European Urology Today Vol. 31 No.4 - Aug/Sept 2019

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My impressions of the ESU-Weill Cornell masterclass Enriching my practice, making new friends, getting expert insights Dr. Abisola Oliyide Stepping Hill Hospital Dept. of Urology Manchester (UK)

aquaaby@ Attending the ESU-Weill Cornell Masterclass in General Urology marked the first time I visited Austria. The masterclass, which was organised by the European School of Urology (ESU) and the Weill Medical College of Cornell University, took place from 23 to 29 June 2019 in Salzburg. In this report, I have collated activities, personal anecdotes, and my overall impression of the masterclass. Day one: Hello, Austria I commend the organisers for the clear and easy-tofollow directions to the venue, Schloss Arenberg. Coincidentally, I noticed a man walking in the same direction as I was. I asked if he was attending the masterclass and he said yes. We continued the walk together and that was when I made my first friend. At the welcome reception, Medical Director of the Open Medical Institute (OMI) Prof. Wolfgang Aulitzky (AT) gave us a brief overview on what to expect in the coming days. He was joined by the rest of the faculty members: Course Director Prof. Peter Schlegel (US), Co-Course Director Prof. Hein van Poppel (BE), Dr. Scott Tagawa (US) and Dr. Rafael Sanchez-Salas (FR). We, the delegates, consisted of 33 fellows from 26 countries; a group who provided an exciting mix of cultures and topics of interests.

Day two: Initial lectures Monday morning began with a 30-minute pre-test which helped me determine my level of knowledge of genitourinary cancers. I felt reassured that the masterclass lectures will address questions and knowledge gaps. The series of lectures began with coverage on Stages I, II and III of testis cancer. We were provided with handouts which we also used for noting salient points. The lectures that followed covered renal cancer management. The discussions from all these lectures were rich with diverse insights and experience of both the faculty and the fellows. The last session of the day consisted of case presentations by the fellows. The presentations were very enlightening as these showed that although management of the same condition may differ per country (based on expertise, technology and experience available), the overall goal was to achieve the best possible outcome for the patient. I was the 8th fellow to present a case. I was quite shy and nervous but in the end, I gained valuable tips that would improve my current practice. We had a bit of time in the evening, so 16 of us headed into the city which gave us the opportunity to bond, exchange ideas and talk about non-academic topics as well. Day three: Fascinating cases On Tuesday morning, the lectures covered classification of renal tumours, nephron sparing surgery, and the controversy surrounding lymph node dissection in renal tumours presented in an easy-to-understand manner. I found the lecture “Ablative therapies for renal cancer” interesting as these therapies are not

routinely offered at the centre back home. I was able to gather a lot of information based on the expertise of the faculty. Following the lunch break, we had 10 more case presentations from fellows; a few of which were unusual and complex which I found very interesting. The most fascinating case for me was the one about a “burned out” testicular tumour as a metastatic prostate germ cell tumour. After the day’s lectures, I decided to visit the Mirabell Palace and Gardens as I am an avid fan of the film “The Sound of Music”. It was a surreal experience. I found myself humming the song “Do-Re-Mi” throughout my tour of the Mirabell Gardens. Day four: Very useful to my practice We started the day with lectures on magnetic resonance imaging (MRI) prostate imaging, the use of positron emission tomography (PET), and treatment options for high-risk localised cancer of the prostate. The coffee break was in perfect timing; it gave me an extra boost for the lecture I had been looking forward to: “Management of men with persistently elevated PSA”. The lecture is very useful to my practice as it can get quite challenging especially when managing the expectations of the patient. This lecture was followed by other lectures about the prostate and the hands-on training (HOT) course in laparoscopy. Day five: Demonstrations This day was full of interesting lectures on andrology and penile cancer such as those by Dr. James Kashanian (US) and Mr. Suks Minhas (GB) whose informative slides generated a lot of discourse.

Afterwards, there were five training points for 17 participants which took us through four basic and essential skill models under the supervision of Prof. Sanchez-Salas and Dr. Theodoros Tokas (GR) during the HOT course. They made it look easier than it actually was! They were very helpful and patient, and shared numerous useful tips and ergonomic tricks. Day six and closing remarks I am grateful for the opportunity to be in Salzburg, gain new friends, and improve my clinical practice with insights one cannot simply find in just any literature. I highly commend the faculty and staff for the seamless organisation of the masterclass. I have learned a lot from the highly-experienced faculty who were willing to share their knowledge, tips and tricks. I look forward to further collaboration with OMI and I hope to participate in future programmes beneficial to my clinical practice. Please see page 27 for other masterclass reports and testimonials by Dr. Rodrigo Suarez-Ibarrola (DE) and Dr. Nelson Morales Palacios (ES).

Together with the esteemed faculty of the masterclass


ART in Flexible: Training the pathway for surgeons 2nd edition’s step 1 commences in Berlin By Erika De Groot ART in Flexible (AiF) step 1 kick-started on 15 July in Berlin, Germany where it welcomed 48 enthusiastic and promising delegates. Organised by the European School of Urology (ESU), the two-day novel programme delivered hands-on training and lectures on the history of stone treatment; overview of the instruments and handling; patient selection and positioning; set up selection; and the latest technologies in endoscopic diagnostics. “The tendency is to believe that the outcome of a surgery depends on a procedure itself and comorbidities. In my opinion, the outcome is determined by the training pathway of a surgeon. Thanks to initiatives such as AiF, we have the opportunity to standardise. I hope that the results from the programme will help encourage standardisation at residency centres worldwide,” stated AiF Coordinator Dr. Domenico Veneziano (IT). In this article, Dr. Veneziano, together with delegates Dr. Yu-Chen Chen (TW) and Dr. Mateusz Czajkowski (PL) recount their experiences at AiF and talk about the future of the programme. Noteworthy highlights “My personal AiF highlight was the final evaluation. We, the faculty, used the Performance improvement (Pi)-score algorithm to analyse the improvement of each delegate. That was the moment when we learned more about the extent of our efforts and the effectivity of our teaching,” shared D. Veneziano. “My AiF highlights were the demonstrations from experts in the field, and learning tips and tricks from them. As an Asian urological resident, it was great for me to know more about the techniques, methodologies and technologies used in Europe,” stated Dr. Chen. 22

European Urology Today

She added, “At AiF, I learned how to properly handle the flexible ureteroscope. I learned about the complications that may result from the procedure so these can be prevented; and how to choose the best ergonomic set up.” “For me, the main highlight of AiF was the programme’s focus on the hands-on training under the supervision of experienced tutors,” said Dr. Czajkowski. “I also valued learning about the efficient handling of flexible cystoscopy; Endoscopic Stone Treatment step 1(EST 1); and endoscopic treatment tips and tricks that I can apply to my daily work.” Reasons for applying “What attracted me to apply was the hands-on training courses which I found fantastic! I was so pleased that the setup of the course was two residents per tutor. This helped me learn from my mistakes and truly improve,” said Dr. Chen. She continued, “I aimed to learn all about flexible as much as I could, especially in the wet lab. In Taiwan, it’s difficult for a resident to learn flexible ureteroscopy because it’s easily broken and costs a lot to repair. That’s why I cherished the opportunity given to me at AiF.”

Dr. Veneziano imparts expert insights

Enthusiastic AiF delegates with dedicated tutors and course organisers

According to Dr. Czajkowski, he applied because of the hands-on training as well. He said that he developed his skills in flexible cystoscopy and Retrograde Intrarenal Surgery (RIRS). “I’m pleased that I had the opportunity to practise because those techniques are only available to a very small extent for young residents in Poland.” Next steps “During AiF, the participants undergo over three hours of technical-skills training. We collect data in real time then use an algorithm to determine who learned the most within the given timeframe. This challenge is also to push each delegate to show his/ her best. The top performers will proceed to AiF’s step 2,” said Dr. Veneziano. AiF is comprised of three steps in total. Step 1’s top 16 delegates will be invited to participate from 4 to 5 December 2019 in Berlin for ART in Flexible step 2. From the 16, four of the most skilled delegates will be invited for ART in Flexible step 3 in February 2020 in Caceres, Spain.

“We have had residents from Malaysia and Taiwan, which confirms that the word is spreading about the quality of AiF. Now the programme is effective and well-balanced. One of the plans is to increase the number of seats available to meet the growing demand. The 48 seats were filled just one week after the application page on the AiF website went live! So stay tuned for 2020!” concludes Dr. Veneziano. Check out the AiF report from another participant, Dr. Pablo Abad-López (ES), on page 26. About AiF The AiF programme is designed for third-year residents. An EAU membership for interested parties is mandatory. Selected applicants for AiF step 1 will receive a complimentary one-night accommodation inclusive of meals. For step 2, the top performers will receive accommodation for two nights with meals and a travel-fee compensation of a maximum of €250. For more information about the programme, visit August/September 2019