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GLOBAL STATE OF UROLOGY The Current Landscape of Urology Training in Italy

By: Anna Ricapito, MD, University of Foggia, Italy; Marco Finati, MD, University of Foggia, Italy | Posted on: 18 Mar 2024

Urology, an evolving field at the intersection of surgery and medicine, holds a pivotal role in health care. In Italy, the landscape of urology training embodies a structured yet evolving framework, continuously adapting to the advances in medical technology and the growing demands of patient care.

The path to becoming a urologist in Italy is robust, demanding, and rewarding. Urology training is a comprehensive 5-year program that equips residents with a wide range of skills and knowledge. Our training includes exposure to various aspects of urology, covering basic endoscopy, the management of common urologic problems, minimally invasive surgery, pediatric urology, and even kidney transplant and organ procurement. This diversity ensures that urology trainees are well-rounded professionals capable of handling the spectrum of urological issues. Within this timeframe, residents immerse themselves in diverse clinical settings, managing patients on the floor, especially during the first years of the program, and learning ambulatory procedures, including prostate biopsies, cystoscopies, and minor surgeries (circumcision, hydrocelectomy, varicocelectomy). During the last years of the programs, the residents mainly focus on learning and improving their surgical skills in the operating room, including endourology, robotic and laparoscopic procedures, and open surgeries.

Research finds its place among these activities in terms of both monthly journal clubs and ongoing studies. Moreover, the Italian residency program includes an 18-month period to spend outside the home institution, even abroad. In this perspective, the collaboration between the Italian Society of Urology and the AUA has enabled many residents to participate in fellowships in the United States, enriching our experiences and knowledge. However, it is important to acknowledge that not all residents have equal access to these opportunities, potentially necessitating personal sacrifices for career growth.

Each year, Italy hosts a significant cohort of residents pursuing urology training, selected during a national test. The exact number of residents varies annually, reflecting the continued interest and importance of urological practice in Italy.

Italian urology residency programs are continually adapting to include cutting-edge technologies and emerging subspecialty topics. There’s a growing emphasis on incorporating telemedicine, artificial intelligence, and genomic medicine into the curriculum, preparing residents for the evolving landscape of patient care. These advancements hold immense promise in revolutionizing diagnosis, treatment planning, and patient outcomes.

Looking ahead, the next 5 years present a myriad of opportunities in urology. Advancements in precision medicine, coupled with the potential of personalized therapies, hold the key to more effective and targeted treatments for urological conditions. Moreover, the integration of artificial intelligence–driven diagnostics and telemedicine promises to enhance accessibility and streamline patient care delivery. However, these opportunities coexist with significant challenges. The field faces persistent issues such as resource constraints, health care inequalities, and the need to bridge the gap between primary and secondary health care centers. Moreover, the rapid evolution of technology demands urologists continually update their skills, creating a need for structured and ongoing professional development.

Connecting with urology residents from around the world through retreats, conferences, and collaborative platforms has immensely enriched perspectives. These interactions indeed facilitate the exchange of ideas, experiences, and best practices, offering a broader understanding of urological practices beyond geographical boundaries. The Global Residents Leadership Retreat experience during AUA2023 in Chicago allowed residents from all over the world to share and exchange their experience. Such global connections have broadened horizons, exposing residents to diverse health care systems, cultural approaches to patient care, and programs’ differences. This retreat brought residents together, pushing them to bond and to live challenging scenarios for a day: it made it possible for urology residents to feel like part of the same team.

The knowledge and techniques acquired through international engagements are invaluable assets that Italian urology residents eagerly share within their professional circles. Collaborating with fellow residents and colleagues, we disseminate insights, techniques, and advancements gleaned from global interactions, fostering a culture of continuous learning and growth within the local urological community. In conclusion, the state of urology training in Italy embodies a balance between tradition and innovation. The robust curriculum, integration of emerging technologies, global collaborations, and the commitment to knowledge dissemination collectively shape a promising future for urology in Italy. As the field evolves, embracing these changes and fostering a culture of shared learning will undoubtedly pave the way for a brighter and more progressive landscape in Italian urological practice. We encourage everyone who has the privilege to attend Global Residents Leadership Retreat 2024 to live this day at its fullest, setting aside hesitation and concerns: this is a unique, once in a lifetime experience that will bring people from different countries together and close in 1 room.