SIU Scholarship: Dr. Viacheslav Iremashvili

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• Viacheslav Iremashvili, SIU Scholar

The Société Internationale d'Urologie offers Training Scholarships for young doctors with basic surgical or urological qualifications. The SIU Scholarships involve training in a recognized Urological center of excellence located in the candidate's geographical region. These SIU-accredited centers provide an excellent environment for learning and, in many instances, hands-on experience, so that candidates may acquire knowledge and skills that they will be able to transfer to their own setting of practice. In this series of short communications, SIU Scholars write about the impact that these training opportunities facilitated by the SIU had on their quality of care and career development. Information about applying for an SIU Scholarship is available at http://www.siu-urology.org/.

I have spent 6 months as a clinical observer in the Department of Urology of the United College of London Hospital. I have to confess that it was my first visit abroad, and I was very anxious about it, but everything there exceeded my expectations.

At first many things seemed strange—the absence of white coats and second shoes, and the whole structure of the urology department that was scattered on different floors of the large building. For me, it was also rather unexpected that the staff was divided into teams, and I had to choose one of them for myself.

I chose the team of Professor Mundy. This team basically treated urethral strictures and sometimes other urologic diseases that could be managed with reconstructive operations. I spent the first half of my visit with this team, and it was a very interesting period. Every week included 2 operative days and 2 days when the team worked in the outpatient clinic; on Wednesdays, 1 of the team members was on call. I tried to get as much experience as I could and stayed in the hospital until the last member of the team was there. I saw a lot of unique operations and became accustomed to the treatment of ambulatory patients.

I also had an opportunity to observe and sometimes even take part in the management of urologic emergencies. To my surprise, the latter was not very different from that in Russia, although it was probably the only area in which that was so. Almost all other aspects of care differed from those in Russia, and it allowed me to significantly improve my clinical knowledge. Professor Mundy's assistant, Daniela Andrich, did her best to help me to understand everything, and the other members of the team were extremely kind and thoughtful as well.

After 3 months in the reconstruction team, I decided to move to the uro-oncologic team. The leader of this team, Mark Emberton, who had greatly impressed me during the general meetings and whose articles I had read when I was still in Russia, was the most important reason for me to do so. This team worked with a much more diverse group of patients than did the reconstruction team. For me, it was very advantageous to observe some laparoscopic operations performed by 1 of the consultants, Dr. Patel, because we do not have any laparoscopic urology in Russia.

At the same time, I had a unique opportunity to attend Mark Emberton's consultations, which lasted for ≥7 hours and >40 patients were seen every time. Mark Emberton's treatment of patients with prostate cancer, especially the extensive use of watchful waiting, was very interesting for me. Mark Emberton is probably the most prominent urologist I have ever had an opportunity to work with, and I consider this experience as the most valuable result of my SIU scholarship.

Every week I attended general meetings, at which I had an opportunity to witness discussions held by prominent urologists working in the United College of London Hospital, such as Professor Mundy and Professor Woodhouse, Dr. Christopher, and others. I also attended meetings with radiologists and pathologists that were extremely fascinating as well.

During my stay, I found that my knowledge of many urologic problems was insufficient, and I spent many hours in the comprehensive library of the University College of London. I even collected some material for future articles that I am going to write on return to my home country.

On Fridays, I also had an opportunity to attend the lectures that were delivered for London urologists at the University College of London. At these lectures, prominent urologists would discuss up-to-date information on different urologic topics.

The experience that I had at the University College of London Hospital had a significant effect on my medical practice in Russia. It changed my understanding of the management of various urologic diseases. For example, in Russia, we virtually do not use any open surgery in the treatment of urethral strictures. Now, after seeing so many successful urethral reconstructions, I am doing my best to implement the method here, in Russia.

It was also extremely interesting for me to see the high-intensity focused ultrasound device and the procedure itself. Although we do not have this device at my home institution, at least I can tell my colleagues and students about it.

However, the most significant changes took place in my understanding of the conservative treatment of patients with diseases of the prostate. As a result of learning the contemporary principles of the treatment of these illnesses during Mark Emberton's outpatient clinics, I am now confident in treating this large and important group of patients.

As for the effect of the SIU scholarship on my career, I regret to say that I have not seen any, because any kind of international experience is not considered important or valuable for the Russian healthcare system. In conclusion, I would like to kindly thank the SIU for this scholarship. I am absolutely sure that this program will help many urologists from developing countries to improve their professional skills, just as it did in my case.

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Abbreviated CV 

Dr. Viacheslav Iremashvili was born on October 2, 1980. He studied at the Russian State Medical University from 1997 to 2003. He underwent clinical training as a Resident in Urology at the City Clinical Hospital No. 1 in Moscow from 2003 to 2005, and as a postgraduate student from 2005 to 2006. He passed his urology certification examination in August 2005. From October 2007 to January 2008, he attended the University College London Hospital as a clinical observer on an SIU Scholarship. He is currently working at the Alpha Clinic in Moscow. His Ph.D. thesis was titled “The Significance of the Assessment of Endothelial Function in Patients with Erectile Dysfunction.” He is co-author of a book on erectile dysfunction and has co-authored 14 articles in peer-reviewed journals, 4 of these in non-Russian English language journals. He has presented reports at several international meetings, including congresses in London, Istanbul, Copenhagen, Paris, Cairo, Vienna, and Portugal.