Resident Scholars: Jonathan Huang,MD – Emory University; and Charles Peyton, MD – Wake Forest Baptist Medical Center
Location/Date: Ajmer, India; December 17-21, 2016
Mentor: Gopal Badlani, MD – Wake Forest Baptist Medical Center
Sponsored by: The Southeastern Section of the AUA and the India Urological Society
Extract from Dr. Huang’s Report
“This past December, I had the wonderful privilege of partnering with IVUmed and Dr. Badlani to participate in a urology camp at Ajmer, India. This week was definitely an eye-opening experience for me. There are three main lessons that I learned: 1. There is a tremendous need for medical and surgical care abroad 2. It is often necessary to be creative in order to utilize what is available to complete a case. 3. It is important to be open-minded and to often go with the flow. 
During the camp, I participated in over 50 cases. Most of these were endoscopic operations, including TURP, TUIBN, and cystolithopaxy. Additionally, we repaired vesicovaginal fistulas, placed mesh slings for incontinence, repaired hypospadiac patients, and performed bilateral simple orchiectomies for androgen deprivation in the setting of prostate cancer. The first case I participated in was a TURP. With the resectoscope in place and as we were about to begin resecting, the room became pitch black – the electricity had stopped. However, instead of there being a chaotic panic, the staff quickly addressed the issue and the electricity resumed within minutes.
In participating in the IVUmed urology camp in Ajmer, India, my goal was to provide surgical care for a patient population in need. I do believe that we accomplished this task. However, I think that I benefited the most from this exchange. This week opened my eyes to the incredible amount of healthcare need in India and across the globe. As physicians, we have the unique opportunity to enter many different regions in the world to provide aid and a voice for those who are less fortunate. Together, we can truly make a positive difference. In the future, I would definitely like to participate in similar camps abroad.”
Extract from Dr. Peyton’s Report
“Never in my life have I felt the joy of service more than India. Upon entering facility it became clear that we would be operating well outside of my comfort zone, which was a welcomed challenge. The week was organized as a “urology camp” with about 110 pre-screened patients scheduled for surgery within the next 4 and a-half days. 
Our OR was equipped with two basic tables and endoscopic towers. The most common operations were transurethral resection of the prostate (TURP), direct visualization incision of the urethra (DVIU) for stricture disease, vesicovaginal fistula repair, and cystolitholapaxy for bladder stones. On day one, I made multiple requests for items that were simply not available. This challenged us to work within our limitations and enhanced our surgical skills. To cope with these operative limitations we were forced to perform at the highest standard of technique in an efficient and safe manner.
The teaching opportunities were abundant throughout our operative days. I found myself in daily conversations regarding urologic practice patterns and operative technique differences between our two countries. Our training in the U.S. is vastly different and we often overlook the basics due to our significant surplus of resources. I found myself being re-taught concepts that I tend to take for granted in the U.S.
The counter story is just as important, as much as I learned from Dr. Ajmera, I hoped to have left his general surgery residents with a good foundation for urology. I spent time everyday teaching the general surgical residents how to think through urologic problems both clinically and operatively. Furthermore, the residents had limited experience with more advanced imaging such as CT and MRI. For the few patients that had these studies done, we spent time reviewing the images and how to interpret the information.
Never have I felt so appreciated as a physician. Even if they were hurting, no amount of pain would allow them to look beyond how lucky they felt to be receiving treatment. Overall it was a trip of a life time and I am so thankful to have been given the opportunity through IVUmed. It has encouraged me to seek out other international opportunities in the future and perhaps return to Ajmer, India again.” 