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GLOBAL STATE OF UROLOGY What Urology Looks Like in Colombia: The Perspective of a Resident

By: Catalina Barco-Castillo, MD (Postgraduate Year 4), Hospital Militar Central, Bogotá, Distrito Capital, Colombia, Universidad Militar Nueva Granada School of Medicine, Bogotá, Distrito Capital, Colombia; Melida Sotelo-Perilla, MD (Postgraduate Year 3), Hospital Militar Central, Bogotá, Distrito Capital, Colombia, Universidad Militar Nueva Granada School of Medicine, Bogotá, Distrito Capital, Colombia | Posted on: 15 Mar 2024

Colombia is located in South America, being one of the most biodiverse countries and the producer of the best coffee in the world. It’s also a developing country with more than 50 million people of varied races and socioeconomical status, which becomes a challenge for all physicians.

We have 286 universities, proudly presenting 1 in the top 200 worldwide, and 3 more in the top 500. A medicine undergraduate program is offered by 55 institutions, graduating 6429 physicians each year. Undergrads perform 5 years of basic, specific, and clinical sciences, and complete the internship in the sixth year. After our graduation, we must perform a social service year as general doctors, most often in vulnerable places of our country.

More specifically, urology training is available at 11 universities with a duration of 4 or 5 years, with an important focus on surgical skills and academic knowledge. In most universities there are 2 residents per year, but there are some with 1 resident per semester and others with 4 residents per year, according to the volume of patients at each hospital. Even though the Colombian Society of Urology encourages all urologists, residents, general physicians, and medical students to investigate and present work at the annual meeting, it is a field that is still growing in number and quality.

Currently, there are approximately 104 residents, with 21 graduating per year. This means, of the physicians who graduate each year, only 0.32% will become a urology resident. Since there are very few residents, and thus urologists, per capita in our country, there are gigantic opportunities in every city of the country, with a great number of patients and good economic recompense.

Although our surgical skills are great, I believe we highlight in open surgery. But, thanks to the availability of technology in most places, our urology field has been growing and we follow the international guidelines more closely. The only exception is the availability of the robot assistant for laparoscopy. Still, in the capital city of Bogotá, we have 4 of these, and the possibility for outside residents to come and perform clinical rotations. However, in the future, we hope to have more robots, so we have global training in advancing our knowledge and the benefits for our patients.

Most of our urologists and residents are associated with the Colombian Society of Urology, but also international associations like the AUA, which becomes a great opportunity to connect with urologists worldwide, share ideas, research, and experience, thus enriching our networks and knowledge, and opening our world to fellow residents and urologists.

Despite the wonders of our specialty and the desire to put aside challenges, there are several. In Colombia we face the lack of availability of urologists in small towns and rural areas. This means that patients need to be transferred to principal cities to get attention, and this usually happens when diseases are serious or advanced, disfavoring the prognosis and quality of life. However, public health actions have improved this situation and we are overcoming it.

And speaking from the resident perspective, I believe the biggest challenge so far is mental health. When I had the opportunity to meet residents from all over the US and the world in the Global Residents Leadership Retreat, we realized that we are facing the same advantages and challenges, even having different cultures and perspectives. This made me think, are we already globalized in our specialty? I think we’re not at 100%, but we’re getting closer. So this experience was amazing in a sense of sharing, looking forward to solutions, and networking, but most important, making new friends.

During the retreat, we also had the opportunity to know more about ourselves and our personalities, to develop better tools accordingly, to put them into practice for better leadership, and to conclude, along my fellow residents, that we are a new generation that wants to set aside rudeness and focus more on the whole perspective of each new resident, to help them learn better and avoid burnout.

I advise residents all over the world to learn and recognize your best qualities to develop your best way for leadership. Always keep your mind open, and do not be afraid of sharing your thoughts with your coworkers, fellow residents, and urologists all over the world. Only in sharing these ideas will we find the right way to globalize and keep improving our urology programs.

Good, better, best. Never let it rest. ’Til your good is better and your better is best.

St Jerome, How to Become the Best at Anything by Glenn K. Seki

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