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GLOBAL STATE OF UROLOGY Thinking About My Career After Completing Urology Training in Japan

By: Takanori Sekito, MD, Okayama University Hospital, Japan | Posted on: 18 Mar 2024

I commenced my urology residency training at Okayama University Hospital in Japan in 2019, concurrently undertaking research as a graduate student at Okayama University since 2020 (Figure 1). In Japan, it is relatively uncommon to embark on research during residency. Despite this, engaging in research while diminishing my surgical exposure provided me with a profound appreciation for the significance of research; it broadened the scope of potential career paths as a junior trainee urologist. My foremost objective is to adeptly offer both top-notch clinical care and urological research with high translational value.


Figure 1. Okayama University Hospital urology department.

I want to introduce you to a brief overview of the training programs in urology in Japan. Recent data indicate that about 300 doctors enroll in residency training programs yearly. Depending on which hospital the resident belongs to, the standard requirement is that the resident must have completed at least 6 months of training at the core hospital of the residency program and at least 3 months of training at an affiliated hospital in 4 years. Participation in conferences is essential and requires various courses designated by the societies. Regarding surgery, the residents must have at least the specified number of surgeries in 4 years, and surgical cases have been managed in an online database called the National Clinical Database since 2010. The residency program does not include research as part of the training and does not require writing papers or presenting at conferences. After 4 years of training, the examination eligibility screening is conducted, and the program offers a written and oral examination on the same day in September of the fifth year. Successful completion of the examination qualifies the candidate to become a board-certified urologist. I obtained the certification this year.

One thing to say is that robotic surgery in urology has become more familiar to urology residents and urologists in recent years, and early acquisition of the technique is essential. The Japanese urology training program led by the Japanese Urological Association (JUA) does not include obtaining certification for robotic surgery. In my opinion, getting the certification should be incorporated in the future, as making it mandatory during the program would help promote robotic surgery.

Getting board-certified allows me to devote myself to surgical procedures, including robotic surgeries, responsibly. Urologists pioneered a lot of laparoscopic and robotic surgeries, and especially, the environment in the United States, with its large number of cases and thriving advanced exploration, would be ideal for learning advanced surgical skills and new techniques. Concerning research, the United States is also the leading power in medical investigation and publications in most scientific fields. There are large grants and large-scale research, and an environment conducive to immersing myself in research in the United States. Moreover, work-life balance is a growing concern in Japan, and learning how to do a good and efficient job is essential to increasing productivity and creating innovations. For these reasons, while striving to achieve my goal of engaging in research and clinical practice in the Unted States, I have always wanted to meet urology doctors worldwide, acquire knowledge, and broaden my perspective for my future career.

Meanwhile, I was selected to participate in the prestigious first Global Resident Leadership Retreat after my application to the JUA and a selection process in October 2022. I was thrilled to have the opportunity to participate in this retreat. This program was an excellent opportunity to deepen my understanding of leadership, recognize and look at my communication style, and learn what I need to do for better leadership. It was also an optimal opportunity to interact with selected residents worldwide and make many connections. For example, during the workshop on Journey for Jewels, I was in a team of 4 people with residents from Argentina, Costa Rica, and Denmark. We successfully completed the task by improvising and sharing roles. After the workshop, we exchanged opinions, deepening our friendship (Figure 2).


Figure 2. Lunch break with international residents during the Global Resident Leadership Retreat.

Participating in this program gave me a valuable experience I wouldn’t have obtained by confining myself to Japan alone. Aspiring to be a globally oriented urologist, I recognize the importance of engaging with peers worldwide and exchanging insights on the current landscape of urology. The enthusiasm displayed by participants from various corners of the globe was truly inspiring. Seeking to broaden my horizons, I sought the challenge of practicing urology in a foreign medical setting. With a focus on global health care, my goal is to venture beyond my home country and engage in clinical practice as an international urologist. The positive impact of my retreat experience has influenced my core values significantly.

Eager to share my participation experience, program insights, and newfound knowledge, I relayed my journey to fellow doctors at my workplace. Moreover, I emphasized the program’s excellence and submitted a comprehensive report to the JUA, allowing urologists across Japan to gain insights into its offerings. The program garnered considerable interest from numerous doctors, showcasing its exceptional appeal. I extend my sincere gratitude to the AUA and the international committee of the JUA for selecting me for this invaluable opportunity.

Participating in these fantastic and enriching experiences, spending time with urology residents worldwide, and engaging in international programs can provide a unique opportunity to broaden one’s perspectives, enhance leadership skills, and foster lifelong connections. Building relationships with fellow residents on a global scale can lead to lifelong friendships and professional collaborations. The networking opportunities in such programs may open doors to future collaborations, research projects, and the exchange of best practices in urology.

Overall, I sincerely encourage other urology residents to seek out international opportunities like this program, emphasizing the potential for personal and professional development, as well as the formation of lasting connections with colleagues from around the world.