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Urology

This page provides useful information on the nature of the work, the common procedures/interventions, sub-specialties and other roles that may interest you.

Nature of the work

Urologists are surgeons, but much of their work also involves the medical management of conditions or disease without surgery. They work with patients of all ages from babies and children to elderly people.

Conditions treated include disorders of the:

• bladder – stones, tumours, congenital disorders, incontinence in women and men and erectile dysfunction
• urethra and prostate – tumours, obstructions and infections
• male reproductive organs – impotence, tumours, congenital disorders, infection, sterilisation and male infertility

Urology was the first surgical specialty to use minimally invasive techniques such as endoscopy and key-hole surgery, techniques which continue to be regularly used by urologists. Urology is also at the forefront of developments in robot-assisted surgery.

Urologists use a thin lighted instrument known as a cystoscope to examine the bladder and urethra. Other conditions can also be treated using endoscopic (telescopic) procedures including the removal of bladder tumours and treatment of bladder and kidney stones.

Urological conditions are relatively common and account for up to 10% of all GP consultations and up to 20% of all acute hospital referrals.

Most urological surgery is elective and urological emergencies are relatively rare. But dealing with acute kidney infections, urinary retention and trauma to the urinary tract can also occasionally be part of a day’s work.

“I love the physical and technical challenges of operating on the human body”. Vaibhav Modgil, Specialist trainee in urology, Good Hope Hospital, Heart of England NHS Foundation Trust. 

Read Vaibhav’s story

Common procedures/interventions

Common open surgery procedures include:

• removal of bladder, kidney or prostrate to treat cancer
• kidney stone removal
• formation of a stoma to divert urine into a bag
• bladder reconstruction after removal
• vasectomy
• circumcision

Sub-specialties

The main sub-specialties include:

• endourology – prostate, bladder and kidney conditions, including kidney stones and small bladder tumours, treated using key-hole techniques
• urological oncology – prostate, bladder, kidney, testicular and penile cancer
• functional urology – the investigation and treatment of bladder symptoms and incontinence and neurological disorders such as multiple sclerosis and spinal injury
• andrology – male fertility and sexual health
• reconstructive urology – repair and restoration of the lower urinary tract, and particularly the urethra and management of urethral stricture disease

It is also possible to specialise in paediatric urology.

Want to learn more?

Find out more about:

• the working life of someone in urology
• the entry requirements and training and development
• two first-hand accounts of life: 
  • as a specialist trainee in urology
  • as a consultant surgeon

• Pay and conditions

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  This section provides useful information about the pay for junior doctors (doctors in training), specialty doctors, consultants and general practitioners.

  Find out more about the current pay scales for doctors, and there's more information on the BMA website.

  NHS Employers provides useful advice and guidance on all NHS pay, contracts terms and conditions.

  Medical staff working in private sector hospitals, the armed services or abroad will be paid on different scales.

  There are opportunities within private practice for urologists.

• Where the role can lead

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  Read about consultant and non-consultant roles in urology, flexible working and about wider opportunities.

  Urology is a competitive specialty, with varied and interesting career opportunities. There is an increasing need for urologists, partly due to the increasing age of the population. Certain urological conditions, for example kidney stones are linked to obesity.

  Consultant roles

  You can apply for consultant roles six months prior to achieving your Certificate of Completion of Training (CCT). You will receive your CCT at the end of your urology training.

  Managerial opportunities for consultants include:

  • clinical lead - lead NHS consultant for the team
  • clinical director - lead NHS consultant for the department
  • medical director - lead NHS consultant for the Trust

  Most NHS consultants will be involved with clinical and educational supervision of junior doctors.

  Here are some examples of education and training opportunities:

  • director of medical education - the NHS consultant appointed to the hospital board who is responsible for the postgraduate medical training in a hospital. They work with the postgraduate dean to make sure training meets GMC standards.
  • training programme director - the NHS consultant overseeing the education of the local cohort of trainee doctors eg foundation training programme director. This role will be working within the HEE local office/deanery
  • associate dean - the NHS consultant responsible for management of the entirety of a training programme. This role will be also be working within the HEE local office/deanery

  SAS doctor roles

  There are also opportunities to work at non-consultant level, for example as a SAS (Specialist and Associate Specialist) doctor.

  SAS surgeons (Staff, Associate Specialists and Specialty Doctors) work as career grade specialty doctors who are not in training or in consultant posts. You will need at least four years of postgraduate training (two of those being in a relevant specialty) before you can apply for Specialty Doctor roles. Find out more about SAS doctors roles.

  The role of an SAS surgeon can vary greatly. Depending on your experience, you might work on complex surgery or relatively minor diagnostic and outpatient work. SAS doctors will frequently participate in routine and elective surgery rather than emergency work. They also train other staff.

  Some surgeons are attracted to the SAS role as the hours are more regular than those of the consultant, and any on-call work and overtime beyond 7am-7pm is paid.

  Further information on the SAS doctor role.

  Other non-training grade roles

  These roles include:

  • trust grade
  • clinical fellows

  Other opportunities

  Urologists often undertake research (see below), which includes collaborating with colleagues in the UK and overseas, writing papers and presenting your work at conferences. Urologists are often involved in teaching undergraduate and postgraduate medical students and supervising junior doctors as well as audit and committee work. With experience there are excellent opportunities to become involved in management and to actively participate in professional organisations.

  There may also be opportunities to work in the private sector and overseas.

  Academic pathways

  If you have trained on an academic surgery pathway or are interested in research there are opportunities in academic medicine.

  For those with a particular interest in research, you may wish to consider an academic urology training programme. Whilst not essential, some doctors start their career with an Academic Foundation post. This enables them to develop skills in research and teaching alongside the basic competences in the foundation curriculum.

  Entry into an academic career would usually start with an Academic Clinical Fellowship (ACF) and may progress to a Clinical Lectureship (CL). Alternatively some trainees that begin with an ACF post then continue as an ST trainee on the clinical programme post-ST4.

  Applications for entry into Academic Clinical Fellow posts are coordinated by the National Institute for Health Research Trainees Coordinating Centre (NIHRTCC).

  There are also numerous opportunities for trainees to undertake research outside of the ACF/CL route, as part of planned time out of their training programme. Find out more about academic medicine.

  The Clinical Research Network (CRN) actively encourages all doctors to take part in clinical research.

• Job market and vacancies

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  This section provides useful information about the availability of jobs, how to find vacancies and sources of further information.

  Job market information

  There are around 812 full-time equivalent urologists at consultant level and 436 urology registrars in England in (NHS Digital, 2016).

  In 2016 the competition ratio for CT1 core surgical training was 2.53, and for ST3 urology it was 2.16 (NHS specialty training 2016)

  For information regarding Scotland, Wales and Northern Ireland please click on the links below.

  NHS Scotland workforce information
  NHS Wales workforce information
  NHS Nothern Ireland workforce information

  Where to look for vacancies

  Applications for core surgery training are made via the Core Surgery National Recruitment Office. Further details including closing dates can be found on the Core Surgery National Office (CSNRO) website.

  London and the South East (LaSE) nationally coordinates the recruitment into Core Surgery Training round one (CT1) on behalf of England, Wales and Scotland. This training programme is open to those who may want to train flexibly on a less than full-time basis (LTFT). You can request and apply for this after you have been offered the job. Restrictions apply.

  The Yorkshire and Humber Deanery coordinates national recruitment for urology training. This training programme is open to those who may want to train flexibly on a less than full-time basis (LTFT). You can request and apply for this after you have been offered the job. Restrictions apply.

  Registration and application for core surgery and specialist training is online via Oriel. Further details person specifications and application deadlines are also available on the Oriel site.

  Northern Ireland has its own recruitment process. For further details please visit the Northern Ireland Medical and Dental Training Agency website.

• Further information

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  Organisations

  British Association of Urological Surgeons

  British Medical Association

  Joint Committee on Intercollegiate Examinations

  European Association of Urology

  General Medical Council

  Royal College of Surgeons

  Royal College of Surgeons of Edinburgh

  Royal College of Physicians and Surgeons of Glasgow

  Video case study

  Consultant in urology - Mr Gurminder Mann