Challenges of Training General Surgery Residents to Do Urology in the Developing World

The purpose this manuscript is to describe the work of one program in Kenya, East Africa, to train general surgery residents in urology to make available the much needed service to the underserved rural population.

People in developing countries continue to face the challenge of accessing surgical care with a ratio of 1 surgeon to 20,000 people. This is due, in part, to the inadequate number of trained surgeons. The availability of specialized surgical care such as urology is even more unlikely due to fewer numbers of specialists in urology. Such disciplines take many years of training before a person qualifies as a specialist. This requires highly motivated and suitable candidates who are willing to spend time in training and acquiring skills as well as proper infrastructure for training. There is an effort to train general surgical residents in enhanced skills to make available urology services to the wider population. This involves equipping them with skills in general urology, basic skills in handling endoscopic equipment, and basic endo-urology procedures such as diagnostic cystoscopy with or without biopsy and direct vision urethrotomy (DVU). The residents are also exposed to visiting faculty through international collaborations, surgical camps, and workshops to enhance their skills and knowledge.

Equipping general surgical residents with urology skills will greatly reduce the shortage of these services to the people of developing countries.