British Association of Urological Surgeons

BackgroundTo deliver and evaluate two Emergency Urology Skills Training (EUST) courses in Ethiopia, aimed at equipping surgical and urology residents with hands-on skills and confidence in managing urological emergencies in resource-limited settings.MethodsTwo one-day, practical training courses were held in Hawassa and Addis Ababa in November 2024 and May 2025. Pre-course questionnaires assessed delegates' baseline confidence, prior training and the utility of a pre-course manual. A blended curriculum comprising didactic lectures, skill stations and one-to-one mentorship was delivered by a collaborative team of local and international faculty. Post-course evaluations measured improvements in knowledge, confidence and satisfaction.ResultsTwenty-three participants from each centre completed matched pre- and post-course multiple-choice questionnaires assessing knowledge of emergency urology procedures. Pre-course exposure to structured skills training was limited (≤30%). Both groups showed statistically significant improvements in post-course scores (Hawassa: p = 0.002; Addis Ababa: p = 0.007). Self-rated confidence and knowledge improved significantly (p < 0.05) in six of eight core procedures.ConclusionsThe EUST model effectively improved trainees' confidence and procedural competence in emergency urology. With adequate support, this model is scalable and applicable to other resource-limited countries seeking to strengthen urological emergency care and their training capacity.

OBJECTIVE:To present a narrative review of evidence to guide the delivery of high-quality, low-carbon urological care using a structured framework. METHODS:Academic and policy papers which outline actions focused on decarbonising urological care and surgical care more broadly were identified and reviewed. The 'STEPS to Low-Carbon Care' framework (an acronym for low-carbon care across 'Settings and Treatments, Efficiency, Prevention and System change') was then used to categorise and present the evidence-based decarbonisation actions, using the National Health Service in England as a case study. RESULTS:Across all STEPS framework elements, tangible actions were identified alongside opportunities for future research and innovation. The evidence-based actions that were identified to transition to low-carbon care settings and treatments included tackling known carbon hotspots in operating theatres: anaesthetic gases, consumables and electricity use. Outside the operating theatre, urology pathway transformation through one-stop clinics, day-case surgery, appropriate use of virtual appointments and streamlined pathways demonstrated opportunities to reduce carbon emissions, with potential additional benefits in terms of cost, efficiencies, and patient outcome improvements. Key climate mitigation actions that support keeping people healthy were identified. There was a paucity of evidence demonstrating the implementation of climate change action as part of routine service delivery. Embedding sustainability across organisational processes and ways of working requires actions to upskill, engage and enable the workforce to deliver and to establish clinical leadership. CONCLUSION:This review identified a range of interventions to decarbonise urological care, whilst highlighting a need for further research. Categorising the evidence according to components of the STEPS framework indicated the potential utility of this framework when determining unrealised decarbonisation opportunities in urology and more widely across healthcare. Delivering sustained and system-wide low-carbon urological care will require the collective action of all who design, deliver and influence patient care across the specialty and all urology patient pathways.

Recently, there has been increased competition for specialist urological training at National Selection. This paper aims to investigate potential factors that may contribute to individuals deciding to pursue a urological career. Core trainee numbers and National Selection competition ratios for core training, general surgery, trauma and orthopedics, and urology were obtained from NHS England between 2016 and 2023. Trainees’ views about stress, burnout, teamworking, the training environment, and global satisfaction with training were extracted from General Medical Council survey data 2019–2024. NHSE data obtained 2010–2023 were analysed to assess urological consultant numbers and their work intensity. Exposure to urology during core training increased by 165% between 2010 and 2023, accompanied by a 60% rise in applications for specialist training. Urology consistently demonstrated higher trainee satisfaction rates compared against general surgery and trauma and orthopedics. In addition, the evolution of consultant practice, a shift towards more outpatient-based activity, may further contribute to the specialty’s growing appeal to an increasingly female workforce. Multiple factors may contribute to the rising competition ratios observed in urological training. These include increased exposure to urology during core training, high levels of trainee satisfaction and the transition towards lower-intensity consultant practice. Not applicable

Working in low- and lower-middle-income countries offers significant professional and personal benefits for urologists from high-income nations. These experiences foster valuable skills that can be brought back and applied within the UK healthcare system. Practising in resource-limited settings enhances communication across cultural boundaries, encourages adaptability in clinical decision-making, and promotes creative use of limited resources. In addition, the experience nurtures essential leadership qualities such as structured teaching, diplomatic collaboration, and a strong sense of ethical and global responsibility. These lessons cultivate humility, inclusivity, and accountability, qualities that enrich patient care and strengthen teamwork within the NHS. Level of evidence: Not applicable

Equity refers to the fair and just treatment of all individuals, with a particular focus on recognising and addressing systemic disparities. This article critically examines efforts within medicine and urology to identify and dismantle structural barriers encountered by marginalised and disadvantaged groups. Core areas of focus include protected characteristics such as ethnicity, gender, sexual orientation, and socio-economic background, including those who are the first in their family to attend university. Notably, there remains a paucity of data and targeted initiatives for other groups who may also experience disadvantage such as individuals with disabilities, carers, refugees, and those from underrepresented geographic or cultural communities. The article underscores the need for comprehensive data collection, meaningful engagement with lived experiences, and sustained structural reform to advance equity across all stages of medical education and professional development. Level of evidence: Not applicable