Year : 2014 | Volume
: 30 | Issue : 3 | Page : 239--240
The shrinking world
Department of Urology, All India Institute of Medical Sciences, New Delhi, India
Department of Urology, All India Institute of Medical Sciences, New Delhi
|How to cite this article:|
Kumar R. The shrinking world.Indian J Urol 2014;30:239-240
|How to cite this URL:|
Kumar R. The shrinking world. Indian J Urol [serial online] 2014 [cited 2019 Sep 17 ];30:239-240
Available from: http://www.indianjurol.com/text.asp?2014/30/3/239/135632
While the 20 th century has been hailed for its industrial revolution, the current century must surely be heading toward a tag of the "information and communication" era. Rapid innovations in how information is gathered, disseminated and consumed have resulted in increased opportunities in all spheres of life, including medicine and healthcare. Travel has become easier and the Internet takes care of those who cannot or do not wish to travel. The recently concluded annual meeting of the American Urological Association saw more than half its attendees coming from outside the US. Live webcasts ensured that even those who could not attend could access information in real time. One of the best video awards went to an innovation that enables the use of a smart phone to aid endoscopy, capture videos and live transmission. 
These developments have the potential to make a large impact on Indian urology in the realms of education and patient care. We are aware of the huge disparities among urology training programs. Web-enabled classrooms and tele-mentoring have been used for a variety of medical subjects and, while they cannot replace the role of hands-on patient care in learning, they can certainly aid in developing an academic foundation and providing a platform for resolving queries.  Simulators and dry and wet laboratories can decrease our dependence on patients for hands-on training and provide an alternative opportunity for students who fail to get enough clinical exposure in their training centers. These may work not just for trainees but also for practitioners who wish to learn new techniques or polish their existing ones. In the area of clinical care, telemedicine and direct-at-home care are already realities and urologists who frequently deal with the elderly who find it difficult to travel may soon find themselves being consulted for remote advice.
Despite the classroom coming into our homes, travel and global exposure play an important role in personality and overall skill development. "Stepping out of the well" widens horizons and forces alternative thinking. At the same time, it reinforces faith in our own institutions when trainees see the same practices being followed worldwide. There can be no greater stamp of approval than seeing your peers follow the same principles that you have been taught.
This issue of the IJU carries articles that exemplify the "shrinking world" in urology. Collaboration between basic and clinical sciences is critical for the development of any specialty. One such collaboration from the Post Graduate Institute of Medical Education and Research, Chandigarh, presents a unique report on metallothioneins expression in RCC while another from Italy details telomerase instability in bladder cancers. , Pandarinath et al. present a large experience of laparoscopic donor nephrectomies and, apart from highlighting the outcomes, bring forth a critical issue of how the vascular pedicle should be controlled.  This remains a controversial topic and the critical comment that follows this article tries to put this in perspective.  The "art" in the practice of medicine is highlighted by Jindal et al., who evaluated the applicability of the IPSS score in Indian patients.  Most of us probably never realize how much our own beliefs influence our interpretation of a patient's answers to our questions. This article shows how answers may differ depending on how we administer a questionnaire.
This issue also carries a symposium on non-prostate robotic surgery, guest edited by Dr. Monish Aron, Professor of Urology at the University of Southern California, USA. These 10 reviews cover the state-of-the-art in robotic surgery related to the kidney, bladder and other non-prostate organs. The team at USC has pioneered minimally invasive urology and has one of the largest combined experiences in this field. The respect they enjoy is highlighted by the list of authors of these articles who represent most of the major robotic centers around the world. These reviews will be a treat for both robotic and non-robotic surgeons as their content is relevant beyond just the surgical approach. I would like to acknowledge the contribution of Dr. Aron and the authors for this symposium who have contributed such well-reviewed articles.
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