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The South West regional training scheme in Urology is currently based in 12 centres in the region that are recognised by the Specialist Advisory Committee in Urology for higher surgical training in Urology.
Each of the units at Southmead Hospital (Bristol), Derriford Hospital Plymouth and Gloucester/Cheltenham has three trainee; Bristol Royal Infirmary, Taunton and Exeter each have two trainees whilst Bath, Torbay, Truro and Weston-Super-Mare each have one trainee.
At present, the rotation involves yearly attachments to the training units to gain experience in clinical urology for a minimum total of five years.
Peninsula School of Surgery
Derriford Hospital, Plymouth
The Plymouth Hospitals NHS Trust provides acute health care for part of South and West Devon and part of East Cornwall, serving a total population of approximately 500,000.
Derriford Hospital is situated five miles north of the city and was opened in 1981. It has over 1,000 beds and houses all specialities except ophthalmology. It also contains a Ministry of Defence Hospital Unit. The hospital has a well-stocked Staff library and a Postgraduate Centre with a 200-seat tiered lecture theatre, seminar rooms, a bar and dining room.
The Universities of Plymouth and Exeter established a new undergraduate medical school in the South West. The Peninsula Medical School took its first students in October 2002. The Tamar Science Park adjacent to Derriford Hospital currently provides accommodation for two new research laboratories and also a department of Molecular Medicine.
The urology service is provided by the Consultants (Mr PD McInerney, Mr AJ Dickinson Mr H Sells, Ms E McLarty, Mr R Pearcy, Mr P Hunter-Campbell) and an Associate Specialist (Mr S Natale). There are three SpR trainees who move through three 4-month rotations, providing excellent training opportunities in all aspects of urological surgery, outpatients and ultrasound - Plymouth is the only centre with a timetabled Consultant Radiologist supervised urological ultrasound training programme. The timetable is flexible and allows individual trainees to adapt their programmes to achieve their educational objectives. There is a 1:5 on call rota.
The six Consultant Urologists and the Associate Specialist work a pooled system for inpatients, outpatients, day cases and referrals. All Consultants have a general urological workload but have developed subspeciality interests which include cystectomy and reconstruction (Ms McLarty, Mr Hunter-Campbell and Mr McInerney), radical perineal prostatectomy (Mr McInerney), radical retropubic prostatectomy (Mr Sells), endourology and full laparoscopic surgery including laparoscopic prostatectomy and cystectomy (Mr Dickinson and Mr Sells) and a regional andrology service (Mr Pearcy). The department has developed a TRUS and brachytherapy service and has an interest in new technology including
The service works closely with oncology, radiology and histopathology with a weekly MDT meeting. The service is supported by dedicated urological radiologists who provide an interventional service including percutaneous stone surgery, in combination with the endourologist. There is a close liaison with the department of nephrology and renal transplantation, which includes regular clinical meetings and there are opportunities for involvement with the Renal Transplant Unit.
Click here to see recent publications from the Plymouth unit.
Royal Cornwall Hospital, Truro
The unit now has four consultants (Mr R Cox - lead clinician, Mr RG Willis - lead for training, Mr C Blake & Mr N Munro). Additional staff include one SpR, two SHOs, one FY1 & one FY2 house officers. We also have three Nurse Specialists.
The department currently shares a male surgical, and separate female surgical ward, with general, vascular & gynaecological surgery at Treliske Hospital, Truro. There is also a separate Day Surgery Unit at the West Cornwall Hospital, Penzance. At Treliske, we have a dedicated Investigation unit for flexible cystoscopy, urodynamics, TRUS prostate biopsy, flow studies and intravesical chemotherapy. The hospital will soon be embarking on a major reconfiguration of wards and departments so these arrangements will be changing over the next 3 years.
Click here to see recent publications for the Truro unit.
Royal Devon & Exeter Hospital
The Royal Devon and Exeter NHS Foundation Trust provides acute health care for Exeter, and East/Mid Devon, serving a total population of approximately 350,000. We also provide specialised urological care for North and South Devon. We are the Urological Cancer Centre for North, East and South Devon, hosting the weekly complex MDT meeting and carrying out all the major pelvic oncological surgery.
The Urology Unit in Exeter is based at the Royal Devon and Exeter Hospital (Wonford). Clinics and surgery are mainly carried out at Wonford but also at Axminster, Exmouth and Tiverton District Hospitals.
The service works closely with oncology, radiology and histopathology through a weekly MDT meeting. The service is supported by dedicated urological radiologists who provide a 24-hour interventional radiology service. There is also close liaison with the department of nephrology, which includes regular clinical meetings.
We provide an integrated pelvic cancer service incorporating urology, gynaecology and colorectal surgery and plastic surgery. Trainees will have opportunities to participate in this service.
The Department of Urology is actively involved in both undergraduate and postgraduate teaching and in research, both in conjunction with the University of Exeter and with the Peninsula School of Medicine and Dentistry. The Department has a research fellow working under the supervision of Mr McGrath. Trainees in Exeter have access to PCMD facilities including the library.
The current staff consists of four Consultants (Mr R Pocock, Mr MA Stott, Mr M Crundwell and Mr J McGrath), two Specialist Registrars, one CT1/2, one FY2 and one FY1. We also have three visiting consultants from North and South Devon undertaking surgery in Exeter. The two STR trainees move through two 6-month rotations, providing excellent training opportunities in all aspects of urology. The timetable is flexible and allows individual trainees to adapt their programmes to achieve their educational objectives. There is no on-call commitment in these posts.
Special interests of the department include radical pelvic surgery, bladder reconstruction, partial nephrectomy, laparoscopic urology, prostate brachytherapy, female urology and stone surgery. Experience can also be gained in basic paediatric urology.
Click here to see recent publications from the Exeter unit.
Torbay District General Hospital
The Department has an inpatient ward with 17 urology beds and a well-recognised Day Care Unit. Inpatient surgery is carried out in a dedicated operating theatre which includes robotic surgery on the Da Vinci system. There are 2-4 paediatric lists per month in the day unit, where many of the TURP and TURBT cases are also performed.
The department is supported by a well-equipped x-ray department, including full-time interventional radiologist cover. There is a close working relationship with the Oncology Department. There are facilities for urodynamics and a visiting lithotriptor unit.
The present staff complement includes three Consultants (Mr MM Kirollos, Mr JPA MacDermott & Mr RG Mason), one Specialist Registrar, one CT1, one FY1 and one FY2, supported by four WTE Urology Nurse Practitioners.
Severn School of Surgery
Bristol Royal Infirmary
As part of the Bristol Rotation, training at Bristol Royal Infirmary focuses on complex retroperitoneal surgery (RPLND and sarcomas), complex kidney tumours (requiring vascular intervention and/or cardiac bypass), penile surgery and laparoscopic surgery (nephrectomy, partial nephrectomy and adrenalectomy).
Emergency work is guaranteed via a busy, city-centre Emergency Department and is supported by a surgical admissions unit (600 emergency urology cases per year).
The service is complimented by a Day Case Unit offering urology lists 5 days per week, by comprehensive diagnostic services and by "hub-and-spoke" community urology services to large GP practices.
Trainees usually spend 6 months working with Mr Mark Wright and Mr Farukh Qureshi (general urology, laparoscopy and endourology) and 6 months with Mr Tim Whittlestone and Mr Raj Persad (pelvic oncology, open and robotic surgery, RPLND and andrology). The team comprises four Consultants, two urology trainees, one ST2 Trainee, one FY1 trainee, one speciality Urology Nurse and two Cancer Care Nurses.
Click here to see recent publications from the Bristol unit.
Cheltenham & Gloucester Hospitals
The Department of Urology in Gloucestershire is based at Cheltenham General Hospital. All inpatient surgery has now been centralised to Cheltenham although there are regular day surgery lists and outpatient clinics at Gloucestershire Royal Hospital and at the various community hospitals throughout Gloucestershire.
This is a very cohesive and busy unit, with about 6500 new referrals per year, and is one of the two cancer centres for the 3 Counties Cancer Network (Gloucestershire, Herefordshire & Worcestershire). Whilst providing a high volume and wide variety of experience in general urology, the department also provides experience in subspecialist areas including major open pelvic surgery, oncology, laparoscopic surgery, endourology (including specialist stone surgery), andrology and some reconstructive urology. There is a 100 watt Holmium laser on site for specialist stone and prostate surgery and, in addition, there are children's beds for a fortnightly paediatric list.
The department works in close cooperation with the Oncology Centre, based at Cheltenham General, as well as with other specialities such as Colorectal and Gynaecological Surgery.
Current staffing includes seven Consultants (Mr RB Kinder, Mr HW Gilbert, Mr DJ Jones, Mr A Okeke, Mr B Patel, Mr J Ord), three Specialist Registrars, two SHOs/ST3, two PRHO, four Advanced Nurse Practitioners and three Cancer Nurse Specialists.
There is a weekly programme for local and Specialist MDTs at which the trainees are encouraged to participate.
Cheltenham is situated within the Cotswolds, an area of outstanding natural beauty. The town hosts a variety of popular events throughout the year including the world famous Cheltenham Racing Festival, Cheltenham Literature Festival and Cheltenham Cricket Festival. It has a fantastic variety of restaurants, bars and clubs and is a great place for shopping.
Great Western Hospital, Swindon
The Great Western is a modern, busy, district general hospital. There are two consultants (Mr RO Beck and Mr J Iacovou) and two Associate Specialists together with one FY1. The hospital has an excellent IT department with all records, results and x-rays easily available anywhere in the hospital. The urology registrar is responsible for the day-to-day running of the wards and for supervising the F1 house officer.
There are up to 7 weekly theatre lists that the registrar can attend, providing excellent experience in general urology. There are two outpatient clinics per week. Flexible cystoscopy is not routinely part of the registrar program but can easily be accommodated if experience is required. Ultrasound teaching is also available.
Musgrove Park Hospital, Taunton
The Department of Urology is based at the Taunton and Somerset Hospital, Musgrove Park. There are 28 urology inpatient beds and, in addition, a purpose-built Urodynamic Clinical Investigation Unit. Specialist interests of the Department include urological oncology, urodynamics and stone surgery. The Unit was at the forefront of introducing video equipment for endoscopic resection and has continuing interest in this area in the development of lasers in endoscopic surgery.
Current staff comprise four Consultants (Mr M Speakman, Mr RB MacDonagh, Miss A Cannon and Mr T Porter), two Specialist Registrars, one Staff Grade, one SHO, two House Officers, one Clinical Assistant in Urodynamics and two Clinical Assistants for flexible endoscopy.
Royal United Hospital, Bath
The Urology Unit in Bath is based at the Royal United Hospital. This department works from a purpose-built urological unit, including a Urodynamic Clinic and a small meeting room with x-ray screens. There are 29 beds, for both male and female patients, in two 12-bedded units and in side wards. There are paediatric beds available and paediatric urology is undertaken by one Consultant.
The present staff include four Consultant Urologists (Mr C Gallegos, Mr G Howells, Mr TS Bates and Mr J McFarlane), one Specialist Registrar, one Senior House Officer, and two House Officers.
Southmead Hospital, Bristol
The Urology Department at Southmead Hospital is the largest in the region with 4 training posts recognised by the SAC in Urology. The unit has 41 inpatient urology beds and a 5-bedded Lithotripsy Unit; paediatric surgical beds are also available. Subspecialist interests provided in the department are stone surgery (including lithotripsy), urological oncology, urodynamics, reconstructive surgery, andrology and paediatric urology. There is an active research programme in the Department reflecting these clinical areas of interest.
There are close links with the Nephrology Unit at Southmead Hospital and there are opportunities for involvement with the Renal Transplant Unit.
The current staff comprises; Prof PH Abrams, Mr MJ Drake and Mr D Dickerson (reconstruction), Mr DA Gillatt and Mr EW Rowe (uro-oncology), Mr A Timoney and Mr FX Keeley (endourology). The junior staff complement is made up of three Specialist Registrars, one Clinical Fellow, one Associate Specialist, two Clinical Assistants (part-time), two SHOs and three House Officers.
Click here to see recent publications from the Southmead unit.
Weston General Hospital, Weston super Mare
The Department has 12 urology inpatient beds and, adjacent to the operating theatre, a dedicated Endoscopy Suite for flexible cystoscopies. There is also access to the Day Surgery Unit. The Department provides a general urological service to the district and both Consultants spend two clinical sessions each week at Southmead Hospital in Bristol.
The current staffing of the department comprises two Consultants (Mr D Dickerson and Mr J Probert), one Specialist Registrar, one SHO and one House Officer.