ultrasound course).

       Regarding books, I am using the following:
  – Urologie clinică- I. Sinescu
  – Tratat de Urologie- I. Sinescu, G. Gluck
  – Tratat de chirurgie- Irinel Popescu, Constantin Ciuce, Ioan Coman
  – Cancerul renal cu extensie venoasă- I Sinescu, C. Gîgu, C. Surcel
  – Ghid ilustrat de tehnici chirurgicale- Bumbu G., Bumbu A.
  – Massachusetts General Hospital- Urology Handbook
  – Imaging and Urodynamics of the Lower urinary tract- Uday Patel
  – Urodynamics made easy- Anand Patel, Christopher R. Chaple, Scott A. MacDiarmid
  – Operative Urology- A. C. Novick, J. S. Jones, I. S. Gill, E. A. Klein, R. Rackley, J. H. Ross
  – Atlas of Urologic Surgery- Frank Hinman
  – Campbell-Walsh Urology

  1

  Share your team’s work & learn:
  – Do 1 Poster and 1 Oral/Video presentation a year.
  – Target 3 congresses and 3 HOTs a year to attend.
  – Stay connected to your community.

  2

  Publish at least 1 of these:
  – Case report
  – Original article
  – Systematic Review
  – Article Review

  3

  Be part of a Research grant.
  Get a PhD.

  4

  Gain an ESRU Scholarship.
  Do an Internship abroad.
  Learn a foreign language.

  5

  Teach students and other residents.
  Add a next level to your learning process.
  You grow by helping others grow.

  6

  Study 1 hour daily.
  Make it a habit.
  Do online learning.

  7

  Get your certificates:
  E-BLUS
  EST S1
  ERUS

  8

  Keep a track of the journey: your surgeries, ideas and collaborations. And most importantly, plan your career.
  Time is priceless and if you fail to plan, you plan to fail!

  9

  Learn skills such as leadership, time management.
  Get to know YOU and ESRU community.

  10

  Take time to appreciate your mentors and friends.
  Choose them, respect their time, feedback & support.
  Cherish the shared journey!

  10 Experiences to have during residency

       Please feel free to comment if you have any suggestions/ tips and tricks and the post will be updated!