Let's Talk Surgery Podcast, Surgical Crossroads: Choosing your specialty - the Urology episode

Welcome to the Urology episode of the Let's Talk Surgery Podcast, Surgical Crossroads series. 

Neil Fenn is a Consultant Urologist at Morriston Hospital Swansea and Chair of the Surgical Specialty Board (SSB) in Urology at the RCSEd. He always wanted to be a surgeon, and after qualifying from the University of Wales he completed his basic surgical and urology training in South Wales. He developed his sub-specialist interest in the management of urological malignancy and its treatment during fellowships at Flinders University, Adelaide and the Cleveland Clinic in Ohio.  

During the last 20 years as a consultant, he has developed a minimally invasive service for patients in South West Wales including laparoscopic nephrectomy, partial nephrectomy and pyeloplasty. In co-operation with colleagues from Cardiff and Newport he is developing the first robotically assisted laparoscopic radical prostatectomy service in Wales. He has enjoyed seeing the development of this type of surgery over the last 20 years with better outcomes for patients. 

Neil is an active trainer. He is an assigned educational and clinical supervisor to all grades of junior surgical trainee doctors. From 2007-2011 he was the program director for urological training in Wales and oversaw the introduction of a new national curriculum. He is currently involved in putting together an online modular urology curriculum and teaching aids that can be used for all medical students with the SSB in Urology. 

Our registrar for this episode is Kamran Hag, currently working in the northeast of England. Kamran completed his foundation year training in Derriford hospital, Plymouth where he had his first exposure to surgery and subsequently chose this as his career path. During his core training post in the Kent Surrey and Sussex deanery he undertook a four-month placement in urology and soon decided it was the specialty for him. After six more months of urology and a frantic few weeks polishing his portfolio, he was able to secure a registrar post. Kamran is currently entering his final year of training, after which he hopes to undertake a post CCT fellowship in renal cancer.  

Our panel give us a comprehensive overview of urology as a specialty, including the busy nature of on-call, urology emergencies and the key role of robotics. They emphasise the importance of getting hands-on experience and explain that there are elements of urology that trainees can get involved with at a junior stage. Urology incorporates a huge spectrum of procedures and sub-specialties, “there's something for everyone”, and those working in urology are known for being supportive and friendly mentors and teachers. 

For trainees interested in urology there are numerous routes into the specialty to suit a variety of skillsets. You are encouraged to get involved with societies, including the British Association of Urological Surgeons, which has a medical students branch, and the SSB in urology for the Royal College of Edinburgh. 

Contact Information
Visit https://www.rcsed.ac.uk/ for further information and details on becoming a member. 

Email: comms@rcsed.ac.uk for any questions or topic suggestions you may have for future episodes. 

This show is brought to you by the RCSEd. Follow us on Twitter, Facebook, Linkedin and Instagram. Hosted by Greg Ekatah, Sesi Hotonu and Sadie Khwaja produced and directed by Heather Pownall of Heather's Media Hub Ltd. 

Chapters

• 1:17 Introducing the topic and guests for this episode.
• 2:13 [Greg Ekatah – Kamran Hag] Kam, you graduated from medical school with the world at your feet and decided to be a urologist; why?
• 3:45 [GE – Neil Fenn] Of all the urological operations out there which one is your favourite?
• 4:47 [GE – NF] Is there clarity around robotic versus laparoscopic radical prostatectomy in terms of outcomes for the patients?
• 6:53 [Sadie Khwaja – NF] So let's just talk about how your week is as a urology consultant. What does that look like?
• 10:23 [SK – NF] And you mentioned office urologists, do they exist, or is that still part of the programme?
• 11:50 [SK – NF] Neil, how did urology excite you at the beginning of your life and in medicine? How did you get to urology?
• 13:55 [SK – NF] Neil going back to you, you obviously decided on urology and then what happened after that?
• 15:38 [SK & NF] Reflections on the speed of change in medicine and surgery.
• 16:17 [SK – NF] So coming to present day you're talking about work-life balance; what's that looking like? I mean, what's on-call urology like?
• 17:24 [SK – NF] What’s the urology emergency for you guys?
• 19:00 [SK – NF] What’s the future in urology?
• 21:29 [SK – NF] What keeps you up at night in urology? What’s the scary stuff?
• 22:19 [SK – NF] How do you switch off Neil, if you’ve had a busy week?
• 23:47 [GE – KH] If you were to look back through your urology training programme, what would your overriding reflections be around the training journey for you, from foundation level to where you're now?
• 25:39 [GE – KH] So what would you say to a medical student out there who thinks, how can I get a little bit of urological exposure?
• 26:29 [GE – KH] And given our audience for this podcast series is particularly medical students, early years, and of course, surgical trainees or foundation doctors, just talk us through the training programme per se in terms of urology.
• 28:02 [GE – KH] In certain surgical specialties academia tends to be more heavily weighted both in terms of the entry requirements to ST3 programmes, but also the requirements to CCT. What is it like in urology?
• 29:09 [GE – NF] Neil, I wonder if I can get your views [on this ] as well … Are you seeing that change in terms of people moving away from PhDs and MDs to doing other things that makes them competitive?
• 32:05 [GE – KH] What is life like as a urology register “at the coalface”, as Neil describes it?
• 33:40 [GE – KH] From the point of view of a registrar, what is your exposure to this variety of sub specialisation and how does that play in terms of deciding what you end up doing both at fellowship level and as a consultant job?
• 35:13 [SH – KH & NF] I'd like to ask you – urology, is it one that welcomes people of all backgrounds, or is it quite limited in its demographic?
• 39:48 [GE – KH] What are some of the drawbacks, or the not so good parts, of being a urology registrar?
• 43:17 [GE – KH] And finally, we've got to talk about COVID … What has life been like as a urology registrar through the pandemic?
• 44:47 [SH – NF & KH] Do you have any final words of advice for our listeners? Any words of wisdom for anyone who is wanting to do urology?
• 48:14 [SK – NF] Are there any urology societies with junior members?