Dr. Kristy Borawski shares what life is like as an academic urologist. She specializes in reconstructive urology, neurourology, and urodynamics. Today, she discusses the schooling, lifestyle, and what it’s like to be a woman in urology. And if you think urologists only treat men, you’re wrong!
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[01:20] Interest in Urology
By the end of her fourth year, Kristy wasn’t really sure what to do. She looked at OB, urogynecology, and urology and ended up doing some selectives.
She didn’t think this really affected her application. It didn’t even come up on the interview trail. The big thing she thought was lacking was urologic-specific research. Although she has done some HIV research when she traveled internationally.'It's just trying to see that you put effort into something. It's doesn't necessarily have to be urologic-specific.'Click To Tweet
Kristy didn’t have any idea what a urologist was. No one in her family was in medicine. She came into medical school completely naive and green. She didn’t feel any bias being a female during her urology rotation as she did in other male-dominated fields.
She never actually thought she would like surgery but she did end up really liking surgery. However, she didn’t like the general surgery clinic she had done.
What she liked was the long-term care and the relationship she saw with the urology faculty and their patients. You have to have a sense of humor and be able to have comical conversations sometimes with your patients. She likes the rapport that she saw built there.
Moreover, the surgical breadth was huge much more so than she saw in the other fields. In just one day, the degree of difference in procedures you see was astronomical. This is what led her to the field. Secondly. the lifestyle was attractive to her.
[Related episode: An Academic Urologist Shares His Thoughts on the Field]
[06:00] Life Outside of the Hospital
As of this recording, Kristy was on her way to pick up her kid at school. It’s a matter of what you deem as your necessities. You just have to not allow people to talk you out of those priorities.
You can definitely have a life outside of the hospital. In fact, Kristy is a triathlete. She does Ironman events. She does a lot of things outside of the hospital. She has the time to do so. And this could mean sometimes waking up at 3 am to work out.
It’s not a nice and easy life but you make your opportunities and keep your priorities and stick to them.
You have to take care of yourself so you can take care of the people around you. It can get to easy to be sucked into the idea that you have to be there for them all the time. Or that something bad is going to happen or no one else can do it as you do.'It's giving yourself permission to put your family first and to put you first sometimes. You matter just as much as those you're taking care of.'Click To Tweet
[Related episode: Medical School Mom – Prioritizing Family, School and More]
[08:25] Types of Patients
Kristy is in a subspecialty area of urology. She deals with incontinence and neurourology mainly, and some reconstructive urology.
Her typical patient population includes those with spinal cord injuries, Parkinson’s disease, and male incontinence. Her bread-and-butter people are those that need artificial sphincters, Botox, meds, etc. For the most part, she’s very much a “quality of life” urologist.
She loves how urology allows her to have long-term relationships with her patients, especially those with spinal cord issues.
[10:25] Taking Calls
Taking calls is not bad for her. Being in an academic group, Kirsty has a lot of partners. So she gets to take calls about 4-5 weeks of calls per year, taking calls a week at a time. Such a week can be miserable, but not that bad. In a week, she could get called in overnight twice.'Even the most miserable week is still not bad.'Click To Tweet
Emergencies can happen but it’s not as bad as the calls would like in general surgery. Being in academics, Kristy also has a buffer with two layers of residents under her. They’re getting the patient phone calls for her as well as putting a catheter in the middle of the night. This is something that someone in private practice won’t get to have. That being said, she doesn’t get paid for taking calls. It’s just part of her job.
[11:35] Academic vs Community Setting
Seeing what her fellowship mentors’ practice was like, it was something she wanted to do. It wasn’t anything feasible in a private practice world unless you’re in one of those huge supergroups that just didn’t exist in the place she wanted to live.'In order to see the patients I wanted to see and practice the way I envisioned to practice, it just wasn't supported in a private practice framework.'Click To Tweet
[12:15] The Training Path
Residency can take five to six years. Kristy did six years, while most are now five. Once you’re done there, you go out and you get to take your boards. You sit for your written boards after you graduate residency. Then you sit for your oral boards after you’ve been out in practice for 18 months.
Kristy chose to do a year of fellowship after her six years of residency. But she didn’t take her boards for a time after finishing residency.
Fellowships can range from 1 to 3 years, mainly 1-2 years. This depends on what field you’re going into.
She credits her mentor as to why she chose her kind of fellowship. She had never met a better surgeon or a more knowledgable individual than her mentor. So she was just naturally drawn to what she does.
They had a separate dedicated lab year and she chose to spend it with her mentor. She really enjoyed the quality of life aspect and in making that improvement in people’s quality of life.
In terms of competitiveness, matching into urology is quite competitive. It’s an early match program. Usually, it’s a 60%-70% match rate. There are many that can go unmatched. They look at how much effort you’ve put in during your training.'It's not just about the grades you got. It's about what can you bring to the program in totality.'Click To Tweet
[15:15] Special Subspecialty Opportunities
In private practice, there are a lot of different options you can get into. Within oncology, you may specialize in bladder cancer, prostate cancer, kidney cancer, etc. You may get into female urology, incontinence, reconstructive urology, infertility, endourology and robotics, pediatric urology, just to name some. Within each of those, there’s the ability to subspecialize further within those fields.
[16:05] How DOs Can Stand Out
Kristy believes DO’s do the same thing MD’s do. Get exposure. Show your interest and get your research in. It doesn’t have to be urology-specific. Just try to show who you are. Be aggressive. Get out there and do things.
[Related episode: The One Thing You Need to do to Stand Out as a Premed]
[17:10] Working with Primary Care Physicians
Kristy wishes to tell primary care providers that more people want to talk about leaking. It’s okay to take a bunch of medicines. It’s okay to try to treat it themselves and they don’t necessarily always have to refer out for every little thing.
On the flip side, the demands increase in primary care, it’s getting harder and harder for them to address each of these issues as they arise.'You just have to be more comfortable and more aggressive in starting the conversation.'Click To Tweet
All too often, people think that it’s just a natural part of aging that they’re having some of these symptoms. They just have to deal with it as they’re getting older. However, it’s about understanding that it’s not the case and there are things they can do.
[18:05] Advice to Women in Medicine
Just enjoy the ride a bit more. When she looks back to residency, it was an awesome time but she didn’t appreciate it as much as she should have while going through it.'There's truly nothing else than the camaraderie among the residents.'Click To Tweet
Call out programs that don’t support females. There are now social media platforms that provide very good support for women in these fields. More importantly, find a mentor whether it’s in your field or not.
It’s also important to stop looking at yourself as a female trying to go into this field as opposed to seeing yourself as a great applicant looking to go into this field. Stop that mental negative thought of being disadvantaged because of your gender. You’re here and you’re part of everybody else regardless of your gender. That’s how it should be.
Have someone that has your back. This could mean being able to go to your dean’s office or seeking help from your faculty. Seek a female mentor. There are enough networks and they can get you in touch with someone in your field who’s able to support you.'Seek a female mentor. They're out there. They may just not be in your specific field but they're out there.'Click To Tweet
[Related episode: How to Improve the Path for Women in Medicine]
[20:35] The Most and Least Liked Things
Kristy likes hearing fun, interesting stories. You just have to laugh occasionally at what you do and what people allow you to do with their bodies.'I haven't found another job where you can just laugh as much sometimes about what your day-to-day life is.'Click To Tweet
She also feels so blessed to have some phenomenal partners and people she works with. As a whole, they’re pretty laid back and they don’t take themselves too seriously. And it makes life and your day-to-day work a whole lot more enjoyable.
Conversely, what she likes the least about her field is sometimes the sexual inuendos from some of the older male patients that still haven’t gotten up with the times.
That said, the longer she’s been doing this, it’s also been happening less and less. And she has gotten better at cutting it off. Just be comfortable with saying it’s not okay if you find yourself in a situation you’re not comfortable with.
[22:44] The Biggest Myth About Urology
At their hospital, the biggest myth is that you have to take a year off to do research. The other biggest misconception is they only treat men. 50% of their patients are women. So it’s not just men talking about their penises and prostate cancer. There’s a whole lot of other aspects in urology that are out there that are awesome.
[Related episode: A Community Urologist Shares Her Journey and Career]
[23:15] Final Words of Wisdom
If she had to do it all over again, she’d still have chosen to be a urologist. To those who might be interested in this field, Kristy encourages students to be more wide open coming into this. Otherwise, you can really miss out on some amazing opportunities that are out there and in fields that you may not be exposed to or experienced with.
Just be open. Go out there. Shadow other things and not just wait for your rotations to pop up. Go out on random days and reach out to different specialties to see what they do. And when you’re there, spend time with them.
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