Urology

Urological Urological SurgerySurgery

David Galvin MDDavid Galvin MD

Specialist Registrar In Specialist Registrar In UrologyUrology

Urological SurgeryUrological Surgery

““Most fascinating area in Surgery”Most fascinating area in Surgery” Deals with all Surgical Pathology Deals with all Surgical Pathology

involving:involving: KidneysKidneys UretersUreters BladderBladder Seminal Vesicles and VasSeminal Vesicles and Vas Testicles and ScrotumTesticles and Scrotum UrethraUrethra Female UrologyFemale Urology

Urological OncologyUrological Oncology

Prostate Cancer: Commonest male cancerProstate Cancer: Commonest male cancer

Bladder Cancer: 4th commonest male cancerBladder Cancer: 4th commonest male cancer

Kidney Cancer: 8th commonest cancer. Most Kidney Cancer: 8th commonest cancer. Most lethal.lethal.

Testicular Cancer: Commonest cancer <40Testicular Cancer: Commonest cancer <40

Ageing populationAgeing population

Urological OncologyUrological Oncology

Partial or Radical NephrectomyPartial or Radical Nephrectomy Open / Laparoscopic / RoboticOpen / Laparoscopic / Robotic

Radical ProstatectomyRadical Prostatectomy Open / Laparoscopic / RoboticOpen / Laparoscopic / Robotic

Radical CystectomyRadical Cystectomy Open / Laparoscopic / RoboticOpen / Laparoscopic / Robotic

Penectomy - Bilateral Groin Dissection - Penectomy - Bilateral Groin Dissection - RPLNDRPLND

EndoUrologyEndoUrology

StoneStone Percutaneous Percutaneous

NephrolithotomyNephrolithotomy Flexible Flexible

UreteroscopyUreteroscopy Rigid UreteroscopyRigid Ureteroscopy Dormia BasketDormia Basket Laser FragmentationLaser Fragmentation ESWLESWL CystolithopaxyCystolithopaxy

Endoscopic Endoscopic SurgerySurgery CystoscopyCystoscopy TURPTURP UrethrotomyUrethrotomy TURBTTURBT

OtherOther ReconstructionReconstruction Female UrologyFemale Urology ED SurgeryED Surgery TransplantationTransplantation

Manpower NationallyManpower Nationally 23 23 Urology ConsultantsUrology Consultants (7 outside Dublin) (7 outside Dublin)

Also 5 Private Urologists (increasing)Also 5 Private Urologists (increasing)

9 9 Specialist RegistrarsSpecialist Registrars Positions (8 filled Positions (8 filled July 06)July 06) Dublin (7), Galway (1), Limerick (1)Dublin (7), Galway (1), Limerick (1)

12 12 Non-SpR RegistrarNon-SpR Registrar Positions Positions 5 will be Urology Residents5 will be Urology Residents

Urology Research RegistrarsUrology Research Registrars Conway (2), Trinity (2) - Cork, Beaumont etcConway (2), Trinity (2) - Cork, Beaumont etc

Future Manpower NeedsFuture Manpower Needs

Lowest Urologists in Europe Lowest Urologists in Europe (1:180,000)(1:180,000)

Maintain Dublin CentresMaintain Dublin Centres MMH / SJH to expand over timeMMH / SJH to expand over time

Develop 4 man units in Cork, Limerick, Develop 4 man units in Cork, Limerick, GalwayGalway

Huge Expansion RequiredHuge Expansion Required Enhance present unitsEnhance present units Single appointments working in triosSingle appointments working in trios Natural increase in private sectorNatural increase in private sector

Urology Training: UKUrology Training: UKIntern

Foundation Year 1 (FY1)





Urology Fellowship 1

Urology Fellowship 2

FRCS (Urol)

Consultant Urologist

Consultant Urological Surgeon

Urology Training: IrelandUrology Training: IrelandIntern

Basic Surgical Training (MRCS)

Urology Residency 1

Urology Residency 2

Urology Residency 3

Urology Residency 4

Urology Specialist Registrar

5 Year Scheme

Consultant Urological Surgeon

Why I did Urology …Why I did Urology …

I wanted to do SurgeryI wanted to do Surgery I enjoyed Endoscopic UrologyI enjoyed Endoscopic Urology It is largely (75%) Elective basedIt is largely (75%) Elective based On call is frequent but generally lightOn call is frequent but generally light Call is from home throughout the countryCall is from home throughout the country Enjoy family life with my wife and childrenEnjoy family life with my wife and children Well structured Training postsWell structured Training posts Very ‘International’ - Regular ConferencesVery ‘International’ - Regular Conferences

How to get into UrologyHow to get into Urology

1.1. Talk to UrologistsTalk to Urologists2.2. Request a Urology rotation while a BSTRequest a Urology rotation while a BST3.3. Do some Urology based audit while BSTDo some Urology based audit while BST4.4. Get Registrar ExperienceGet Registrar Experience

• Cork - Galway - Limerick best betsCork - Galway - Limerick best bets

5.5. Apply for new Residency programmeApply for new Residency programme6.6. Do Urology Research (MCh, MD)Do Urology Research (MCh, MD)7.7. Attend teaching / ISU meetingAttend teaching / ISU meeting

Present and FuturePresent and Future

Training undergoing changeTraining undergoing change

Future is bright - huge expansion long Future is bright - huge expansion long overdue in an ageing populationoverdue in an ageing population

Very competitive SubspecialtyVery competitive Subspecialty

Training is well structuredTraining is well structured

Getting ‘in the door’ is now much easierGetting ‘in the door’ is now much easier

ContactsContacts

Urological Trainees of Ireland (UTI) Urological Trainees of Ireland (UTI) website:website:

www.homepage.mac.com/www.homepage.mac.com/davidgalvindavidgalvin

European Society of Residents in Urology:European Society of Residents in Urology:www.esru.netwww.esru.net (Ireland webpage) (Ireland webpage)

Me: [email protected]: [email protected]

Education

Urology