GENERAL INFORMATION - DEMOGRAPHICS
Sweden is a rather small country with a population of a little more than 9 million people. There are about 380 urologists in Sweden including around 70 residents in urology. Urologist: population ratio is then about 1:24000. Sweden is a member of the European Union (EU) and the European Board of Urology (EBU). 42 Urological Departments are operating all over the country.
NATIONAL UROLOGICAL SOCIETY
Svensk Urologisk Förening (SUF)
Blivande Urologer i Sverige (BUS)
To become a urologist in Sweden you have to go through three steps of education: Medical Shool 5,5 years, internship 1,5-1,75 years and then residency for at least 5-6 years. You apply for a residency as for any other position of work. Most departments of urology will first offer a trial period of about six months. During this time the resident-to-be works in the speciality, gets acquainted with the colleagues and both parties usually develop a mutual understanding. Until now residents in urology in Sweden have had 1-2 years of general surgery, 3-6 months of anaesthesiology and 2½-3 years of urology in their training. We have also had the option for other rotations such as gynaecology, nephrology, paediatric urology and radiology. There is often collaboration between smaller training centres and university hospitals in order to cover all aspects of urology for the resident. The order of different rotations is something you decide in agreement with your tutor and your head of department at the beginning of residency and often you sign a formal contract. During urology training in Sweden most residents take an active part working in the emergency room (ER). We share on-call service with the residents in surgery. Most hospitals now require that you take the ATLS (Advanced Trauma Life Support) course. In addition there are 1-2 specialist competence courses per year for residents in urology in Sweden. These courses are for 3-5, and cover most aspects of urology. They are arranged so as to allow for everyone to take advantage of them at some time during residency. Often we are required to have had at least six courses. The separate regions in Sweden also organise day courses for residents and we usually try to invite all residents from all regions, even though only 15-20 normally will be able to participate each time. We are expected to work full-time with patients in the wards, in the out-patient clinic, in the operating theatre and in the ER, thus gradually acquiring an understanding of, and familiarity with, the care for urological patients and surgical techniques. We also have a responsibility to teach residents and students during the every-day-work.
The Swedish Association of Urology, SUF (Svensk Urologisk Förening) has established a list of competence to be achieved for becoming a qualified urologist. It is the responsibility of the tutor and the head of department to supervise that these goals are met with. Our training is of one of continuous control and we do not have a compulsory Swedish exam in urology. We are encouraged to sit the EBU exam. Those who have successfully passed the EBU exam will get a grant of 5000 SEK (almost 550€) from SUF. BUS (Blivande Urologer I Sverige) is the Swedish Society of Residents in Urology and is a democratic and independent branch organization of SUF and has its own executive committee. After having completed residency with written consent from the heads of departments where you have trained, your qualification is issued by the National Board of Health and Welfare. This is how it has been until now. Lately our speciality is threatened in Sweden because of a decision from our Ministry of Health and Social Affairs to make urology a sub-speciality of general surgery. This means that we might have to become fully qualified as general surgeons (which takes 5-6 years) before we can start urology training. This decision was taken despite massive protests from urologists and general surgeons alike. We fully agree that this would seriously impair the education for both urologists and general surgeons. Until now we have tried peaceful negotiations but as it has not worked more drastic measures are planned. The fight is still going on!
As a qualified specialist you can apply to become a senior registrar. At university departments you often train to become a sub-specialist for example in urological oncology, neurourology, stone disease or LUTS. To become a consultant in urology with responsibility for a section in your department five years of additional training, after qualification as a specialist, is recommended. In most university departments it will be difficult to become a consultant if you have not got a PhD degree.