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P.W.: Absolutely! If you teach others, you have actually to think about what you are doing, because you cannot teach if you don’t think. I think that when you become a teacher or a mentor you should know of what you are talking about. It’s a very good idea to do some type of research early on your career, because that’s very stimulating for your intellectual, power and it gives you the opportunity to reflect on what you are doing. The other thing which I think is very important for surgeons is to follow your own results. So, you really have to know your own outcomes, because you cannot teach otherwise. And you don’t know your outcomes if you don’t measure them very carefully.
T.S.: Do you like sharing your experience and tips with others? Are you proud of helping other urologists to improve?
P.W.: Yes! But I think that that’s one of the biggest problems in urology and in surgery in general. People learn how to do something and then they want to keep that. They think: “I want to be the expert”. “If I teach someone else in my own department, he will take my cases”. A lot of people are afraid of competition. I’m not like that. So, I think if you are a good surgeon and you know what you’re doing you will always have patients. So, you can teach others, it’s not dangerous!
F.N.: Did you have a mentor during your first steps in the field of urology?
P.W.: Yes. I had a very good research mentor for my PhD, who was a super smart person, much smarter than me. He taught me a lot about how to think scientifically about things. So, I think he was one of my best mentors. Although he didn’t know anything about surgery, he knew everything else. I had also one mentor in general surgery and with him I did a lot of gallbladders and hernias. He taught me the basic things in surgery. That was very important. Then, when I started in urology, I had several mentors who helped me. In Sweden, back then, you started basically with endourology and then you went to the bigger surgeries. I had two colleagues in the urology department, who helped me a lot with endourology. After, a very good surgeon was the one who taught me how to do cystectomies basically. He also taught me the idea that every surgery is divided in different steps. He did the surgery exactly the same way every day. He was doing the cystectomy and he was going just through the same steps. He was also able to tell you during the surgery “now it’s 45 minutes to go, now it’s one hour and a half to go...”. Once I understood that, that’s when I learned surgery basically. I understood that instead of art, surgery is a deliberate practice, in which you follow certain number of steps
and you do them in a certain way. You repeat the same steps all the time and then you become a good surgeon. It sounds boring, but it’s not boring. It’s actually the way to go.
F.N.: In your opinion, which are the most important things a young urologist should have, in order to succeed?
P.W.: It depends from how do you see your career. Do you want to be an office urologist, do you want to become an academic urologist? I think it’s also different in different countries. I chose early in my life to have an academic career. Already before starting my residency in Urology, I had a PhD. So, I already was half way in my academic career when I started. And I usually say to everyone don’t forget, you operate with your brain, you don’t operate with your hands. Because I see a lot of people who just want to operate, operate, operate. But it doesn’t matter. You can operate as much as you like, but what happens to your brain is going to decide whether you will become a good surgeon or a bad surgeon. It’s not so much what happens in your hands. The important part it’s how you reflect on what you do and how you follow your outcomes. I think that if I were in Greece and I wanted to do academic Urology, I would spend the first years after my MD doing science in order to train my brain, so that I could get a good position. I would also maybe go abroad to do like a fellowship. I have met a lot of international fellows from Greece in different countries in Europe and I do think that this is something I would encourage you to do, especially if you want to do a career in a way that you do a lot of surgeries or maybe an academic career. It’s also good because you see how they do it in other hospitals, in other countries. So, I think travelling around it’s well worth doing.
T.S.: We live in the era of minimally-invasive surgery. Do you believe that residents should be still trained in open surgery? Do you believe that a urologist should start with open surgery and then procced to the minimally-invasive path?
P.W.: No. I think that we are leaving open surgery. When we started, everyone said that we have to teach open surgery. But I don’t teach open surgery. Most of the residents in Karolinska don’t learn how to do open surgery anymore. Many of them have done thousands of robotic procedures and they seem to do fine. So, I think we still need to have few surgeons to be able to do open surgery, but I don’t think everyone should know how to do it.
Tεύχος 23 | Μάϊος-Ιούνιος 2023
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