Honing surgical, medical skills in a friendly environment

11 Dec 2014

Honing surgical, medical skills in a friendly environment

The EUREP is an excellent opportunity for urology residents to update themselves in all the key areas of urology in a six-day course, a programme annually held in Prague, the Czech Republic, which is its permanent venue.

The delegates rotate through five modules which are designed as a series of interactive lectures and discussions that address a specific area of urology each day. This provides a comprehensive update of all the key areas of urological practice. However, the talks are not mere lectures or updates one would listen to hear at scientific sessions of meetings. Instead, as an active teaching programme, the discussions are focussed on being interactive, which fosters learning by direct involvement of the audience.

In addition there are excellent hands-on training (HOT) sessions. The teaching is delivered by a carefully selected faculty from several centres of excellence, which effectively brings together a large resource of experience and knowledge that urology trainees can tap into. There is a social element to the EUREP as well which enables professional networking. Although the obvious benefits of this social interaction may not be immediately evident to a resident, this will certainly become apparent in the long-term. I am not aware of the existence of a comparable course for urology residents elsewhere, and it’s a testament to the EUREP’s success and reputation that the programme is now being emulated in some countries outside Europe.

Preparing for EUREP 

Held since 2003, the EUREP is now in its second decade. Although an ever increasing number of residents apply each year, I would like to see it become a course that all residents can attend. I sincerely believe that those who did not attend during their training have missed a valuable opportunity to interact with, and learn from other residents and an excellent faculty of experts. Consequently if you haven’t attended the EUREP as yet, apply for it now!

To get the most out of the EUREP, residents should review as many of the scheduled topics as possible in advance, as this will lead to more insightful discussions, reinforcing the participants’ current knowledge and help clarify areas of uncertainty by engaging in one-to-one discussions. The slides from the previous year’s presentations are available online and these provide a framework for the areas to be covered.

The success of the EUREP programme derives from the interaction between the faculty and the residents, and although this is already superb it is an area which we should continually try to improve. There are several means of achieving this and one way is to encourage residents to bring examples of difficult clinical cases from their own practice for discussion with the faculty, both at the formal sessions as well as over lunch or coffee. The ability to apply the taught information to their own real-life practice will foster deep and long-term learning.

It was clear to me that the friendly and informal approach of the faculty clearly helped many residents realise that no question was too basic to bring up for discussion, and this helped them overcome any reservations they might have had, enabling them to freely discuss difficult issues.

Functional urology 

Regarding functional urology which I enjoyed being a part of the faculty for, I found residents enthusiastic and eager to learn as much as possible within the time allocated to the module, and I was posed interesting questions over coffee and lunch every day. It is common for some residents to lack confidence when dealing with various aspects of functional urology. This is because often the diagnosis of various functional conditions poses challenges which require a logical approach not too different to that required for solving a puzzle. From the discussions I had with several residents, topics such as the role and interpretation of urodynamics, the rationale for the choice of management options for stress incontinence and prolapse and the management of chronic pelvic pain are common grey areas of uncertaintyconsequently trainees were grateful for the opportunity to discuss such topics on a one-to-one basis.

I certainly do think there was an increased interest in functional urology among residents during the EUREP.

This probably reflects the inspiring teaching by my colleagues as well as a realisation that the subject requires analytical minds and a very different approach than other aspects of urology.

Elevator pitch

Residents attending the EUREP have already chosen their career path and consequently I don’t see them in need of persuasion or so-called ‘elevator pitch’. All of us who practise urology are aware that this very interesting surgical speciality involves the diagnosis and management of a vast range of pathology ranging from various common and uncommon cancers, functional and neurological disorders, and so much more.

The rapid expansion in evidence base that underpins our knowledge have now made it impossible for any individual to know all the various aspects of urology in great depth, which gives trainees the freedom to choose from a wide range of subjects to subspecialise in or to remain proficient in, which includes core aspects of urology. The use of ever-advancing developments in technology keeps this speciality quite literally at the cutting edge of medicine and makes it both exciting and interesting.

In many countries the expanding ageing population will guarantee that urologists will be kept busy. Urology is well recognised as a ‘family friendly’ surgical speciality which allows improved work-life balance, and this has attracted more female residents to the profession in recent years. Most importantly, the almost universal sense of humour that urologists seem to possess guarantees a good working environment in which to pursue a surgical career.

Mr. Jay Khastgir, Morriston Hospital Dept. of Urology, Swansea (UK).