The future of urology.

The Future of Urology has been written in times of economic downturn, with the inevitable effects on health sector spending. Nevertheless, this document aims to define a path whereby the EAU can play a pivotal role in ensuring the highest standard of care throughout Europe, and by setting standards, throughout the rest of the world. The future of urology will be dependent on improved education and training leading to high quality urological care, and to developing a service that is patient focused. The patient focus is becoming increasingly important in urology. This means providing full information about disease processes and urological procedures to patients and allowing them to judge the quality of the urological service that they may choose. Education must start in medical school and as 5% of community medical practice is urology then every medical student must receive urological training. This also applies to nurses and the other professions allied to medicine (PAMS). The EAU should provide a urological curriculum for training of medical students, nurses and PAMS, as well as the more conventional curriculum for postgraduate training and continued medical education for urological specialists. An integrated EAU Knowledge and Learning Centre would provide an invaluable resource to patients and to those who deliver urologic care alike. With high quality training must come a vigorous assessment of knowledge and competence. In the future, the competence of all those delivering urological care will need to be assessed. For urologists in training and specialist urologists this will include not only an assessment of knowledge but an assessment of surgical competence. Improving quality will be supported by the continued subspecialisation of urology, ensuring that all urologists have a surgical portfolio which ensures their competency in the procedures they deliver. This will inevitably result in a concentration of urological services and indeed to the development of larger urological centres. The concept of Centres of Excellence could be developed to include all aspects and subspecialties of urological care. The SPO envisages that all urology will be carried out in Centres of Excellence which will vary in terms of their size and the range of urology offered, but nevertheless all urological care will be of the highest quality. Finally, the future of urology will depend on the medico-political interface and the EAU has a great deal to offer in this respect. The patterns of urological care differ throughout Europe but this should be seen as a challenge for the EAU to define quality, irrespective of the different methods of healthcare provision. The EAU has made extraordinary advances in the last two decades and the SPO hope this document will support the EAU's efforts to maintain its aim of improving urological care for the benefit of patients.