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GLOBAL STATE OF UROLOGY Graduating from Medicine and the Path of Research: An Experience from Colombia

By: Cesar Diaz Ritter, MD, Fundación Santa Fe de Bogotá Universidad de La Sabana; Andres Felipe Gutierrez, MD, Fundación Santa Fe de Bogotá | Posted on: 20 May 2024

The journey to becoming a doctor is one of the most complex, beautiful, and challenging paths one can undertake. It begins with ambitious dreams, which inevitably encounter numerous obstacles, exposing us to diverse realities that shape our journey. Although graduation often symbolizes the culmination of this arduous process, it merely signifies the commencement of a larger expedition filled with continuous learning and life-altering experiences (Figure 1). What makes this journey truly captivating is the realization that with each passing day, our knowledge expands, yet we remain aware of the vast areas of knowledge yet to be explored.

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Figure 1. My graduation as a doctor with my family.

In Colombia, there are over 55 medical schools, where every cycle a new cohort of doctors emerges, equipped to confront the health care challenges plaguing our nation.1 Throughout our academic journey, we undergo both theoretical and practical training across various medical domains. Additionally, we have the opportunity to practice through numerous hospitals spanning different socioeconomic status, providing us with a comprehensive understanding of health care delivery. My initial exposure to urology occurred in a prominent hospital, where I developed a profound appreciation for urological pathologies, surgical interventions, and the impactful role of urologists. I was fortunate to have exceptional mentors who not only guided my professional growth but also nurtured my personal development. I will never forget the first time I saw a kidney stone endoscopically in surgery and how surprised I was to see it out of the patient without causing any injury. I was impressed by the skill of my professors and always dreamed of being able to operate like them.

During the final year of our medical education, we engage in selective rotations, affording us a deeper immersion into our preferred specialties. In this phase, I was privileged to rotate within my university’s clinic, honing various skills. I learned from my 2 great mentors how I wanted my clinical practice to be, how I could positively impact patients, how I could learn by steps to operate, and how I could teach future generations of physicians on a day-to-day basis. This experience helped me to solidify my love for urology and to start working on my teaching skills, which has had a positive impact and has allowed me to currently participate as a teacher in urology skills. It was at this time that I was able to perform an endoscopic ureterolithotomy for the first time with the help and guidance of my professors (Figure 2).

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Figure 2. My first endoscopic ureterolithotomy in the company of my professors.

Moreover, I also had the opportunity to rotate in 1 of the country’s leading hospitals, which would soon become my workplace and second home. Here, I was introduced to cutting-edge technologies such as robotic-assisted surgery and minimally invasive water vapor therapy for benign prostatic hyperplasia (Figure 3). Additionally, I delved into research and academia, exploring avenues to address clinical inquiries arising from daily practice. My group of mentors and teachers grew larger and larger and taught me new skills not only professionally but also personally.

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Figure 3. Meeting for the first time the Da Vinci Robot.

Research, intertwined with clinical endeavors, emerged to address the myriad questions encountered in patient care. Gradually, I cultivated the ability to formulate structured research inquiries, finding solace in the realm of statistics and its capacity to delineate reality and the potential impact of interventions. I fell in love with the possibility of creating databases, which would help me answer questions and understand reality much easier. On this path I also had the opportunity to learn in depth the use of the REDCap2 platform that not only allowed me to facilitate and automate processes in the urology service, but also to complement my taste for knowledge transfer by having the opportunity to participate in a research masterclass.3

Alongside, I leveraged various resources, including online platforms like YouTube and Coursera, accessing courses ranging from scientific writing to advanced epidemiology. These resources, often curated by esteemed institutions like Stanford University and Johns Hopkins University, facilitated my academic growth and contributed positively to my country’s scientific landscape. This is why, without a doubt, I advise students around the world to look for all these tools so that they can continue to grow academically, taking advantage of the fact that many of them are free. I also had the opportunity to take a diploma course in epidemiology and biostatistics, strengthening my knowledge in this area.

Despite the universal language of science, the predominant dissemination of research articles in English presents a formidable barrier to many researchers, impeding access and comprehension.4,5 Studies have underscored the detrimental effects of this language barrier, leading to prolonged reading times or, worse, incomplete comprehension.6 It is imperative for future universities to devise strategies for early English-language instruction, thereby equipping students with the necessary tools to navigate the academic realm proficiently.

With each stride, I fortified my love in urology, guided by illustrious mentors who paved the way. Challenges were omnipresent, yet each hurdle fueled my enthusiasm and dedication further. My involvement with organizations like the AUA, granting access to a plethora of academic resources, including the AUA University, proved invaluable for both students and residents alike.

Participation in academic events, such as national and international congresses, constitutes a pivotal aspect of professional and academic development (Figures 4-5). Experiences like those offered by the AUA illuminate the collective prowess of the urological community, instilling a sense of purpose and foresight into the promising future of urology. It is also a great place to meet future colleagues and network. The possibility of participating as research fellows in projects together with experts in urology should also be expanded and can be an amazing opportunity for my residency and future.

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Figure 4. My first AUA annual meeting in Chicago.

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Figure 5. Participation in the Colombian Congress of Urology.

As I embark on the next phase of my journey postgraduation, I aspire to consolidate my research knowledge, paving the way for future endeavors and collaborations (Figure 6). Furthermore, I aim to refine my skills in preparation for urology residency, ensuring continued growth and contribution to my country’s health care landscape for which I am also pursuing a specialization in health management. Ultimately, I aspire to leave a positive imprint, transcending geographical boundaries and impacting the field of urology on a global scale.

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Figure 6. Urology Department of Fundación Santa Fe de Bogotá.

Acknowledgments

I thank Jennifer Regala, who from AUA has accompanied me and helped me in my urology path.

  1. Facultades Afiliadas - Asociación Colombiana de Facultades de Medicina. Asociación Colombiana de Facultades de Medicina. 2024. Accessed March 4, 2024. https://ascofame.org.co/web/quienes-somos/facultades_afiliadas/
  2. Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42(2):377-381. doi:10.1016/j.jbi.2008.08.010
  3. Diseño y creación de bases de datos en proyectos de investigación. Accessed March 4, 2024. https://www.youtube.com/watch?v=oE6T1nr0eJM
  4. Carlsson SV, Esteves SC, Grobet-Jeandin E, Masone MC, Ribal MJ, Zhu Y. Being a non-native English speaker in science and medicine. Nat Rev Urol. 21(3):127-132. Published online January 15, 2024. doi:10.1038/s41585-023-00839-7
  5. Lenharo M. The true cost of science’s language barrier for non-native English speakers. Nature. 2023;619(7971):678-679. doi:10.1038/d41586-023-02320-2
  6. Lenharo M. Scientists who don’t speak fluent English get little help from journals, study finds. Nature. 2023;620(7976):931-931. doi:10.1038/d41586-023-02529-1

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