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GLOBAL STATE OF UROLOGY Current Situation of Urology in Chile: An Emerging and Exciting Journey Into the South of the World

By: Paulette Narvaez Fuentes, MD, Hospital el Carmen, Maipu, Chile, Member, Sociedad Chilena de Urología; Sergio Guzman Karadima, MD, Immediate Past-President, Sociedad Chilena de Urología, Clínica Universidad de Los Andes, Santiago, Chile; Mario I. Fernandez, MD, Clinica Alemana Universidad del Desarrollo, Santiago, Chile | Posted on: 15 Mar 2024

Urology, as a medical specialty, plays a crucial role in addressing and managing a wide range of conditions related to the urinary tract and male reproductive system. In Chile, the practice of urology has evolved significantly over the years, shaped by unique challenges, innovations, and special collaborations with professionals worldwide.

One of the most distinctive features of urology in Chile (Figure 1) is the quick advance and introduction of new technologies. Despite the country’s territorial distance from the rest of the world, Chile has been able to keep pace with new technologies and surgical techniques, introducing them effectively and successfully. In this regard, the national society (Sociedad Chilena de Urología) has been of extreme value and has played a pivotal role. Through organized conferences (Figure 2), workshops, and networking events, the society facilitates opportunities for young practitioners to stay abreast of the latest advancements in urology and build valuable connections within the field. Financial assistance and scholarships are often provided to assist new urologists in attending educational programs and pursuing specialized training. By actively supporting and integrating new urologists into the broader community, this society contributes to the growth and dynamism of the field, ensuring a robust future for urological care in the country.

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Figure 1. Torres del Paine, Chile.

Since we began practicing urology, the field has undergone remarkable transformations. Technological advancements, changes in patient demographics, and evolving treatment modalities have reshaped the landscape. The shift from traditional open surgeries to minimally invasive procedures, such as endourology, laparoscopy, and robotic-assisted surgery, has been particularly noteworthy. These changes not only have enhanced patient outcomes, but have also reduced recovery times, marking a significant improvement in the overall quality of care and costs.

The expansion, both in terms of numbers and geographically, is another transformation that urology has undergone in Chile. The growth in the number of professionals and the geographical widening of urological practice reflect significant development in the discipline. This expansion is evident not only in the increased presence of urologists in the country, but also in the decentralization of urological health care to regions that were previously underserved. Nowadays in Chile, the field of urology comprises a total of 414 professionals, including 28 women, indicating a growing diversity within this specialty. The training of new experts takes place in 15 centers affiliated with 10 universities, with 4 located in provinces and 6 in Santiago, including 3 private institutions. This landscape illustrates a comprehensive training network that spans both major urban areas and more remote regions, promoting the decentralization of medical education. Furthermore, with 77 residents distributed across the first 3 years of training, there is a clear commitment to the ongoing development and renewal of the urology community in Chile. This inclusive and diverse panorama underscores the strength and expansion of the specialty in the country.

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Figure 2. Board of Directors of the Sociedad Chilena de Urología at the Confederación Americana de Urología Congress in Santiago, Chile, 2023.

Looking ahead, the greatest opportunities in Chilean urology lie in the further integration of technology for enhanced diagnostics and treatment. With a focus on research and education, there is potential for breakthroughs in personalized medicine and targeted therapies. Another great opportunity is the integration of female urologists in Chile (Figure 3). This represents a positive and progressive shift in the landscape of the medical profession in our country. As more women enter the field, their contributions bring diverse perspectives, skills, and insights that enrich the practice of urology. This inclusivity not only reflects a commitment to gender equality, but also enhances the overall effectiveness and adaptability of the health care system. The growing presence of female urologists in Chile is a testament to the recognition of talent and expertise irrespective of gender, fostering a more dynamic and well-rounded approach to urological care.

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Figure 3. Meeting of “Urólogas de Chile,” 2022.

Chile has been at the forefront of adopting emerging technologies in urology. The utilization of artificial intelligence for image analysis, precision medicine, and data-driven decision-making is on the rise. Telemedicine platforms continue to play a crucial role, particularly in reaching patients in remote areas, which is crucial since we are a 4270 km—long country. Furthermore, Chilean urologists are exploring the potential of virtual reality for surgical training and patient education.

Despite the strides made, urology faces several challenges in Chile. Challenges in Chilean urology may vary, ranging from access to specialized care in rural areas to economic constraints affecting health care resources. Since we have a mixed health care system which involves private and public health, one of the challenges is to develop new technologies in the public health system.

The importance of staying connected to urology colleagues globally is universal, and Chilean urologists have always benefited from international collaborations. This involves participating in global research initiatives, attending international conferences, and engaging in knowledge exchange to stay abreast of the latest advancements in the field. In an era of globalization, such connections foster a sense of solidarity among urologists globally, ultimately benefiting patient care on a global scale.

For the next generation of urologists in Chile, advice would be to focus on adaptability and continuous learning, especially among young urologists. Embracing technology, understanding the unique health care challenges of the country, and actively participating in professional networks can contribute to a successful and impactful career in urology. It is always important to foster a commitment to lifelong learning, actively participate in collaborative networks, and encourage a holistic approach to patient care that considers both medical and psychosocial aspects.

In conclusion, urology in Chile is a dynamic and evolving field, shaped by unique challenges and opportunities. By reflecting on the distinctive aspects of urological practice, recognizing the importance of global collaboration, and embracing emerging technologies, the urological community in Chile can continue to provide high-quality care and contribute to the advancement of the specialty on a global scale.

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