The 2024 Annual Symposium of the Jamaica Urological Society was held on March 3rd, 2024, in Kingston, Jamaica. The conference focused on the dichotomy in the delivery and outcomes of urological care in the first world versus that in middle- and low-income countries and what steps can be taken to close this gap (Figures 1 and 2).

The AUA guest speaker was Jeffrey J. Tosoian, MD, MPH (Vanderbilt University Medical Center, Nashville, Tennessee) (Figures 3 and 4). He addressed race-based differences in tumor biology of prostate cancer as presented in the literature and examined how these differences could impact cancer outcomes for Black men who are known to carry more aggressive phenotypes of the disease, as well as how accuracy of diagnostic testing is affected in diverse demographics.¹ In addition, these discrepancies in tumor biology will impact active surveillance practices for these men; key factors were identified that could portend for safer active surveillance outcomes.

Other guest speakers included Alexandra Shields, PhD (Harvard/Massachusetts General Hospital Center on Genomics, Boston, Massachusetts), who emphasized the paradox that the majority of genomic studies in urological cancer research are carried out using samples from White, middle-class men in the United States, whereas the more aggressive cancer gene mutations in Black populations, including in the Caribbean, are being underrepresented in global research efforts. Mechanisms to equalize distributive justice were examined.

We were honored to present the Inaugural Professor the Hon. L. Lawson Douglas Distinguished Lecture in Urology at this symposium. Professor Douglas served Jamaica for over 50 years as a pioneer in the field of urology, having performed the first series of kidney transplants here in the 1970s, as well as setting up the region’s first postgraduate program in urology. The inaugural lecture discussed the establishment of living-donor kidney transplant services in middle- and low-income countries with the assistance of Transplant Links Community, a UK-based nonprofit organization. The Transplant Links Community has facilitated the reintroduction of the national program and fostered local expertise through skill transfer on site, observerships in the UK, and online teaching and mentoring. Their efforts in assisting to lay the groundwork for a sustainable service were summarized, which range from securing political support and financial commitment to fostering multidisciplinary collaboration.

Chad Ritch, MD, MBA (University of Miami, Miami, Florida), and Belinda Morrison, MBBS, DM (University Hospital of the West Indies, Kingston, Jamaica), recounted the various treatment modalities, both novel and standard of care, available for men with advanced and hormone-refractory prostate cancer (Figure 5). Their presentations examined the discrepancies in delivery of novel products to Black versus White men and the resulting deleterious impact on mortality rates.

Reconstructive urology was represented as Kurt McCammon, MD, FACS, FPMRS (Eastern Virginia Medical School, Virginia Beach, Virginia), recounted his experience in various Caribbean and African countries, transferring surgical skills and assisting to set up mentorship programs with local surgeons. The insightful, and sometimes humorous, tales of his experiences teaching urethroplasty underlie the complexities of developing a specialized program and working with physicians of varying grades of experience and ability. The use of virtual technologies is an innovative solution to the problem of providing remote support intraoperatively, and virtual technologies have been used by the mentorship teams with success.

The resident’s session featured a review of the epidemiology, pathological features, and morbidity and mortality rates of men presenting to the University Hospital of the West Indies over a 20-year period (Lasania Crosbie, MBBS, DM, University Hospital of the West Indies, Kingston, Jamaica). The agenda was rounded off with presentations on the challenges of providing psychiatric care to urological patients, as well as the ethics involved in decision making when choosing palliative versus curative care.