Patients with urinary and reproductive organ injuries often travel long distances for treatment in Kigali, as the country has just 15 urologists for a population of 14 million. ALSO READ: Health: Urinary troubles in elderly men To address this gap, resident doctors—physicians in postgraduate training—are being equipped with skills to provide treatment in regional hospitals. Dr Emile Rwamasirabo, a retired urologist and surgical educator, said the training focuses on enabling residents to manage the types of cases they commonly encounter in hospitals. ALSO READ: Understanding prostate cancer “We discuss the training residents need to care for patients with injuries to the urinary and reproductive systems, many of which are severe and require hands-on clinical experience,” he said. For several years, US-based specialists have supported the programme by working with local teams to strengthen resident training. According to Rwamasirabo, this partnership allows trainees to gain experience in managing complex cases that are not routinely handled in local facilities. ALSO READ: Prostate cancer survivor, 77, urges men to test early Once well trained, residents are able to manage more than 80 percent of the cases patients present with, which are the most common conditions. However, they occasionally encounter rare and highly complex cases that require a higher level of expertise. “Becoming a fully trained urologist takes about five years after graduation, while reaching expert level can take up to 10 years. Even after graduation, doctors continue to receive ongoing training to develop their expertise,” Rwamasirabo said. He added that since no doctor can cover all areas of urology, some residents choose to specialise in specific fields, such as cancer management or reconstructive surgery for injuries. Doctors, he noted, build expertise in particular areas to manage very complex cases, recognising that no one can be a super-specialist in everything. Rwamasirabo also highlighted the role of experienced specialists in mentoring younger doctors, ensuring that knowledge and skills are transferred and sustained within the healthcare system. “Most specialists currently work in major hospitals in Kigali, but our goal is to have trained doctors in provincial and district hospitals. Even second-level and district hospitals should eventually have specialists. With trained doctors and adequate resources, specialists will be able to work there,” he said. The number of urology specialists in the country has steadily increased. In 2012, there were only two, but today the number has grown to 15, with a target of reaching 30 by 2030. “Expanding the number of specialists would reduce the long delays patients face before receiving treatment. Some patients wait one or two years, and many have families who are affected when the patient is incapacitated. Patients should receive care when they need it,” he said. The residency programme began in 2013 with just two trainees due to a limited number of trainers. As more specialists completed their training and became trainers, the programme expanded. The programme now has 17 residents. The five-year programme is primarily hospital-based, combining patient care with study, research, and supervision. Residents learn through reading, mentorship, research, and hands-on clinical experience. Despite limited equipment and other challenges, Rwamasirabo said the doctors remain eager to learn and determined to become experts.
