The Use and Misuse of the PSA Test: A Retrospective Case Note Review of Testing in a UK Teaching Hospital

An introductory course in urology: results of a novel course for foundation doctors and medical students

Objective:

The objective of this article is to critically assess the value of a medical student and junior doctor weekend introduction to urology course.

Materials and methods:

All UK medical students and foundation doctors were invited to attend an introductory course held at The Royal Society of Medicine, London, organised by the Section of Urology. The course included consultant-delivered lectures, practical skills sessions and an academic competition. Pre- and post-course feedback questionnaires were used to assess (a) perceptions of urology as a specialty, (b) career aspirations and (c) confidence performing basic urological surgical skills.

Results:

Sixty delegates attended from a variety of UK medical schools and hospitals. Seventy-three per cent of respondents were more likely to pursue a career in urology post-course. The most common negative perceptions included being a competitive career with long training and lacking glamour. Confidence in suturing, knot tying, suprapubic catheterisation, basic laparoscopy and cystoscopy were significantly improved following this course ( p < 0.005).

Conclusion:

A short urology course should be offered to medical students by urology departments and surgical societies; it will benefit students as well as the specialty. It is important that medical students are exposed early to urology given both positive and negative perceptions. Such initiatives may help strengthen the positive perceptions and dispel negative perceptions while increasing delegates’ desire to pursue a urology career.

Undergraduate Urology in the UK: Does it Prepare Doctors Adequately?

Objectives:

Undergraduate medical education in the UK has recently changed. Medical schools are expected to provide the core knowledge required for medical practice, with the foundation programme building upon this. However, studies have suggested that both undergraduate and postgraduate exposure to urology have declined. This study aims to evaluate the views of newly qualified doctors regarding undergraduate urology training.

Subjects and methods:

An online questionnaire was emailed to all UK foundation doctors in August 2010 (total 4339).

Results:

289 responses were received, giving a confidence level of 95% with an error rate of 5.6%. 26.6% of respondents had no undergraduate urology attachment, with a further 30.5% receiving one week or less. 68.9% felt that more time should be devoted to urology teaching, with only 9.7% believing that their undergraduate training was adequate. Most (67.8%) thought there was not enough practical skills experience, with 60.4% never having inserted a female urethral catheter. 77.5% felt that a basic urological skills course would be beneficial, with 54% wanting a longer clinical attachment. Interestingly, 70.1% of those surveyed will not complete a urology rotation during the foundation programme, with only 15.6% having considered a career in urology.

Conclusion:

This survey highlights the wide variation in undergraduate urology teaching across the UK, and demonstrates that the foundation programme does not necessarily compensate for this. A national basic urological skills course may provide a standardised way to improve training across the country.