Read about IVUmed’s collaborative work in Trinidad through the experience of Dr. Ian Metzler, IVUmed Resident Scholar and new board member

“Global health has been a long-time interest for me, and providing more specialized care to less fortunate people has been a priority. I started working with IVUmed in medical school to develop a data driven intake form to track hypospadias patients. I travelled to Senegal and Vietnam to perform this research and was thrilled to see the productive and personal relationships that had developed between US-based urologists and their local counterparts over the years. This experience fueled my career goals when applying to a urology residency.

“Thanks to the generosity of the SUFU IVUmed resident scholarship I was given another opportunity to work with IVUmed during the end of my residency. In the fall of 2018, I was able to join Dr. Kurt McCammon and his team, including his fellow and pelvic floor physical therapist, to travel to San Fernando General Hospital in Trinidad for a female reconstruction workshop. Clinically, the opportunity to work with Dr. McCammon on female reconstruction was extremely valuable to me because the female cases was one of the least strong areas of exposure during residency. Learning the preoperative assessment of prolapse and incontinence, and when not to operate, was as critical as the surgical techniques demonstrated through the workshop. This was particularly clear with a young woman who had seen so many local doctors and was scheduled for incontinence surgery as part of our workshop. When appropriately questioned, it became clear that she was suffering from pelvic floor dysfunction and had urge incontinence. We were so lucky to have Erin Glace, pelvic floor PT specialist, who worked with the local PT and the patient on exercises she could do at home. This patient, and several asymptomatic prolapse patients, demonstrated how important the preoperative work up and counseling was to proper treatment, especially in female urology.

“In addition to the clinical exposure, I was able to attend the Annual Conference of the Caribbean Urologic Association. The presentations were varied and interesting, although sometimes lacking in the numbers needed for rigorous statistical analysis, they were commendable given the structural challenges of doing research in these settings. Meeting with the urologists that were performing this research was very insightful regarding the challenges they face. Currently at UCSF, I am working with faculty and other interested residents on a survey of international urologists to identify the most common challenges in providing urologic care in low-resource settings. Continuing my relationship with IVUmed and participating in the Caribbean Urologic Association gave me more connections and future partnerships to continue this work.

“Some of the most impressive research was undertaken by the residents of the San Fernando Hospital Urology Department. Each resident gave a short talk on their research project. These were generally small cohort disease or treatment studies. There was a dedicated afternoon session for resident research where talks were on academic development, although during one of these sessions it was admitted that many of the urology faculty had no published papers and many of the residents were more advanced in this than them. After discussing the need for further academic mentorship with the senior urology residents, we developed the idea to create a collaborative forum for students interested in pursuing further research and to run ideas by those in large academic centers and the US. The IVUmed Academic Urology Collaborative was born, the goal of which is to identify US-based mentors in academic urology and pair them with residents and junior faculty at IVUmed sites that have research questions and potential projects that need more guidance. The goal is to broaden the effect of IVUmed partnerships and begin fostering academic growth at centers in developing countries to prevent brain-drain and diversify the academic urologic literature.”

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Read Dr. Paulas Vyas’s Reflections on His Experience in Mexico

Reflecting on his experience in Mexico, Dr. Paulas Vyas wrote:

“The IVUmed trip to Mexico was a wonderful experience, augmented by a great host and trip leaders. While volunteerism has been a long-standing passion, IVUmed provided the ability to do so specific to my training and specialty. I was able to meet Drs. McCammon and Aube at the Atlanta airport on the way to Monterrey, Mexico; both proved to be great mentors and companions for the duration of the trip. Upon reaching our host, Dr. Suarez, lived up to every compliment spoken about him prior to arrival.

“Our first hospital in Saltillo was a great example of the purpose of our trip; the reconstructive surgeries Dr. Suarez and his colleagues had arranged for us proved to be perfect surgeries in which the OR attendees included general surgery residents, Ob / Gyn residents, and their faculty. We were able to not only describe to them the procedures, but also help guide them through the steps with their active involvement. These surgeries and the hospital also provided an insight into how a resource-limited environment is able to practice within its means yet still provide good quality of care.

“Upon completion of our time in Saltillo, we traveled to Monterrey. Monterrey exhibited a completely different environment; we were able to meet and connect with local physicians, including some from various locations, while operating with local urologists and urology residents. We were able to share knowledge of our practice while watching presentations and lectures regarding their techniques. During our time there, we were able to operate alongside the local urology residents and understand their training and how their hospitals and practice function. As part of the educational aspect of the trip, we performed a video broadcasted surgery of a urethroplasty with a buccal mucosa graft.

“Culturally, the trip provided a fulfilling experience of the local cuisine and activities. Dr. Suarez arranged for us to not only try many of the local restaurants, but also attend a local soccer match. Thus, this IVUmed trip was a very fulfilling trip – both in its mission of providing an educational experience for local healthcare professionals, but also in the personal growth and development of us as urology practitioners in the US. It was obvious that there is the opportunity to help in other countries, and in our discussions, we learned that there may even be a further need for specialized care such as pediatric urology, in these locations. I will certainly recommend IVUmed to co-residents and anyone interested in reaching out beyond our day-to-day practice.”

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Nate Jung, MD reflects on his experience in India

Thanks to the generous support of the Southeastern Section of the AUA, Dr. Nathan Jung had an impactful experience in Bhopal, India where he worked with local personnel to provide care for people in need.

Dr. Jung stated about his experience:

“India was my first choice and fortunately I was able to receive the opportunity to work there.  I was able to work with some of the leaders in my field including Dr. Raju Thomas.  I was also able to work with a colleague from a different program, Katie Rydze.  She was a 5th year resident who was also volunteering at the camp. Our standard days at the camp were much different than the days I experience at my “regular” work week.  We would wake up early in our lodging have breakfast and then go to the camp to get started with rounds.  Rounds needed to be translated and notes were written.  After starting the day by rounding we would then proceed to the operating rooms where we would get started on our cases.  The simple things we take for granted could not be taken for granted in Bhopal.  One striking example of this is a patient in “pre-op” who had to hold their own IV bag above their head as there were no IV poles available.  We also operated in operating suites with two beds per room, something I had never seen before.   After our cases we generally went back to our lodge and had dinner and usually went to sleep.

“Many unique things happened while in Bhopal.  I got to participate in three major cases which included some anatomy I had rarely seen before.  We also had plenty of opportunity to improve as we did about 35 cases per day while in Bhopal.  We were also doing all of these cases under a high spinal anesthetic.  This was new to me as we rarely use spinal anesthesia in our institution.  I was impressed with the results.  Fortunately for me my trip was not only for medical learning but also for cultural learning as well.  I had the opportunity to see the Taj Mahal!  This is truly something I will never forget.

“In the end I think that I can identify three things that were truly special about this opportunity.  The first thing is that it allowed me to re-examine why I became a physician and re-explore that choice.  This is something that I think we all need to constantly remind ourselves of as this can get lost quickly in the day to day struggle of running an effective service.  The second thing that I will keep with me forever is the perspective gained on healthcare around the world and how different each system is and how fortunate I am to train in a system with many advantages.  Thirdly, I think that it is obvious that from a purely medical/surgical perspective I have become a better urologist through the opportunities I had to struggle through difficult situations requiring adaptation without the comforts of my own equipment. Thank you for the opportunity!”

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IVUmed is committed to making quality urological care available to people worldwide.