EAU-National Societies Meeting 2018: Emergent challenges in Europe

10 July 2018 By Jarka Bloemberg

Around 65 representatives of 39 urological national societies from all over Europe gathered at the Grand Hotel Huis Ter Duin in Noordwijk, The Netherlands, to address challenges in European urology.

“The collaboration between the EAU and the European national societies is essential in advancing our medical specialty,” said EAU Secretary General Prof. Chris Chapple (GB) in his welcome remarks.

The two-day meeting which commenced on 8 June kicked off with an update of the various EAU Offices by the Executive Committee members: Professors Manfred Wirth (DE), Hein Van Poppel (BE), Chapple and Jens Sønksen. Addressing the representatives, Chapple said, “Without the dynamism of urology, we wouldn’t be where we are today. We would like to work more closely with you, to learn from you, and to add value to what you do in your country.

Young generation

The EAU actively supports promising urologists through scholarship programmes and by involving them in the EAU Sections which is, collectively, the clinical core of the EAU. Sønksen, who attended several regional meetings, was impressed by the young generation in the Baltic States and what they have accomplished. “Our aim is to help and support the various national societies, not to constrain. By providing young urologists opportunities to improve their skills and present their work, we offer them a good foundation for their future career,” Sønksen said.

Expanding core responsibilities

There is an emphasis on the technical side with surgeons, but urologists should be more multi-faceted. “We need to change the way we deal with oncology”, said Chapple. “Urologists should be allowed to prescribe new medication which are no longer as toxic as its predecessors. We should be able to change this on a national level.”

Onco-urology was a recurring topic during the meeting. Prof. James N’Dow (GB), Chair of the EAU Guidelines Office, presented a five-year research programme called PIONEER that aims to improve outcomes in prostate cancer by using big data. A consortium of academia where researchers and industry partners are coordinated by the EAU and funded by the European Commission, PIONEER is Europe’s largest public-private partnership in healthcare research.

Electronic health records will be an important source of data and N’Dow urged national societies to provide support. N’Dow: “The ideal setting is to have all prostate cancer patients registered on the PIONEER platform. Can you imagine one million PCa patients from around the world and their health records are in one database? This goal will not be achieved without your support and participation. We need your help in spreading the word.”

EAU Patient Information

Globalisation is also impacting the daily clinical practice in urology. More and more urologists are seeing patients of different nationalities. How significant would it be to provide information about an anticipated procedure in a patient’s native language? Prof. Thorsten Bach (DE), representative of EAU Patient Information, said: “If your patient can understand what to expect in a procedure, for example, they will be better prepared for it and, in turn, it will possibly lead to a better outcome for them. The EAU offers the most comprehensive, complete and unbiased Guidelines. These are now translated into the best and most reliable patient information as well. We need your help to continue with the translations in more languages. Inform your healthcare providers and be aware of what information and translations are available.”

Future of Urology – Part 1

The “Future of Urology” was the concluding topic of the Plenary Sessions on Day 1. During the lecture, Sønksen said: “For 2018, we need more information from national societies to secure the position of urology. What is the biggest challenge for the future of urology in your country?”

Although situations vary per country, there are similarities in the challenges faced by urologists in Western and Eastern Europe. Due to the increase in the ageing population, one of the biggest concerns is work pressure. In Germany it is expected that there will be 20% more urological patients in 2019. The Chair of the German Society of Urology (DGU) said, “There will be a time that we cannot treat all patients.”

In Estonia and Greece, they are struggling to recruit young urologists whereas, in the United Kingdom, they expect equipment shortage vis-à-vis the anticipated number of patients in the future. In Ireland, young urologists generally lean towards robotics, but are not trained adequately in general urology, where the increase in the number of patients is expected to be high.

Several national societies expressed that the EAU should exert more political influence and increase the awareness of urology at an EU level. Significantly, more information and knowledge are needed to have a strong strategy on how the EAU can play a major role in supporting the national societies.

Future of Urology – Part 2

On Day 2 of the meeting, a digital poll-taking took place to gauge the urological needs of participating countries. A total of 57 representatives shared their views by answering multiple-choice questions.

About 72% of the representatives conveyed that urological healthcare in their countries is mainly provided by the public healthcare sector.

A huge number of participants communicated that recruitment of young urologists will be a significant challenge in the future. Only 9% think otherwise. Opinions on whether all urologists should be supra-specialised in the future were significantly divided: 41% agreed, 34% disagreed and the remaining were neutral. Half of the participants anticipate a division between operating urologists (who perform major surgeries) versus non-operating urologists (who perform minor surgeries or none at all).

Majority of participants agreed that the EAU should recommend a urological curriculum for medical schools (77%) and for urological residents throughout Europe (88%). More than half agreed that exams such as the Fellow of the EBU (FEBU) qualification should be mandatory to practise urology in Europe. About 89% agreed that re-qualification and CME should be compulsory for urologists after residency.

When asked what is needed to cope with the growing number of urological patients, the top three opinions were: involvement of nurses/mid-level providers (26%); increased recruitment of medical students and residents into urology (23%); and improved quality of education (22%). About 93% conveyed that specialised nurses or other mid-level providers should be encouraged to take over specific tasks normally performed by urologists such as peri-operative counselling (34%), evaluation and treatment of some categories of patients (29%), and prescription and renewal of certain medications (16%).

An astounding 93% voted that the EAU should work towards greater patient education and involvement, and 92% voted that the EAU should closely work together with patient groups.

The meeting was considered by many participants to be truly productive. The EAU will incorporate the valuable insights from the meeting with the objective to further boost urology in Europe and beyond.

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