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  1. 1. Urological SurgeryUrological SurgeryDavid Galvin MDDavid Galvin MDSpecialist Registrar In UrologySpecialist Registrar In Urology
  2. 2. Urological SurgeryUrological Surgery ““Most fascinating area in Surgery”Most fascinating area in Surgery” Deals with all Surgical PathologyDeals with all Surgical Pathologyinvolving:involving: KidneysKidneys UretersUreters BladderBladder Seminal Vesicles and VasSeminal Vesicles and Vas Testicles and ScrotumTesticles and Scrotum UrethraUrethra Female UrologyFemale Urology
  3. 3. 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 lethal.Kidney Cancer: 8th commonest cancer. Most lethal. Testicular Cancer: Commonest cancer <40Testicular Cancer: Commonest cancer <40 Ageing populationAgeing population
  4. 4. 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 - RPLNDPenectomy - Bilateral Groin Dissection - RPLND
  5. 5. EndoUrologyEndoUrology StoneStone PercutaneousPercutaneousNephrolithotomyNephrolithotomy Flexible UreteroscopyFlexible Ureteroscopy Rigid UreteroscopyRigid Ureteroscopy Dormia BasketDormia Basket Laser FragmentationLaser Fragmentation ESWLESWL CystolithopaxyCystolithopaxy Endoscopic SurgeryEndoscopic Surgery CystoscopyCystoscopy TURPTURP UrethrotomyUrethrotomy TURBTTURBT OtherOther ReconstructionReconstruction Female UrologyFemale Urology ED SurgeryED Surgery TransplantationTransplantation
  6. 6. Manpower NationallyManpower Nationally 2323 Urology ConsultantsUrology Consultants (7 outside Dublin)(7 outside Dublin) Also 5 Private Urologists (increasing)Also 5 Private Urologists (increasing) 99 Specialist RegistrarsSpecialist Registrars Positions (8 filled July 06)Positions (8 filled July 06) Dublin (7), Galway (1), Limerick (1)Dublin (7), Galway (1), Limerick (1) 1212 Non-SpR RegistrarNon-SpR Registrar PositionsPositions 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
  7. 7. Future Manpower NeedsFuture Manpower Needs Lowest Urologists in Europe (1:180,000)Lowest Urologists in Europe (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
  8. 8. Urology Training: UKUrology Training: UKInternFoundation Year 1 (FY1)Foundation Year 2 (FY2)Foundation Year 3 (FY3)Foundation Year 4 (FY4)Foundation Year 5 (FY5)Urology Fellowship 1Urology Fellowship 2FRCS (Urol)Consultant UrologistConsultant UrologicalSurgeon
  9. 9. Urology Training: IrelandUrology Training: IrelandInternBasic Surgical Training (MRCS)Urology Residency 1Urology Residency 2Urology Residency 3Urology Residency 4Urology Specialist Registrar5 Year SchemeConsultant UrologicalSurgeon
  10. 10. 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 andEnjoy family life with my wife andchildrenchildren Well structured Training postsWell structured Training posts Very ‘International’ - Regular ConferencesVery ‘International’ - Regular Conferences
  11. 11. How to get into UrologyHow to get into Urology1.1. 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 bets1.1. Apply for new Residency programmeApply for new Residency programme2.2. Do Urology Research (MCh, MD)Do Urology Research (MCh, MD)3.3. Attend teaching / ISU meetingAttend teaching / ISU meeting
  12. 12. Present and FuturePresent and Future Training undergoing changeTraining undergoing change Future is bright - huge expansion long overdueFuture is bright - huge expansion long overduein an ageing populationin 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
  13. 13. ContactsContactsUrological Trainees of Ireland (UTI) website:Urological Trainees of Ireland (UTI) website:www.homepage.mac.com/www.homepage.mac.com/davidgalvindavidgalvinEuropean Society of Residents in Urology:European Society of Residents in Urology:www.esru.netwww.esru.net (Ireland webpage)(Ireland webpage)Me: davidgalvin@mac.comMe: davidgalvin@mac.com