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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