Report of UAA sponsored Resident attendees of the USANZ Trainee Week from 21st to 27th November 2009 in Perth, Western Australia

1: Prabhjot Singh, All India Institute of Medical Sciences, New Delhi, India

First of all, I would like to thank UAA for selecting me to attend Urological Society of Australia and New Zealand (USANZ) Trainee week. It was really an Informative week. All 6 days were full of knowledge, interaction and enjoyment.

There were 73 trainees including 4 overseas residents (2 from Asia recommended by UAA and 2 from Europe recommended by EAU) as an observer. On first day (21st November), there was an AUA Exam for trainees, which consisted of multiple choice questions. Overseas residents were not eligible for that.

On 2nd day, there was a viva session and a written exam for trainees. I was an observer in both the sessions. In viva session, there were four tables including Anatomy and Operative viva table, Pathology, Radiology and structured oral viva table. Structured questions were being asked from trainees by experts using laptops. In structured oral viva session, trainees were given some clinical situations. It checked trainee’s knowledge, presence of mind and communication skills. Written examination consisted of 8 short answer questions which were to be completed in 2 hours. Results were declared on 5th day. After above session, one senior examiner took lecture on ‘overview of fellowship examination in Australia’.

On day 3, there were morning sessions on Bladder cancer and BPH moderated by senior consultants. There were 4-5 topics in each session, which were already allotted to the trainees. Each trainee spoke over their respective topic for 15 minutes using power point presentation. At the end of each session, questions were asked to the presenter and other trainees. At the end, 2 moderated cases were discussed between trainees and consultants. In the afternoon, a senior consultant took lecture on in vitro fertilisation (IVF). After that, we visited a private Uropathologist’s lab where we discussed cut section and histopatholgy of specimens. In the evening, we had a welcome party hosted by USANZ representatives.

4th day was very different. It was a non-clinical session. This session was focussed on teamwork, interpersonal skills, communication, leadership qualities etc. Trainees were divided into 9 groups with each led by a moderator. All the groups were given some task, which had to be completed in a given time e.g. making a house with a rope blindfolded. I think this session is essential for every medical professional to develop his overall personality.

On 5th day, we had morning sessions on “Neurogenic voiding dysfunction and Paediatric urology”, which was also moderated by 2 senior consultants. In the afternoon, there was a session on “Urological complications of pelvic surgery and Genitourinary Fistulae”. At the end of each session, there were moderated case presentations and questions were directed to allotted trainees. In the evening, we had small group case discussions facilitated by SET5 (exam passed) trainees. They discussed two long cases with SET4 trainees. In the evening we had a group dinner with sponsor companies. All trainees were randomly allocated to one of the sponsors.

On the last day, we had 4 long sessions on “Imaging in urology, Nephrolithiasis, Urological Trauma, Prostate and Renal cancer” moderated by senior consultants. At the end of each session, there were moderated cases and a question hour. In the evening, we had a final dinner by USANZ, where representatives of USANZ presented gifts to overseas residents.

Overall this trainee week was very enjoyable, informative and beneficial to me. It helped me to revise the entire urology in just 6 days. The non clinical session on teamwork inculcated in me, sense of becoming a complete medical professional. At the end, I am extremely thankful to UAA for giving me such a privileged opportunity.

 

Meeting Room	Group Discussion	Presentation by a Trainee

2: Lin, Pei-Yu (Kate); National Cheng-Kung University Hospital, Tainan, Taiwan.

Purpose: To get more understanding of urological training program in New Zealand and Australia, 4 overseas observers are invited to participate in trainee week of USANZ (Urological society of Australia and New Zealand).
 
Urological Training program in New Zealand and Australia: Physicians who graduate from medical school in New Zealand and Australia have to get 2 years experience of clinical works as PGY1 and PGY2 (post-graduate year1 and 2). Then they have to spend 2 more years being general surgeons before getting into urological training program. The total urological training program needs 4-5 years to accomplish as set 3, set 4, set 5 and fellowship for 1-2 years. Every year they change hospital where they are trained and change to different state during fellowship in order to gain the best experience and knowledge in different subspecialty. The trainee week is held by USANZ every year in different state. It contains writing exam, vivo session (sham test), and discussion of important topics in urology during the week. Set 3 as the first year into urological training are observers during vivo session and they are presenters of most discussion topics. Set 4 are going to have the license exam the next year, so they are the candidates of vivo session and have to answer the questions most of the time. Set 5 just passed the exam and they are the leaders and assistants during the week to help all trainees to get used to the mode of the exam and get familiar to the important topics.

What I have learned: Trainee week of USANZ is really a well-organized training activity for trainees. It not only provides the sham tests for trainees to get familiar with the mode of official exam, but also trains them to have the logical thinking process and the voluntary learning. For example, set 3 have to present the important topics and they prepared it seriously. They search for update reports, guidelines, data and sort all information in order, finally present the topic clearly in a short time (about 7~10 minutes). It takes a lot of time to prepare one topic, but they just do it perfectly. I ask one of them how they make it, his answer is “No one want to waste time listening to garbage, so we try not to make the presentation useless.” It must be the common thought between them, and that’s why every trainee is enthusiastic and competitive. Besides, the society invites the authorities on every aspect as moderators in each session. It implies that the society treat the training conscientiously and wish the trainees get the most from them. When the society provides the best, they can get the best urologist in the future. Except the academic aspect, the trainee week play as a communicating bridge between all trainees in Australia and New Zealand. They can know each other, and share the experience and any difficulty during the training course. They become friends and help each other. The sincerity is also proved by the way they treating the overseas observers. They invite us to go to every leisure time activity and they care about us all the time. It is really a good experience to be in Perth and learn with all the trainees. I learned not only the enthusiasm and conscientiousness toward career, but also the friendship, the kindness between them. Moreover, the philosophy of life also affects me a lot. Except job, they do care about family and leisure time and cherish it. They have 100% focus during work, and 100% relax at leisure time. I think when you can clearly define the work time and leisure time, you can do thing more efficiently.

Recommendation: In Taiwan, the training course is not so fruitful compared with that in Australia and New Zealand. We tend to limit ourselves in one hospital, in one city, and within one country. Besides, spoon-fed education is always the major problem not only in Taiwan but also in most Asia countries. Whenever there are teaching activities, we can see a scene which consultants (visiting staffs or professors) give lecture extracted from textbook without interaction, and residents are just like college students sitting down in the room and being in the trance all the time. The biggest problem is that people lack of motivation to learn. It is a cultural and educational difference to make people deal with thing in this way. My recommendations are as bellows. First of all, selecting residents who have strong motivation to learn Urology is better than to choose a person who just want to find a job. Once they enter the urological training, the goal is to train them to be a good urologist instead of treat them like labors who handle the clinical trivial stuffs only. The training is aim to help the residents to pass the exam. Second, all the training programs need to be designed in an interactive way in order to make the residents to learn actively. Moreover, encourage residents to give presentation in regional monthly conference or annual urological society academic meeting. The last but not the least, the numbers of yearly new urologists should be set up initially instead of being controlled by the license exam. The aim of exam is to check if one is have the professional ability to be an urologist (quality control). International cooperation of training courses may be a good way to promote the quality, but it needs integration of cultural difference. It is also a challenge to all urologists and trainees since English is not native language in most Asia counties. But it can be set as a long term goal.

Special Thanks: I would like to say thanks to the Urological Association of Asia and Urology Society of Australia and New Zealand to offer me the chance to get the experience. I do learn a lot more than I expect during the week. I also appreciate all the trainees of USANZ for their kindness and warm-heartedness. It is a great and fruitful week.