title: Urology training in the developing world: The trainers' perspective.
abstract: BACKGROUND
  Despite producing some of the leading urologists in the world, urological training in the developing world is marred by inconsistency, and a lack of structure and focus on evidence-based practice. In this review we address these issues from the trainers' perspective.
  
  
  BACKGROUND
  Teaching the art and science of urological practice is a demanding task. It not only involves helping the resident to develop the depth of cognitive knowledge, but also to have an appropriate surgical judgement, and an ability to act quickly but thoughtfully and, when necessary, decisively.
  
  
  CONCLUSIONS
  The surgeon must have compassion, communication skills, be perceptive and dedicated. Most importantly, however, he or she should have the ability to cut and suture. Not all of these can be inculcated in the training programme, even with the best of efforts. The selection of an appropriate candidate therefore becomes an issue of pivotal importance. The changing focus of urological training incorporates research and evidence-based practice as essential components. It is particularly important in the developing world, as there is a dearth of standardised practice models across the healthcare system. Encouraging female residents can be done by improving and tailoring the working conditions. The 'brain drain' is a major problem in the developing world, and bureaucracy and government need to take appropriate measures to provide high-quality healthcare facilities with room for professional growth.
  
  
  CONCLUSIONS
  The future of urology will depend on improved education and training, leading to high-quality urological care, and to developing a service that is patient focused.
authors.affiliation: Department of Surgery, Aga Khan University, Karachi, Pakistan.
authors.forename: M Hammad
authors.initials: MH
authors.lastname: Ather
authors.affiliation: Department of Medical Education, Karachi Medical and Dental College, Karachi, Pakistan.
authors.forename: Tahmeena
authors.initials: T
authors.lastname: Siddiqui
keywords: CPSP, College of Physicians and Surgeons; Developing world; EBM, Evidence-based medicine; Programme; Residency training; Urology