Urology underexposure in medical schools: Are we catching up?

Abstract

I read with great interest the article by Pereira et al which aimed to evaluate how good undergraduate teaching of urology is in Portuguese medical schools. The authors distributed a 16-question questionnaire through email to freshly graduated junior doctors in an attempt to gather views regarding their exposure to the urology specialty during their time spent in medical schools. Based on the analysis of 186 responses, they concluded that Portuguese medical schools’ urology teaching is insufficient and does not reflect the anticipated importance of the specialty. The finding is intriguing, but it comeswith no surprise. Indeed, urology underexposure inmedical schools is a worldwide issue. Over the last decade, several authors examined this issue with similar outcome and suggestions. It is peculiarly worrying to know that in some medical schools, undergraduate urology exposure is not considered mandatory. A study from theUnited States indicated that itwas likely for amedical student to graduate without any clinical exposure to urology. The end result would be having difficulties in managing urology conditions when encountered in clinical practice. When it comes to the study by Pereira et al, the authors intentionally decided to question junior doctors who have recently graduated because they have acquired some degree of experience in clinical practice.Nevertheless,would it have beenof value to include a cohort of urology residents already enrolled in recognized urology residency programs because they are better suited to voice their opinion about their undergraduate exposure and how they ended up in urology, having had some actual structured exposure during residency. In addition, was the questionnaire used to gather participants’ views validated before implementing it? If so, how the validation was performed? Final thought. As urologists involved in the training process of medical students, junior doctors, and residents, are we doing enough to overcome this issue of poor exposure within the health system of our countries? A good example to follow is the Convergence Plan of Bologna signed in 1999. Its main objective is to normalize, harmonize, and standardize the teaching of medicine among European medical schools by implementing a similar curriculum in which it assumes the presence of urology as a university discipline in all European medical schools. Because undergraduate exposure to urology continues to be heterogeneous worldwide, let alone Europe, has the Bologna plan really been implemented in full or partial? If yes, has it been monitored and governed to achieve its objectives for better future physicians and health system? I think medical schools should be more transparent regarding any progress done or any shortcomings faced.