AUA2022: REFLECTIONS How to Reach Excellence in Urology: Challenges and Opportunities

By: Francesco Montorsi, MD, FRCS (Hon); Giuseppe Basile, MD | Posted on: 01 Sep 2022

Pursuing excellence should be the final goal of everyone regardless of his/her profession. There is no shortcut to excellence as it requires extensive personal and professional growth, and this involves a number of subsequent steps that need to be followed.

“Finding a mentor may take a lifetime, but it is a priority for those who want to pursue a great career.”

Rather than doing everything on our own, we should learn from the best examples who already achieved success and discovered the skills and habits necessary to be excellent and successful. Thus, regardless of the career position reached—a post-graduate medical doctor, a young urologist consultant, or a senior professor—everyone should have a mentor to follow. A mentor is someone who can guide, inspire, and encourage others to apply for new opportunities, critique ideas without judging them, and help them to face challenging situations. Finding a mentor may take a lifetime, but it is a priority for those who want to pursue a great career. It is essential to learn from the most proficient colleagues in your field, both from their achievements and their failures. This will help us in determining the gaps in our work performance and understand what we need the most to improve our practice. In this regard, urology is a constantly evolving area, and a regular update is pivotal regardless of our position and responsibilities. Every year, clinical guidelines are updated according to the most important articles published in the peer-reviewed literature, and urologists cannot ignore them during the decision-making process in clinical practice. To this end, program directors should invest their time in making their disciples understand the importance of staying updated with the latest advances in urology. Thus, every urologist who aims at reaching excellence should ask himself or herself clinically relevant questions and try to provide the optimal answers to the scientific community. Once one becomes an expert in a specific field, he/she should not stop investing time and energy to improve. When surgery is considered, it is necessary to know one’s own results and complications to improve outcomes. This concept is of crucial importance, especially for younger urologists who aim at improving their surgical skills to reach excellence. The concept of the learning curve makes sense only for those surgeons who carefully follow their patients and are aware of their results.1 Additionally, urologists should be totally honest when presenting their results at scientific meetings, as it is part of a surgeon’s life to learn from mistakes and look for better surgical solutions. Sharing authentic and valid data, focusing also on negative outcomes, is a milestone for being excellent. Colleagues will recognize a surgeon’s global leadership and integrity, while patients will appreciate and trust us when clearly explaining the major issues that may arise intra- and postoperatively. When outcomes are satisfactory, one should change to further improve his/her results. To do so, surgeons working in tertiary referral centers should create a multidisciplinary team and optimize the collaboration with the other specialists who are often the pillars for reaching the best patient management.2 Lack of collaboration is often a shortcoming common to many urologists. Cooperation with dedicated pathologists, medical oncology, radiotherapist, radiologist, experts in nuclear medicine and tumor genetics, and psychologists can only improve results while achieving the best outcomes for patients. We are witnessing a revolution in the treatment of many urological diseases and will likely continue to do so in the upcoming years, along with technology and scientific research updates. Therefore, a call for a multidisciplinary approach is no longer sufficient to guarantee the best supportive care to urological patients; rather, we advocate for an integrated network of highly specialized physicians and professionals, guided by the urologist, to offer the patient the treatment that best suits his/her comorbidity status, preferences, and disease characteristics.

“Urology is a constantly evolving area, and a regular update is pivotal regardless of our position and responsibilities.”
“Sharing authentic and valid data, focusing also on negative outcomes, is a milestone for being excellent.”

I founded my career on these simple concepts. Following these steps, I have shaped the team currently working at the Department of Urology of Vita-Salute San Raffaele University in Milan. Only through hard work and dedication was I able to mold my ideas into habits, and then habits into a lifestyle, to become successful. For many years, now, I have been continuously working as an educator, dedicating my time to supporting younger colleagues to follow the principles of scientific integrity and intellectual honesty. In conclusion, reaching excellence is a challenge and opportunity for many of us. Nevertheless, I think it should not be the destination of one’s career, but a continuous journey that never ends.

  1. Montorsi F. On having grey hair. Eur Urol. 2019;75(4):541-542.
  2. Montorsi F. On being sick and tired. Eur Urol Oncol. 2020;3(1):7-9.