title: Urology training in the developing world: The trainees' perspective in Kurdistan, Iraq.
abstract: OBJECTIVE
  To analyse the advanced systems of urology residency in the developed world, to compare them to a system in the developing world, and thereby identify the shortcomings and make recommendations to improve residency programmes for urology in the Kurdistan Region of Iraq.
  
  
  METHODS
  A survey was conducted amongst the urology Residents (55) in the three governorates of the Kurdistan Region of Iraq, to assess the accessibility of the training programme, the types of the residency programmes, skills acquisition, the use of modern technology for teaching and assessment, the environment of the settings of practice, and the status of research in their training.
  
  
  RESULTS
  An overwhelming majority (88%) of trainees reported difficulty in securing a training position. A high proportion (43%) felt disappointed at the beginning of their training. There is no unified curriculum of training, and more than two-thirds of the respondents reported a lack of a proper evidence-based medical education. There is no formal subspecialty training programme. Of the respondents, 65% referred to the difficulties in the environment for training, and that there was a low level of research involvement (12%).
  
  
  CONCLUSIONS
  Urology training is not easily accessible, there is no unified programme of residency, there are limited facilities, and a minimal assessment of practical skills. The environment for practice needs enormous improvements and a strong foundation for research should be created.
authors.affiliation: Department of Urology and Renal Transplantation, Sulaimani Surgical Teaching Hospital, Sulaimani City, Kurdistan Region, Iraq.
authors.forename: Goran
authors.initials: G
authors.lastname: Friad
authors.affiliation: Fertility Centre, Sulaimani Maternity Teaching Hospital, Sulaimani City, Kurdistan Region, Iraq.
authors.forename: Kawa
authors.initials: K
authors.lastname: Sabah
authors.affiliation: Urology Department, Sulaimani Surgical Teaching Hospital, Sulaimani City, Kurdistan Region, Iraq.
authors.forename: Ismaeel Hama
authors.initials: IH
authors.lastname: Ameen
keywords: Developing world; EBM, evidence-based medicine; Residency; Training schemes; Urology