Urological Surgery

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Urological Surgery

• David Galvin MD
• Specialist Registrar In Urology

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Urological Surgery

• Most fascinating area in Surgery
• Deals with all Surgical Pathology involving
• Kidneys
• Ureters
• Bladder
• Seminal Vesicles and Vas
• Testicles and Scrotum
• Urethra
• Female Urology

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Urological Oncology

• Prostate Cancer Commonest male cancer
• Bladder Cancer 4th commonest male cancer
• Kidney Cancer 8th commonest cancer. Most lethal.
• Testicular Cancer Commonest cancer lt40
• Ageing population

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Urological Oncology

• Partial or Radical Nephrectomy
• Open / Laparoscopic / Robotic
• Radical Prostatectomy
• Open / Laparoscopic / Robotic
• Radical Cystectomy
• Open / Laparoscopic / Robotic
• Penectomy - Bilateral Groin Dissection - RPLND

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EndoUrology

• Stone
• Percutaneous Nephrolithotomy
• Flexible Ureteroscopy
• Rigid Ureteroscopy
• Dormia Basket
• Laser Fragmentation
• ESWL
• Cystolithopaxy

• Endoscopic Surgery
• Cystoscopy
• TURP
• Urethrotomy
• TURBT
• Other
• Reconstruction
• Female Urology
• ED Surgery
• Transplantation

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Manpower Nationally

• 23 Urology Consultants (7 outside Dublin)
• Also 5 Private Urologists (increasing)
• 9 Specialist Registrars Positions (8 filled July
  06)
• Dublin (7), Galway (1), Limerick (1)
• 12 Non-SpR Registrar Positions
• 5 will be Urology Residents
• Urology Research Registrars
• Conway (2), Trinity (2) - Cork, Beaumont etc

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Future Manpower Needs

• Lowest Urologists in Europe (1180,000)
• Maintain Dublin Centres
• MMH / SJH to expand over time
• Develop 4 man units in Cork, Limerick, Galway
• Huge Expansion Required
• Enhance present units
• Single appointments working in trios
• Natural increase in private sector

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Urology Training UK
Intern
Foundation Year 1 (FY1) Foundation Year 2
(FY2) Foundation Year 3 (FY3) Foundation Year 4
(FY4) Foundation Year 5 (FY5)
FRCS (Urol) Consultant Urologist
Urology Fellowship 1 Urology Fellowship 2
Consultant Urological Surgeon
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Urology Training Ireland
Intern
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
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Why I did Urology

• I wanted to do Surgery
• I enjoyed Endoscopic Urology
• It is largely (75) Elective based
• On call is frequent but generally light
• Call is from home throughout the country
• Enjoy family life with my wife and children
• Well structured Training posts
• Very International - Regular Conferences

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How to get into Urology

• Talk to Urologists
• Request a Urology rotation while a BST
• Do some Urology based audit while BST
• Get Registrar Experience
• Cork - Galway - Limerick best bets
• Apply for new Residency programme
• Do Urology Research (MCh, MD)
• Attend teaching / ISU meeting

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Present and Future

• Training undergoing change
• Future is bright - huge expansion long overdue in
  an ageing population
• Very competitive Subspecialty
• Training is well structured
• Getting in the door is now much easier

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Contacts

• Urological Trainees of Ireland (UTI) website
• www.homepage.mac.com/davidgalvin
• European Society of Residents in Urology
• www.esru.net (Ireland webpage)
• Me davidgalvin_at_mac.com