Urology in Malaysia had its beginnings in the 1960s, with the endeavors of the late Dato' Sreenevasan. As in other countries, at that time urology was the concern of general surgeons. Ironically, it was hemodialysis that paved the way for urology to develop as its own specialty. Dato' Sreenevasan was instrumental in bringing hemodialysis services to Malaysia. With the development of this service, the public's attention and, more importantly, that of the government was drawn to the importance of urology.
With increased public and government attention, Dato' Sreenevasan lobbied for funds and space to develop urology as a specialty.
In 1968, the first Urology Unit was started in Malaysia at the General Hospital, Kuala Lumpur (GHKL), which was the biggest hospital in the country at that time. The Institute of Urology and Nephrology (IUN) was started at the GHKL in 1974 and had its own block, consisting of wards, operation theatres, an intensive care unit and a dialysis unit.
Since then, urology has grown as specialty in its own right with the development of urology departments in many other hospitals. Currently within the Ministry of Health (MOH) there are urology departments in eight of the 14 states in Malaysia. There are also urology units in the three main university hospitals and urological services are available within many private hospitals in nearly all the states of Malaysia.
The Malaysian Urological Association (MUA) had humble beginnings in 1974, within the confines of the new urology block at the GHKL. When the Association was first founded, there were only four members and Dato' Sreenevasan was the founding president. Currently, the MUA has 82 full members, with all practicing urologists in Malaysia being members. Since its inception, the activities of the MUA have grown from journal club sessions to the organization of major international conferences and workshops.
The first Malaysian Urological Conference (MUC) was held within the grounds of the General Hospital in 1991. Since then, the MUC has grown to be one of the major medical meetings in the country. In 2011, the MUA will be hosting the 20th MUC in conjunction with the Asia Pacific Society of Uro-oncology meeting in Kuala Lumpur.
The MUA has been at the forefront in urologist training in Malaysia. In the beginning, this training was mainly a residency style of training, with the first 3 years in the IUN and a further year in an international center. This was subsequently consolidated with a structured program involving the main urology centers in the MOH and universities. In addition, private urologists contributed to the teaching program. The training was then formalized with the formation of the Board of Urology under the MUA in 2000. The main aim of the board is to coordinate urology training, as well as to provide a comprehensive and structured training program. This was the first board-based training system, for any specialty, in Malaysia. The first board examination was conducted in November 2000 with two candidates. Since then, the board examination has become well established and accepted by the government and medical fraternity. Another milestone was achieved in 2008 when the board examination was held in collaboration with the Royal College of Physicians and Surgeons of Glasgow. This was a joint examination held in Kuala Lumpur with four local examiners and three examiners from Glasgow. The format of the examination is the same as the intercollegiate examinations in the UK. Two of the three candidates were successful and were awarded both the Malaysian Board of Urology certificate and the FRCS (Urol, Glasgow).
We have held two further examinations with four overseas candidates taking the joint examination for the first time in 2010. The fourth joint examinations will be held again in November 2011.
Urology training in Malaysia has attracted overseas candidates keen to undergo their full training in Malaysia. Currently there is one trainee from Brunei and another from Sudan in the training program.
Malaysian urology has close links with Australia and UK for training. Many of the urologists in Malaysia have completed part of their training in one of these countries. The MUA and the Urological Society of Australia and New Zealand (USANZ) signed a Memorandum of Understanding (MOU) in 2006 that includes an agreement for two training posts for our trainees in their final year. This cooperation has been very successful and our trainees have benefited greatly from their time spent in the urological centers in Melbourne and Adelaide.
Urology in Malaysia had made great strides since its humble start in the late 1960s to its present status, with most of the latest equipment and facilities available here in Malaysia. There are three Da Vinci robots in the Malaysia and many laser machines for the treatment of both stones and prostate diseases.
Endourology and the treatment of urinary calculi forms the bulk of the workload of many urologists in the country. Renal transplantations are performed regularly in three main hospitals in Kuala Lumpur, primarily with live related donors. We are seeing a gradual development of subspecialties within Urology and this trend will continue as more urologists are trained.
There is a growing trend for research in urology. The MUA recently organized a Malaysian Urology Research Forum with the aim of developing urological research. The ultimate aim is to form a Malaysian Urology Research Group to allow collaborations among the various institutions. This will allow us to pool resources and data to generate meaningful research.
The MUA is committed to developing urological services to ensure easy access in all parts of the country. We will also continue to enhance and strengthen the training program to ensure an adequate ratio of urologists per head of population. In this regard, closer links with urological communities within Asia, as well as across the rest of the world, will be strengthened and we will continue to look for opportunities to host international conferences and meetings. We also hope to ensure that research in Urology continues to thrive to ensure further progress in urological services.