Urology covers a wide range of topics. We have the opportunity to focus on a specific, well-defined field, including urologic oncology, endourology, incontinence, andrology, or robotic surgery, for example. This demonstrates the variety of urological specialties and the fact that many individuals might find something of interest in this field.
How to Become a Urologist – and How I Did It
Which medical school did I attend, where did I do residency, and what was that like?
I attended the Medical faculty at the University “St. Cyril & Methodius” in Skopje, N. Macedonia. I am now doing my residency in Urology at the same faculty in the University Urology Clinic in Skopje. The curriculum in medical school is divided into two halves. The first three years of medical school are spent in class acquiring the basic sciences. The last three years of medical school are spent at teaching hospitals, where students study medical procedures and clinical skills/techniques. I really enjoyed the medical faculty. Although I found value in the instruction provided by all of our professors, I found surgical training to be especially challenging.
During the last 2 years of my studies, I routinely followed all tours, but I focused mostly on surgery. I voluntarily stayed late to assist and pick up some new surgical techniques. I knew even then that mastering manual procedures would be crucial to my development as a surgeon. The ability to make a significant difference in someone’s life at a time when they really need it is what draws me to this field.
Why and how did I decide on this specialty, did I always know?
Choosing Urology for me was a tough decision, but it turned out to be an excellent choice.
My defining characteristics are being ambitious, persistent, and hardworking. I am a woman who is not content with mediocrity and who is determined to achieve her goals. It’s difficult enough to get a medical degree, and much more so to persist in the field of surgery.
Where I come from, men are still seen and considered as more capable surgeons than women. However, I’m glad that this stereotype is finally being overcome.
My career goals were established at the end of my 6-year faculty journey. During the last year, I gave my utmost attention to f which specialty I should concentrate on. Despite the fact that I have always been more interested in surgical specialties, making this choice has proven to be challenging. It requires a significant amount of self-sacrifice. By nature, I am the sort of person who thrives on adrenaline. I look for challenges. So, obviously, my choice would be surgery.
In terms of medicine, I’ve always loved surgery because it’s concrete. By what I do, I contribute to a concrete cure or improvement of the patient’s condition. Of course, my educators and professors have the final decision as to whether I have the talent and if I am capable of performing surgery. Surgery requires persistence, endurance, and responsibility. It is an art, and surgeons are the artists. At the beginning, it is not possible to draw, for example, without the support of your teacher, who will teach you the main principles of drawing. Later, your talents emerge as original and unique! In surgery, however, you both always work for the benefit of patients.
Several principles guided my decision to specialize in urology:
1. Most urological surgeries are planned, so patients choose to have the procedure rather than having it performed in an emergency. Acute conditions (kidney infections, urinary retention, kidney stones, and urinary tract trauma) are less common than in other branches of surgery.
2. In general, I’ll be unusual as a female urologist. In my area, it is still regarded as a male branch. However, women urologists are in high demand, though society isn’t aware of it.
3. If I want, I can devote myself to ambulatory urology at any point in my career.
What does a typical day look like for me?
Every day is unique in its own way. At the clinic, I have a standing appointment with each of my patients on Mondays. The rest of the days consist of work in the operating room, specifically performing procedures, as well as additional work with patients in the urology department. My place of employment is a university; thus, the majority of my time is spent collaborating with professors on academic projects and writing scientific papers for journals. Patients should always come first. However, we must maintain sight of the fact that the end goal of any scientific research is to improve patient care.
What’s the best part about working in this specialty, and what’s the most challenging?
Urology has multiple subspecialties. Currently, I am focused on oncological urology. What’s the hardest thing about that? For me, kidney transplantation and robotic surgeries are the biggest challenges.
Surgery involving a kidney transplant requires a high degree of accuracy, scientifically sound judgment, attention to detail, speed, and decisiveness on the part of the surgeon. Kidney transplantation is performed to prolong and improve the lives of patients. Basically, you give a different and new life to a young patient, and this is highly rewarding.
As far as robotic surgery, I love this technique because robotic surgery offers better visualization, dexterity, and precision.
A computer-controlled robot helps us, the surgeons, perform certain minimally invasive or laparoscopic (small incision) surgeries in robotic surgery. The robot’s “hands” are flexible, allowing us to operate in tight body areas that would typically require open (long incision) surgery. Robotic and minimally invasive surgery reduces pain and scars due to smaller incisions.
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What Is Urology?
Urology is a branch of medicine that focuses on treating conditions that affect both the male and female urinary tracts. It also discusses men’s reproductive organs.
This specialty of medicine covers a wide range of topics. Urology as a branch of surgery is treating oncological and non-oncological diseases. Oncologic urology includes the following conditions: prostate cancer, urinary bladder cancer, kidney cancer, testicular cancer, urethral cancer, and upper urinary tract urothelial cancer. Non-oncologic urology includes urolithiasis, sexual and reproductive health, urological trauma, renal transplantation, urological infections, low urinary tract symptoms (male and female), chronic pelvic pain, and urologic trauma.
How long does it take to become a urologist?
Urologists often have a minimum education requirement of 13 years after graduating from high school.
What does a urologist do?
Urologists are medical professionals who have completed additional training and study to become specialists in the treatment of conditions affecting the urogenital tract. These surgeons are able to perform even the most difficult operations on the kidneys, bladder, testicles, prostate, adrenal gland, ureters, penis, and pelvic diseases.
There are many procedures that urologists perform. Some of them are:
- Cystectomy with urinary diversion, for example, bladder reconstruction following removal and formation of urostomy.
- Endoscopic surgery
- Laparoscopic surgery
- Robotic surgery
Additionally, urologists will often refer their patients to an outpatient clinic for tablet therapy.
How much can I earn if I am working in the US?
The average annual urologist salary in the United States is $219,265, currently checked on indeed.com.
According to the Medscape Physician Compensation Report of 2021, the starting compensation for urologists is $427,000, and they receive an incentive bonus of $72,000 on top of that. According to the findings of this compensation report, urology is the fourth best-compensated specialty in the medical field.
The AAMC Careers in Medicine publication provides information on the incomes of university physicians. According to what they found, the average salary for an assistant professor in the field of urology is $362,000, while the average salary for an associate or full professor is $449,000.
In the field of urology, female urologists are making history
According to the American urological association, the number of women practicing urology has increased by nearly 50% in five years.
On one page listing urologist demographics, it notes that 69.5% of urologists are women and 30.5% of urologists are men.
Urological surgery is a blessing for me
Doctors will often say that if they had to start over, they would not choose to be doctors. Those doctors who perform urology, in my opinion, do not belong to that group.
Our field is rich with possibilities for initiative and originality. Urologists have been at the forefront of developing innovative technologies and treatments for this area. Now is the time to put our innovative thinking to use in finding better, less invasive approaches to treat urologic disorders. Urologists’ colleagues have been major supporters of the initiative to shift care out of hospitals and into private practices, where doctors can choose their working hours.
My advice for young doctors is this: “Have an open perspective while you participate in clinical rotations. If you want to be the best version of yourself, do the things you love. Also consider how your career will fit in with the rest of your life.”
About the author:
Martina Ambardjieva, MD, is a urology resident and a PhD student of clinical science in Prilep, Macedonia who enjoys teaching and writing.