For Doctors

Preceptorship Program for Surgeons and other Clinicians

 

Continence Matters provides an opportunity for urologists with an interest in incontinence and prolapse surgery to observe consulting and urodynamics sessions, and observe and assist in theatre. This is an advanced intensive training experience.

Urologists who have visited Continence Matters are:
(read their reports below)

  • Dr Briony Norris, Melbourne, 2016
  • Dr Karen McKertich, Melbourne, 2013
  • Dr Audrey Wang, Sydney 2013
  • Dr Lydia Putra Johns, Ballarat, 2013
  • Dr Kate Gray, Brisbane, 2012
  • Dr Alison Blatt, Newcastle, 2012 
  • Dr Elaine Ooi, Perth, 2012
  • Dr Karen McKertich, Melbourne, 2012
  • Dr Claire Wheelan, Orange, 2010
  • Dr Karen McKertich, Melbourne, 2007

"In February 2013, I spent 3 and a half days with Dr. Samantha Pillay as part of a preceptorship sponsored by Astellas Pty. Ltd.

Dr. Pillay is a leader in the area of Female Urology and is widely respected for her experience, dedication and advocacy. The time I spent with her gave me the opportunity to observe her operate, consult and run her practice.

I was able to watch and assist with a variety of procedures including tibial nerve stimulation, intravesical Botox injection, sacral neurostimulation and pelvic organ prolapse repair. I also observed a number of patient consultation sessions and learned more about practical things such as pessaries and post-operative programming of sacral neurostimulators. At many junctures, I was able to ask questions and there were quite a few one-on-one “mini tutorials”.

Having been in specialist practice myself for 4 years, this experience was ideal. It has helped refine my own clinical approach; by highlighting areas that would benefit from change and by reinforcing my practices that are appropriate. Private practice can limit exposure to the activity of one’s peers and experiences like this are a great way to calibrate and improve what we do. Furthermore, the opportunity to have close contact with an experienced practitioner was invaluable.

I am deeply grateful to Dr. Pillay for sacrificing her time for this preceptorship. Similarly, I appreciate the time put aside by Dr. Ailsa Wilson-Edwards, Esther Michelsen, the staff of Continence Matters and the staff of Calvary Hospital. Finally, a thank you goes to Astellas for their generous sponsorship."

"While the entire field of urology continues to evolve, female urology remains a small part of most general urology practice. While I was completing my FRACS this fact was reflected in the exams where female urology was barely tested. Fortunately this aspect of urology is becoming more seriously recognised as an important subspecialist field and it’s probably no surprise that this realisation has coincided with an influx of female trainees and consultants.

I was fortunate to have exposure to female urology as a third year trainee at Concord Hospital with Drs Lewis Chan and Vincent Tse. However, after completing a research fellowship in hypocontractile bladder and then a robotic oncology clinical fellowship, I returned home to the reality of practising urology as the only female between Sydney and Brisbane.

Well, it doesn’t matter how many GP talks I gave on PSA, erectile dysfunction and LUTS, it seems my gender wins out and my practice is heavily female orientated. As a trainee one of my bosses told me I would always remember my first patient – and he was right: she cried in my office for close to half an hour. The burden of illness in the community of unmanaged, unmanageable or poorly managed female urology seems to be enormous from where I’m sitting.

I was fortunate to receive an offer of a preceptorship for three days with Dr Sam Pillay who is one of the few urologists in Australia and New Zealand offering a purely female urology service. Working in Adelaide means that this practice drains not only South Australia but also the Northern Territory. And being so subspecialised means that much of the casemix is tertiary referral – from colorectal surgeons, gynaecologists and urologists – with complex issues, multifactorial illness and multiple previous operations the norm.

We spent each morning in theatre and I joined her in consulting rooms and urodynamics in the afternoons. While we barely touched on basics of simple cases such as stress incontinence, the focus remained on the diagnostic dilemmas, the management failures and the operative challenges faced in complex female urology. This was an intensive masterclass delivered by a passionate and tireless teacher. I don’t recall a moment passing by without a learning point or clinical tip. Operative cases included mid-urethral mesh sling, fascial sling, Interstim insertion, prolapse repair and urethral bulking. Clinical cases varied from refractory OAB in the elderly using posterior tibial nerve stimulation to severe end-stage OAB with multiple comorbidities considering diversion.

This brief but intensive preceptorship was a superb way to “top up” knowledge, skills and confidence in dealing with complex female urology. While there is endless value in attending world-class workshops such as AUA and other international meetings there is also a rich bank of knowledge and experience right here on our doorsteps of which I was most fortunate to take advantage. I am greatly indebted to Dr Sam Pillay for so generously sharing her time and wisdom. My sincere thanks also go to Astellas for their support and organisation of this valuable learning experience."

"I write to express my appreciation to yourself and Astellas for allowing me to be the first to participate in the National Preceptorship programme. Spending two days with you allowed me to consolidate much of what I had learnt about incontinence and female urology in my urological training. I am truly grateful for being able to up-skill with one of Australia's leading urologists in the field. It came at a timely moment, as I learnt not only clinical and operative skills, but how to run a practice effectively for better care and comfort of patients. Since returning to Perth, I have applied what I learnt from you in so many ways. I wish you all the best and hope that you will continue to inspire young surgeons like me."

Mrunal Hiwase (MBBS V Hons)

Observing 3rd & 4th December 2018

I met Dr. Pillay at the local USANZ SA/NT section meeting in 2018, where I had the opportunity to present some of the research I had undertaken in my honours year. I had had some exposure to female urology during a Urology rotation at the RAH, and found the material fascinating (particularly the way structure, function, neurology and pharmacology intertwine). I expressed interest in seeing more to Dr. Pillay and she was more than happy to have me observe.

I was able to observe one full day’s operating list, including a rectus sheath sling repair for a lady with severe stress incontinence, a mesh excision, the second stage of inserting sacral nerve neuromodulators for neurogenic bladder, and cystitis cystica. Each of these cases was fascinating – I didn’t realise how severe and life impairing stress incontinence could get, and it was fantastic to see the potential for good in Urology; learning some of the principles of sacral nerve neuromodulation was fascinating; and then learning about an approach to recurrent UTIs and seeing like cystitis cystica was amazing! Seeing the fast track appointments was also fantastic because it gave me the opportunity to observe everything from history to exam to investigation.

The next day I sat in on a urodynamics clinic, again observing a number of fast-track appointments. It was really a privilege to see, and you could really see the cogs turning and the detective coming out of Dr. Pillay in this clinic. This was definitely a highlight of my observation, and I am very lucky to have seen it.

Dr. Pillay was also a fantastic mentor –asking and addressing the important questions I should consider in embarking on a career in surgery, and I can’t thank her enough for her honest advice. I feel a lot more reassured and capable of making a reasoned decision now, and Dr. Pillay’s advice will undoubtedly put me in good-stead for the future.

Thank you for hosting me. I had a lot of fun, saw some very exciting things and gained a lot of great advice, insight and rationality.

Thank you!

Sincerely,

Mrunal Hiwase

23rd August 2018

Dear Dr. Pillay,

I am writing to say thank you for allowing me to observe a session of fluoroscopic urodynamics on Monday afternoon. As part of my current study towards my post graduate certificate in Pelvic Floor Physiotherapy I am required to undertake 20 hours of observation of procedures, surgery and treatment relevant to my role as a women’s health physiotherapist. This was a great opportunity for me to broaden my understanding of the clinical significance of the findings and Dr Pillay was fantastic and the explanations she gave and reasoning for treatment options. I was fortunate as during Monday’s session we encountered a diverse group of patients so I was able to see the two extremes of pelvic floor and bladder support in real time as well as normal voiding compared to substantial retention.

In my role as a physio, I am part of the first line of conservative treatment so it was a great opportunity for me to see first-hand the next line of investigation and subsequent treatment options discussed with the patients. It was also fantastic to have such an ambassador for my profession. I was impressed by many aspects of the practice but especially the efficiency in relation to the fast tracking of the urodynamics as many patients I see often need to wait months to see a urologist only to then wait months again to complete all the necessary diagnostic tests.

Thanks to David for your efficiency and prompt organisation – very much appreciated.

Overall the experience was really interesting, it is a fantastic practice and I will be sending more patients your way. Dr. Pillay, thank you for being such a great educator and so generous with your time

Kind Regards,

Rose Green

Women’s Health Physiotherapist

Physiotherapy for Women

Women’s and Children’s Hospital

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