Victorian Urologists in Action

The following article is an excerpt from the Royal Australasian College of Surgeons Newsletter from Autumn 2013.

This an opportunity for Victorian Urologists to share their professional national or international work experience.

david_pan Mr David Pan, FRACS

I am a Victorian/Tasmanian trainee. After completing 3 years of urological training in 2011, I reached a point where I needed to decide on a Fellowship that will expand my horizon. Similar to all my contemporaries, I was keen for an overseas trip that both my family and I would enjoy, that provided satisfying academic and operative experience.

After exploring jobs in Singapore and Europe, I was encouraged by A/Prof Bolton to consider USA Fellowships, in particular the two years SUO recognised Oncology Fellowship at University of Miami, USA.

After much discussion with my family and senior colleagues at the Austin Health, I luckily secured the Miami Fellowship through a SUO match and then started a 9 months process of paperwork to get through the infamous USA’s license exam.

In June 2011, I embarked on what turned out to be quite a remarkable journey of my life.

My first impression of Miami was everything it was rumored to be.  Hot, humid and sexy with a splendid mix of American and Latino culture. With a population of 5.5 million, and ranked fifth in terms of purchasing power per capita in the world, it is an exciting, dazzling city with welcoming residents. Unfortunately for me I only had a very short time to enjoy the city as a tourist.

Two weeks after arriving in Miami, I started my Fellowship. I operated mainly at the University of Miami Hospital,
a 560 bed accute private hospital which caters for all specialties. Furthermore, I attended the Jackson Memorial Hospital across the road, a 1550 acute county hospital.

The department of urology at the University of Miami has 12 consultants, led by Professor Mark Soloway who is a world leader in treating bladder and prostate cancer. Dr. Manoharan Murugesan, my training supervisor is an urologic oncologist who specialises in bladder cancer, ureteric reconstruction and robotics. The unit also has 4 other oncologists, 2 endourologists, 2 reconstructive urologists and an andrologist as well. I spent most of the time learning from Dr. Soloway and Dr. Manoharan.

I also had ample opportunities to learn from Dr. Guertano Ciancio, a urologist/transplant surgeon who heads the American Society of Transplantation and Dr. Dipen Parek, a Memorial Sloan Kettering trained urologic oncologist who specialises in robotic upper tract surgery. He joined the department as Director in 2012. The unit also has 3 clinical fellows, 2 research fellows, 15 residents as well as 2 database managers.

The schedule was hectic:  7am – 6pm, 5 days a week. I operated two and half days a week, and attended outpatient one and half days a week. The remaining time is usually set aside for clinical research. Being part of a busy tertiary urology unit, it is not uncommon to have 7 operating theatres concurrently running. In total I logged more than 450 major cases, with a great balance between open and lap/robotic procedures.

Research was an important part of my fellowship as well. It is always actively encouraged. As an overseas fellow, there was plenty of opportunity to participate in clinical and laboratory research. Collaboration between the department of urology with the Transplant Institute, the Stem Cell Institute as well as the Louis Pope Life Centre certainly creates a unique opportunity for those pursuing an academic career.

Whilst in USA, I also attended the AUA in Atlanta in 2012, the society Urologic Oncology Meeting in Washington, the Cleveland Clinic for a partial robotic course as well as meetings such as the World Robotic Symposium in Florida and the Florida Robotic Symposium ran by Dr. Vip Patel.

Having a hectic schedule didn’t deter us from enjoying extra-curriculum activities. Apart from enjoying the Miami Marlin’s game and Heat’s game, thanks to the hospitality of Dr. Soloway and Dr. Manoharan, I found ourselves enjoying cities such as LA, New York, Chicago, Cleveland, Seattle, Bahamas as well as the wonderful Disney World in Orlando.

What I have gained from this two-year fellowship is hard to put in words. I was extremely moved by the hospitality displayed by my mentors, and also felt very lucky to be able to form a true friendship with them. The practice of medicine in America is an eye opening experience and the volume of patients is staggering.

david_panHowever, most importantly it is a very humbling experience to see how world’s top physicians collaborate, discuss and work in a collegiate manner. I feel very inspired by this experience and I look forward to share my knowledge and contribute to our wonderful society for many years to come.

An overseas fellowship is truly life changing and it is highly recommended.

* Article Courtesy Royal Australasian College of Surgeons