Specialty Profiles

What it’s like to specialize in urology: Shadowing Dr. Davuluri


As a medical student, do you ever wonder what it’s like to specialize in urology? Meet Meena Davuluri, MD, a urologist and a featured physician in the AMA’s “Shadow Me” Specialty Series, which offers advice directly from physicians about life in their specialties. Check out her insights to help determine whether a career in urology might be a good fit for you.

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Meena Davuluri, MD
Meena Davuluri, MD

“Shadowing” Dr. Davuluri

Specialty: Urology.

Practice setting: Academic medical center.

Employment type: Employed by hospital.

Years in practice: One.

A typical day and week in my practice: The nice thing about being a urologist is the variety in our days and week. On average, I am in the office seeing patients three days a week. This includes any in-office procedures such as cystoscopies and prostate biopsies. I spend about one day a week in the operating room doing a mix of outpatient ambulatory surgery and larger surgeries that may require hospital admission.

Urology is a surgical subspecialty but is a very diverse field so no day is ever the same. We treat patients with any issues associated with the genitourinary tract. Common problems that we address include kidney stones, urinary issues, and prostate cancer diagnosis and treatment. You get a little bit of everything which makes it a very fun specialty! 

I'm also very interested in health outcomes research, so I have protected research time. I dedicate at least one to two days a week toward my academic research.

Typically, I work about 50 hours a week. I am in the office, seeing my first patient by 8:30 a.m. and finish with my last patient  around 4 p.m. I spend about an extra hour at the end of each day just reviewing patient charts, calling patients back on any results that they need to know and planning for what my next day is going to entail. I usually get home around 5:30 p.m. or 6 p.m. My OR days start at 7:30 a.m.   

The most challenging and rewarding aspects of urology: There are a lot of quality-of-life issues that we tend to deal with—for example, an elderly person having difficulty urinating.

Urology is such a diverse field. While we do treat various cancers, which can be very rewarding, we also treat a lot of benign conditions that significantly impact quality of life. Therefore, we develop very strong relationships with our patients. It’s wonderful to have a patient trust you with some of the most delicate aspects of their life. It’s wonderful to be able to offer the patient an intervention and see how drastically the quality of life can improve.

The most challenging part of urology is that often times the treatment may not be straight-forward. In these scenarios, taking into account patient preferences requires a good amount of patience. You want to make sure that your patient understands everything and eventually you can have a very good clinical outcome, but you definitely need patience to help the person you're treating understand why you're doing the things that you're doing to find a treatment that works. However, those patients can give you some of the best patient. When you get that kind of instant gratification, it's so nice to see your patients so happy.

How life in urology has been affected by the global pandemic: During the peak pandemic time, over 90% of operative cases paused in an effort to decrease the spread of COVID and to maximize the ventilator availability.

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As the first curve flattened, we were able resume cases and prioritized cases based on urgency such as oncology cases as we worked through our backlog of cases. During peak COVID, we also minimized in person visits and transitioned a large part of our practice to Telehealth. Since then, we have continued to do a lot more telemedicine, which I actually think can be really beneficial as we return to normal practices.

The long-term impact the pandemic will have on urology: We will see that there will be a permanent uptake in telemedicine. Again, this is actually one of the silver linings of the pandemic. There's a lot of patients that we can see and do visits for where we don't need to physically see the patient in the office or examine them. We can do a telehealth visit to just check in and see how they're doing. It is so much easier for the patient to be able to do that and schedule that.

Three adjectives to describe the typical urologist: Intelligent. Jovial. Sense of humor. The best thing about urologists is that we are known as the “happy surgeons.” When I was a medical student, I noticed that every urologist I interacted with seemed to always be smiling. It drew me to the field. As a urologist, I definitely think that continues to hold true.

How my lifestyle matches, or differs from, what I had envisioned: It's really important to understand that urology as a surgical specialty is, first and foremost, a surgical field. Some surgical fields allow you to do an intern year in medicine, but for urology that's not the case. You're doing an intern year in surgery and you're doing four years of a surgical residency. My residency experience was exactly what I expected it to be. I worked on average 80 hours a week in residency, sometimes a little bit less. It definitely got better every year, but you work hard.  

I was at the hospital as early as 5:30 a.m. and usually left around 6 p.m. You're busy operating all day every day, taking care of your patients in the hospital. It is a very demanding residency program. Of course, as you get more senior, it does get a little bit better. You can’t go into this field expecting to coast by. But coming off residency and transitioning into attending life, it was exactly what I expected. As an attending, there is actually a very nice work-life balance that exists. Urologists can tailor their practice to specific interests. It is one of the many reasons that I was drawn to it.

Skills every physician in training should have for urology but won’t be tested for on the board exam: Being proactive is really important in urology, particularly as you are going into your third and fourth year rotations. Urologic pathology is not usually covered in the first two years of medical school, therefore it is important to identify resources—a few which are listed later—to help you learn some urology basics.  

By being proactive, you are putting yourself in a position to be a better a student, resident, and urologist. Ultimately, all that matters is: What did I learn? Do I know how to practice medicine and urology to treat the patient at hand? Am I able to predict what my needs are going to be for this patient?

One question physicians in training should ask themselves before pursuing urology: Before you pick anything, you always have to ask yourself—why am I picking this specialty? That sounds really basic, but I think it's a really important question.

Are you picking it because you have a particular experience with a family member or something else that draws you to a disease process that you're interested in? Are you picking it for what you think is work-life balance? Its important to know that answer.

Books every medical student interested in urology should be reading:. I'm more of a podcast person, but for me, there are two books that are related to medicine that have made a big impact. One is called The Emperor of All Maladies: A Biography of Cancer, by Siddhartha Mukherjee, MD. It’s a nice book that goes through the overview and discovery process of cancer treatment. As a urologist we deal with various cancers such as kidney, bladder, prostate and testicular cancer. It really allows you to have an appreciation for how cancer treatment has evolved over the years. .

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The other book that I found really interesting is Sapiens: A Brief History of Humankind, by Yuval Noah Harari, MD. It talks about the evolution of humankind starting back in the BC period and talking about how humans evolved over time. Then it talks about the human nature of forming societies and the need for social interaction. For me, that has really helped me understand human behavior and certain aspects of what we’ve seen with human behavior throughout the pandemic. It has personally helped me relate better to a lot of patients and helped me be a little bit more of a compassionate physician.

My third suggestion is just read a book that brings you joy. Everything you read doesn't have to be about something that furthers your career or helps you be introspective. A lot of times you just need a book that’s a beach read that doesn't have any meaning, but it's just a fun story to help you relax. Plus it gives you something to talk about!

The online resource students interested in urology should follow: Urology has a large social media presence on Twitter. Following the American Urologic Association is a great way to start to learn about urology. I also recommend downloading the American Urological Association (AUA) app.

The AUA has always done a really great job of combining all urology resources and making a one-stop shop for medical students interested in urology, residents who are pursuing urology, and urologists who are already in practice. It kind of serves as our library for everything urologic.

There's one that's called AUA for students and it goes through different cases that medical students can review. It highlights the basics of Urology, relevant guidelines and common urologic conditions, so it’s a great resource for anyone preparing for their urology rotation.   

Quick insights I would give students who are considering urology: Urology is one of the best specialties that exists. It has a phenomenal combination of medicine and surgery, so you do get to operate a lot. You can be a great surgeon, but because a lot of these patients have chronic conditions, you have to follow them for a while, and you do get the opportunity to develop great relationships with your patients. It’s the best of both worlds.

Mantra or song to describe life in urology:Don’t Worry, Be Happy,” by Bobby McFerrin. You can spend a lot of time worrying about a lot of things, but ultimately you have to just be happy with what you're doing. I find that song going through my head consistently whenever I'm in the clinic.