SIU Scholar: Dr. Egi Edward Manuputty

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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/.

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• Egi Edward Manuputty, SIU Scholar

I started my SIU Scholarship Training in Singapore General Hospital (SGH) on March 28, 2009 and the funding was sufficient to support the program for an additional month until October 30, 2009. It was a precious and worthwhile experience. Prof. Christopher Cheng Wai Sam as Head of the Department of Urology together with Prof. Anantharaman Vathsala from Renal Medicine at SGH designed and supported my program, and it was the encouragement of Prof. Foo Keong Tatt that inspired me in the first place to undertake SIU Scholarship training.

The Scholarship enabled me to learn about surgical, medical, and other aspects of kidney transplantation. The first 3 months were focused in the Department of Renal Medicine under Dr. Terence Kee Yi Shern. I was introduced to immunosuppressant therapy and disease management of kidney transplantation. As he is the coordinator of the kidney transplantation program in SGH, he also introduced me to the transplantation coordinators, counselors, and National Organ Transplant Unit, which played important roles in my involvement in every kidney transplant case management (evaluation, donor kidney harvesting, and recipient implantation) and research data collection. My research topic was deceased donor kidney transplantation in SGH. Every Tuesday we had a kidney transplant teaching session and transplant management clinic. I was allowed to fully participate in the teaching and to share the relevant knowledge of surgical aspects of kidney transplantation.

The next 4 months of my training were focused in the Department of Urology. This is a nicely integrated center, providing advanced and convenient services for clinic patients, with ultrasound, flexible cystoscopy, prostatic biopsy, extracorporeal shock wave lithotripsy and other office urology procedures. Urology services include endo-urology, uro-oncology, prostatic diseases, kidney transplantation, urological reconstruction, and andrology. To maintain the service quality, there are also clinician-scientists within the team.

Daily department meetings included a journal club and research project presentation on Monday, where I also had opportunities to present journal reviews and a research project; morbidity-mortality report and surgery planning on Tuesday; tutorial on Wednesday; joint urology and radiology conference on Thursday; and grand ward round on Friday. Every month we had a Uro-pathology meeting, Genitourinary tumor meeting, and SGH Minimally Invasive Surgery (MIS) forum meeting.

The learning process was very much influenced by the consultants in the departments. I enjoyed the privilege to join every consultant's surgery and patient round. My supervisor was Dr. Ng Lay Guat, senior consultant in charge of kidney transplantation. She arranged to the best possible extent my involvement in transplantation and other surgical procedures. I am grateful that I was able to participate in every kidney transplant performed by the SGH team during my training period, although 85% were emergency procedures. The development of my surgical skill and peri-operative knowledge owe much to her encouragement and guidance.

Both departments were also actively hosting or participating in scientific activities, which enabled me to be updated on the topics. Twice a year there was a transplant surgeons' meeting, where the cases of the previous 6 months were reviewed. Topics discussed in the Department of Renal Medicine included: Symphony Study in Kidney Transplantation; an introduction to transplant immunology assessment and visit to Singapore Health Science Authority; ABO blood group–incompatible kidney transplantation; symposium on new immunosuppressant strategies; early and late conversion to m-TOR inhibitors in renal transplantation; and management of high-risk kidney transplantation.

Topics of scientific sessions related to the Department of Urology included: Robotic surgery at Yonsei University; second Asia-Pacific Preceptorship, where I was granted an opportunity to present a poster; Current Surgical Options for Male Incontinence course and workshop; Urology Resident's Course; and invasive bladder cancer. Other courses that I attended during my scholarship training were end-of-life decisions and transplant ethics; SGH 18th Annual Scientific Meeting; ultrasound in critical care; and communication courses.

Generous hospitality was shown during my training period. The departmental staff provided helping hands to facilitate my training. Registrars, medical officers, and other fellows shared the training opportunities and encouraged each other in the learning process. An important event that I was grateful to attend was Singapore Transplant Games, a biannual organ transplant recipients' sport competition to promote public awareness and recipients' physical fitness—winners qualified to participate in the 2009 World Transplant Games.

Combined training in surgical, medical, and other aspects of kidney transplantation improved my skills, enabled me to speak the same language as our working partners, and made me a better team player. Although the training period has passed, the partnerships and friendships built with my host urologists and the kidney transplantation team will last.

Back in my home country, Indonesia, a great deal needs to be done to increase the volume of kidney transplantation to help the increasing number of people who suffer from end-stage renal disease. I hope that continuation of the SIU Scholarship program will enable more young urologists to develop better urological care in their respective practices.

Abbreviated CV. Dr. Egi Edward Manuputty was born on April 27, 1977 in Jakarta, Indonesia. He obtained his medical degree from the Faculty of Medicine, University of Indonesia, in 2001. He started his specialist training in 2002 and graduated as a urologist in 2007. He has been working in Cikini Communion of Churches in Indonesia (CCI) Hospital since 2008. The hospital is a center for kidney transplantation in Indonesia. He has presented 2 papers at the Asian Congress of Urology, has published 2 articles in Indonesian journals, and has 1 article in process.