Dr. Maggie Lovin Shares Her Experience in Mongolia

Thanks to the generous support of the Southeastern Section of the American Urological Association, Dr. Maggie Lovin had an outstanding experience in Ulaanbaatar, Mongolia, where she worked with local urologists and patients at the National Center for Maternal and Child Health from October 20-28, 2018.

Dr. Lovin shares her experience:

“Our team was composed of two pediatric urologists, Dr. Carlos Angel and Dr. Angela Arlen and two pediatric anesthesiologists, Dr. Scott Stenquist and Dr. Laurie Steward, and myself. Our group bonded immediately, making working together effortless and enjoyable.

“We were hosted by the Pediatric Urology Department at National Center for Maternal and Child Health under the direction of Dr. Kurelbaatar Lkhagvademberrel. The 1500 bed hospital in the capital city is the main government referral hospital in Mongolia and provides free medical services to its patients through the national government insurance plan. There are six pediatric urologists serving approximately 1.2 million children in the country.

“After our flights, we got to work immediately the day we arrived to Ulaanbaatar. We conducted a busy 40 patient clinic that Sunday afternoon, booking 28 cases for the following week’s operating room schedule. We encountered a great variety of disease pathology including proximal hypospadias, ureteropelvic junction obstruction (UPJO), vesicoureteral reflux (VUR), urethral stricture, nephrolithiasis, epispadias-exstrophy complex, posterior urethral valves and disorders of sexual differentiation. We concluded our clinic Monday around mid-day, seeing 81 children in total.

“Monday afternoon, we began our surgical cases. We operated simultaneously with two surgical teams in separate operating rooms. This allowed ample time to teach the Mongolian surgeons the intricacies of several pediatric urologic procedures. The pediatric urologists were very eager to learn, and their enthusiasm for the workshop and their patients alike was contagious. In addition, this trip would not have been possible without our incredibly hard working operating room team, including the anesthesiologists, nurses and surgical scrub technicians. Together, we were able to treat several children with proximal hypospadias, ureteropelvic junction obstruction, vesicoureteral reflux and posterior urethral valves.

“On the last day of the workshop, we made rounds handing out soccer balls and toys to our patients to thank them for allowing us to be a part of their journey. The Mongolian parents presented us with Mongolian cashmere scarves and a traditional Mongolian game to thank us for helping their children. It was very touching to see people with so little to give, give so much.

“The Mongolian pediatric urologists made a conscious effort to make us feel at home in Ulaanbaatar. We worked hard all week, but took the afternoon of the last day off to have some fun. The Mongolian urologists took us sightseeing in the countryside. We rode camels, held eagles, and visited the Genghis Khan equestrian statue. The day ended with a Mongolian barbeque with our entire team.

“While this was my first global health mission, it certainly will not be my last. The people I met and the experiences I had in Mongolia have made an everlasting impact on my life. While there is great need for further pediatric urologic care in Mongolia and worldwide, organizations such as IVUmed are helping to bridge that gap. I would like to thank IVUmed and my physician mentors for this opportunity and I hope to use this experience as a stepping-stone to a lifelong commitment to international service.”

Resident Scholar Dr. Tan Travels to Senegal

Dr. James Tan’s IVUmed scholarship experience in Dakar, Senegal was made possible by the generous support of the South Central Section of the AUA. During his time in Senegal, Dr. Tan was accompanied by mentor, Francis Schneck, MD.

Dr. Tan, reflecting on his experience, reported, “We quickly got through our intake of 30 plus patients with efficiency despite some of us still recovering from severe jet lag.  Amongst these we chose the most appropriate cases to proceed with and scheduled them appropriately on each of the operative days.  Despite the facilities being much different from what we were used to we were quick to unpack and start cases the following day.  It was clear from the get go that the aim of our time would be focused on training the local doctors new techniques and procedures.  There was a willingness to allow the local surgeons to have as much hands on time and struggles as possible much like during our residency training.  This would not be a time of pure observation.  They would get valuable experience with cases they’d never seen before.  Each day was long and tiring but at the end of the day there was a satisfaction I had in working with a great group of people as a team helping the kids we operated on.

My goal as I progress in my career is to eventually do continuous short-term mission trips.  I made many valuable observations.  Organization was key as we had a set schedule from the minute we landed.  This demands an established relationship with the local people and doctors that can only be developed through years of working together much like Dr. Schneck had with the Grand Yoff hospital.  As I learned, two of the local urologists had spent time in the U.S. and had visited Dr. Schneck and Tina the nurse who traveled with us.  An additional element of a successful trip was the need to teach your skills to as many as possible.  As the old saying goes give a man a fish and he eats for a day, teach a man to fish and he eats for a lifetime.  The same can be said for doctors.  The most helpful thing for the local people besides sending more doctors is to teach the doctors already there new skills and techniques so that they may reach as many people as possible even when the team leaves.”

IVUmed Resident Scholar Dr. Liam Macleod Reports from Mozambique

Dr. Liam Macleod’s IVUmed scholarship experience in Mozambique was made possible by the generous support of Verathon.   During his time there, Dr. Macleod was accompanied by mentor, Ryan Terlecki, MD.  The visit occurred in parallel with a conference arranged for African urologists including several well-known surgeons and other urologists from Nigeria, Zimbabwe, Guinea-Bissau, Kenya, Niger, Liberia, Angola and local urology and general surgery residents. 

Upon arrival in Mozambique Dr. Macleod was able to quickly scrub in to assist with surgeries.  He noted, “Needless to say, the OR was very crowded with observers when I arrived.  Nonetheless Dr. Terlecki invited me to scrub in immediately.”

He observed, “There were numerous cases of urethral strictures, urethral distraction injuries, obstetric fistulas and congenital anomalies.  The northern part of the country is less developed and the roads are typically small and narrow.  Thus, when patients come to Maputo (or an urban center) for care it requires a long and arduous journey often taking several days.  The result is that many patients reside in the ward for an extended time while awaiting surgery.  We met one young lady that had been living there for a year (during which time she had undergone a fistula repair and two revisions but was awaiting a final repair).

Of all the components of the trip—operating, caring for patients, seeing the way wards, hospitals and operating rooms are run in another country, listening to talks and participating in discussions—I think that the newly formed relationships will have the most lasting impression.  I have remained in touch via email with a number of people since being back in the U.S.  I am hopeful that these relationships will serve as a conduit for future trips and a mechanism to divert resources for improving urological care into capable hands.”

Dr. Timothy Brown, IVUmed Resident Scholar, Travels to Bhopal, India

Dr. Timothy Brown

Dr. Timothy Brown’s IVUmed scholarship experience in Bhopal, India was made possible by the support of the Resident Scholar Alumni Fund. During his time in India, Dr. Brown was accompanied by mentor, Sakti Das, MD, another IVUmed Resident Scholar, Kerri Brown, MD, and many other doctors that participated in the 75^th Mega Free Urology Camp.

Regarding his experience in India, Dr. Brown reported, “Although we wouldn’t begin operating until the next day, the Urology camp was well underway.  The hospital was filled with patients completing their preoperative evaluations and imaging.  This was the first time I began to appreciate the magnitude of this camp and its dependence on a remarkable group of local physicians.  It is this group of doctors that made this operation possible by providing countless hours of pre- and post-operative care.  In total, 646 patients were evaluated and 156 of them would end up undergoing surgeries over the next 3 days.”

“Not surprisingly, we operated without the same level of technology and resources at our disposal that I have grown accustomed to while training at a major medical center in the U.S.  Who knew you could still practice medicine without a CT scanner?  While we were forced to use older equipment and deal with occasional power outages, the experience reinforced the notion that while technology changes, surgical principles remain the same.  Meanwhile, while the facilities and resources may have been of lesser quality to what is available in the U.S., the ability of the Indian urologists was far from inferior.  What they lacked in equipment, they more than made up for with skill.”

“My experience with the Bhopal urology camp has drastically changed my view of international medical volunteerism.

Surgical Team

Prior to this trip, I envisioned international medical work as expeditions to remote corners of the earth to deliver needed care.  The Bhopal Urology Camp was far more than this.  It is a finely orchestrated operation.”

IVUmed Resident Scholar Omar Soto-Aviles, MD — Trinidad

In March 2015, Dr. Omar Soto-Aviles traveled to Trinidad and Tobago as an IVUmed Resident Scholar.  He was accompanied by mentor, Kurt McCammon, MD, a reconstructive urologist at Urology of Virginia.  This opportunity was made possible by the generous support of the Southeastern Section of the AUA.

IVUmed Medical Team in Trinidad

After returning from the workshop, Dr. Soto-Aviles reported, “During our week at San Fernando General Hospital, Dr. McCammon and his fellow were able to operate on two patients per day and give lectures at evening during dinner. We were able to provide the help they needed with regards to patient care as well as provide the workshop to guide them throughout the complex reconstructive surgeries. The cases that were done consisted of almost, if not all, the spectrum of male urethral stricture disease. From simple bulbar strictures, redo cases, to post radical prostatectomy bladder neck contractures. Also the local staff was able to learn graft harvest from the cheek and tongue.

One of the highlights of the trip for me was when one of the residents pulled me aside and asked me for help with regards to setting up a retractor for open prostatectomy. I think the fact that we still do a lot of open surgery in Puerto Rico helped me teach him the step up for an open radical prostatectomy as well as to discuss some technicalities of the procedure.

Going into this experience I had the expectations of providing a service to an underserved area and have some hands on experience with reconstructive urology cases, but it turned out to be completely different. I was able to create new bonds with other colleagues from the Caribbean, from which I expect great things to come in the future with regards to collaborations. Also, I was greatly influenced by their desire to learn despite having some disadvantages. I am extremely grateful for the experience that IVUmed and their sponsors give residents to explore underserved areas during their training. I am sure the Resident Scholar program plants a seed for all the participants that will later flourish and the IVUmed mission of ‘Teach One, Reach Many’ will come to life.”

Resident Scholar Report: Zambia

Amanda Saltzman, MD
Louisiana State University/Ochsner Clinic Foundation
Lusaka, Zambia
September 26-October 5, 2014
Mentor: Dr. Francis Schneck
Sponsored By: Southeastern Section of the AUA

Through the generous sponsorship provided by the Southeastern Section of the AUA, Amanda Saltzman, MD traveled to Lusaka, Zambia with mentor Francis Schneck, MD to assist during a pediatric urology workshop.  During her visit, Dr. Saltzman was able to provide much-needed urological care to 50 children.

Reporting on her experience, Dr. Saltzman stated:

“We rounded on all the kids for the day in the morning.  There were immediately differences from America.  The first was the open wards and multiple kids per bed.  The shoes at the entry to the ward were also surprising.  Diapers are not supplied by the hospital and are the responsibility of the families, with many using rags or nothing as diapers.  There is an area called “high cost” where kids with insurance are housed. This area has more sheets and each kid has his/her own bed.

“I think our trip was a great success.  We had a great exchange of information with the Zambian urologists and they did a great job learning the reconstructive techniques.  The only disappointing thing about the week was that we had to turn away many kids and families that travelled from far away to seek our help.  However, we passed on our knowledge to the local urologists and they scheduled many of the distal hypospadias to be fixed the week after we left during their ‘jubilee.’

“This trip was my first international medical trip and will not be my last.  I had such a wonderful time meeting new people, seeing how to cope and work with less, appreciating the sophistication of the American medical system and working with such adorable children.  I felt like I helped more children and families during my week in Zambia than I have during my 3 years of residency so far.  The joy on the kids’ faces when they saw us and got toys everyday was priceless.  I can’t wait to go back, hopefully every year!”

Urology Residents: Apply Now

Applications are now being accepted for our Traveling Resident Scholar program for the 2015-2016 academic year.  North American urology residents and fellows who will be PGY-3 or above during the next academic year are eligible to apply.  For applications, please visit http://www.ivumed.org/what-we-do/traveling-resident-scholars/ .  The deadline is February 1, 2015.  For more information, please contact our office at 801-524-0201.

urology resident scholarship opportunity

Traveling Resident Scholar Highlight – Jack Lambert, MD, Senegal

IVUmed team with local Senegalese staff.

Through the generous sponsorship provided by the Mid-Atlantic Section of the AUA, Dr. Jack Lambert traveled to Dakar, Senegal with mentor, Dr. Kurt McCammon, to conduct a reconstructive urology workshop.

Reporting on his experience, Dr. Lambert stated:

Dr. Lambert working with long-time IVUmed partner, Dr. Serigne Gueye.

“We ate our ritual hotel breakfast – chocolate croissants, slices and ham and swiss and bread. We would quickly change into our scrubs after a cup

“Although it would have been nice to bring our own instrumentation to the OR, I think being in the environment in which you are forced to simply “make do” is important. We may not always have access to the best instruments or technology and it’s important for surgeons to experience operating in a resource-limited country. It gave me a new appreciation for our country and the simple things we take for granted.of coffee and head to the ORs. We reviewed the films for the day and Dr. Gueye would give us the case line-up and then we plunged in. This was the tone for the rest of the week, and as the week progressed I felt like we more quickly became integrated into their hospital and there became more of an exchange of surgical technique between the American and Senegalese

doctors. We did approximately 20 cases over the week and some of which we would rarely do in the United States.

“We had numerous exchanges which provided a pleasant camaraderie between our group and the doctors from Senegal. Also, on our final work day in Dakar, myself, Dr. Brown and Dr. McCammon each gave a lecture for the Senegalese staff and residents on several urology topics in seminar they organized for us to exchange ideas and understand how we might manage certain urologic diseases differently. This didactic session was very insightful and was a great way to the end our week with our wonderful hosts.”

L to R: Dr. Lambert, Dr. McCammon and Dr. Brown

Resident Scholar Applications are Open

A Unique Opportunity

Since 1999, IVUmed has provided over 150 urology residents with
the opportunity to gain unique surgical experience in resource-limited

settings throughout the world. Residents in PGY-3 and above obtain
significant hands-on experience in urology under the supervision of
board-certified mentors.
Program Highlights

• 1-2 week international trip, coordinated by IVUmed staff
• Scholarships available to cover most trip expenses
• Diverse surgical experience, with exposure to cases not often seen in the US
• Service abroad to underserved populations
• Share and interact with residents from other countries
• Collaborate with mentors from other programs
• Gain a greater insight of the international medical community

Application Information
The 2013-2014 application deadline is February 1, 2013. Applications
can be found on our website at How You Can Help.
Please contact Amy Steele for more information at 801-524-0201 or amy.steele@ivumed.org.

Tell your friends by sharing this link: http://www.ivumed.org/2012/12/resident-scholar-applications-are-open/

Traveling Resident Scholar Highlight – Laurie Bachrach, MD, Mongolia

Through the generous sponsorship provided by the North Central Section of the AUA, Dr. Laurie Bachrach traveled to Ulaanbaatar, Mongolia with mentor Dr. Jeremy Myers to conduct a reconstructive and laparoscopic urology workshop this Fall.

Reporting on her experience, Dr. Bachrach stated:

“When I signed up for my IVUMed trip, I had high hopes for a great experience, but this was tempered by my previous international experiences. I had been on other trips where I felt limited in my ability to leave a lasting impact let alone even adequately treat patients with the limited resources available to my team. I was more hopeful for this trip based on the experiences of other IVUMed participants and the strong mission of Teach One, Reach Many. I am delighted to say that this trip exceeded all of my hopes and expectations. A combination of a receptive and competent hosts and realistic goals made this a worthwhile experience, that I believe will have a lasting impact on the Mongolian urologists and patients.

“This was a professionally and personally very gratifying experience. I truly enjoyed working alongside Drs. Erka and Nyamaa and enjoyed getting to know them better. One of my concerns early on was that it would be tough to balance my desire to pursue my own training and education without taking away from the their training. Dr. Myers was very helpful in negotiating this by defining specific roles for each case. In the end we became so busy that there was room for all of us to be working at the same time. That allowed us to take care of more patients, while also permitting all of us to get a richer training opportunity.

“I feel fortunate to have had such a rich and worthwhile experience. I was very impressed with the organization of the trip and the impact we had and I hope to make IVUmed a part of my professional life once I go into practice.”