Small cuts, faster healing
Urology is an immensely attractive branch of surgery, thanks to technological advancements in the field and the poor surgeon-patient ratio Vimal Chander Joshi reportseducation Updated: Mar 18, 2010 09:30 IST
After completing his MBBS and MS programmes from Chhatrapati Shahuji Maharaj Medical University (formerly King George Medical College), Lucknow, Dr Anshuman Agarwal became fascinated by minimally invasive techniques practiced by surgeons in the urology department. A speciality surgical field, urology deals with disorders of the urinary tract (males and females) and the reproductive system of males. Dr Agarwal learnt the intricacies of this surgical branch while working at KGMC’s urology department for two years as a general surgeon.
One, however, must be a registered urologist to handle complex surgical cases and transplants. For that an MCh (Master of Chirurgical), a super specialty degree, is mandatory after MS.
“Urologists cater to patients of all age groups as anyone could suffer from the problem of stones (in the gallbladder). The problems are so acute and in such huge numbers that the limited number of urologists (total number of practicing urologists in India is 1900) is not sufficient,” says Dr Agarwal, who now works with Fortis Hospital, Vasant Kunj, New Delhi.
Urology has various sub-specialties, such as paediatric urology (related to urological problems in children), andrology (related to the male reproductive system), endourology (which deals with minimallyly invasive or closed surgical procedures), neurourology (related to nervous system), among others.
Dr Agarwal’s sub-speciality is endourology and he believes this can work wonders for patients in a very short span of time. “A patient comes to you crying in pain and within four hours, he could go back happy without stitches or cuts on his body. This is possible only because of the minimally invasive techniques (MITs).” For the uninitiated, MITs are surgical procedures in which small incisions are made on the body. Narrow tubes are then inserted through these cuts into the abdominal wall. Instruments can be slid through to perform surgical procedures. “One of the breakthroughs in urology is minimally invasive surgery.
This includes laparoscopic surgery (performed on the abdomen or pelvis) and robot-assisted laparoscopy. It minimises the trauma of access to internal organs and helps avoid many post-surgical complications,” says Dr Kim Mammen, secretary, Urological Society of India.
While the scope for urology is immense, the journey to becoming a successful urologist is tough. “Being a super specialist is like reaching the zenith of a pyramid. Just as in Bollywood, where only one or two actors become stars, in surgery too only a handful qualify to become urologists. In a city like Delhi, there are at the most a hundred qualified urologists and in towns like Kanpur, there are barely two or three practitioners,” says Dr Manu Gupta, a urologist at New Delhi’s Sir Ganga Ram Hospital.
Those wanting to specialise in this field will have to work with a senior urologist for a year or two before going in for an MCh. This makes it easier to clear the entrance test.
What's it about?
Urologists practise a superspecialty branch of surgery, which focuses on the urinary tracts of men and women, and on the male reproductive system. Urologists are trained to diagnose, treat, and manage patients with urological disorders. Urologists deal with organs such as the kidneys, uterus, urinary bladder, urethra, and male reproductive organs
9 am: Reach hospital and attend OPD
12.30 pm: Visit patients in wards
1 pm: Lunch
2 pm: Do surgeries (if any)
7 pm: Attend to patients
8 pm: Call it a day
If you manage to find a job in a private hospital, you can start earning as much as Rs 1 lakh per month. The earnings rise sharply with experience and expertise, as in any other branch of surgery. In a government hospital, the starting salary is around Rs 50,000 at the post of an assistant professor, which increases to Rs 75,000 for associate professors. As a professor, you can earn as much as Rs 1 lakh per month. Urologists earn the maximum through private practice. However, that requires a lot of investment and experience
. You must have an inclination for medicine and surgery
. You ought to be tech-savvy as this branch of surgery (like many others) is technology driven. For example, robot-assisted surgeries are being performed in some hospitals
. Ability to perform fine surgical procedures
How do i get there?
You must first earn your MBBS and MS degrees before you can appear for the MCh entrance test. This is a multiple-choice exam followed by an interview and a practical test. “You must have some exposure to urological surgeries before you sit for the entrance as the practical test assesses your surgical abilities.
Surgeons who have already worked in urology departments always have an edge over others,” says Dr Kim Mammen, head, department of urology, Christian Medical College and Hospital, Vellore
Institutes & urls
. All India Institute of Medical Sciences, Delhi
. Sanjay Gandhi PG Institute of Medical Sciences, Lucknow
. Postgraduate Institute of Medical Education and Research, Chandigarh
. Jawaharlal Institute of PG Medical Education and Research,
. Christian Medical College, Vellore,
. Kasturba Medical College, Manipal
Pros & Cons
. Minimally-invasive surgery is a highly rewarding branch of surgery
. With rising cases of stone and erectile dysfunction, demand for urologists is expected to increase
. The competition is tough. There are only 150 seats for this specialisation throughout India and the number of applicants is quite high
An expert talks about the career scope in urology
Do we need more urologists to fill the gap between demand and supply?
Yes, we do. There are only 1200 trained urologists in a country of 1.2 billion people. And most of them are based in metros.
How many seats are available for urology in your college?
We have 150 seats at present and there are plans to increase them by another 10-15 per cent soon, depending on the approvals given by the Medical Council of India and the National Board of Examination.
Should one study in India or abroad?
Studying in India is better. We have many good medical colleges here. A very small percentage of doctors goes to the US or the UK to study urology. Indian colleges have earned such a good reputation that doctors from several Middle Eastern countries and east European countries come to do their MCh here.
What are the new developments in this branch of surgery?
With technological advancement, it is getting more and more minimally invasive.
Dr Kim Mammen, head, department of urology Interviewed by Vimal Joshi