Lessons learned in andrology: clinical medical practice combined with research can be fun and rewarding

Abstract

I feel honored and humbled to contribute to this series of articles, especially considering the stature in our field of those who have written previous ‘Lessons’ articles. My entry into the field of Andrology was serendipitous. I had been trained as a general urologist. Although I always had an interest in academic medicine, I decided to enter private practice immediately after my residency training. After 10 years in the private practice of urology, I had the opportunity to learn microsurgery from Dr. Robert Acland. He recently had been brought from the United Kingdom by our world class hand surgery team to establish the microsurgery teaching laboratory at the University of Louisville School of Medicine. Dr. Acland was among a handful of innovators in the development of modern microsurgery. He had special interests in the development of microsurgical instruments and the ergonomics of microsurgery. He developed a series of teaching videos demonstrating microsurgical techniques that were (and still are) used all over the world. I listened when Dr. Acland casually mentioned that his initial presentation of the results of anastomosis of digital arteries at an annual meeting in the United Kingdom was met with skepticism. However, when he showed actual photographs of such anastomoses at the same annual meeting the following year, his work was received with accolades. However, my microsurgical skills and ability to photograph microsurgical anastomoses of the vas deferens and of the vas to the epididymal tubule provided the opportunity for me to take a photographic exhibit to various meetings of national organizations and to begin publishing (Belker et al., 1978; Belker, 1982, 1984, 1988). Be careful to listen to and appreciate the significance of casual offhand remarks of your mentors. After becoming proficient in urologic microsurgery, I realized that I needed to have a comprehensive understanding of male infertility. While there were no fellowships in male infertility then, it would have been impractical anyway at that time in my professional career to take time away from my practice to spend a year or two in fellowship training. It was at that time that I began attending ASA annual meetings. During intervals between sessions and in the evenings, I increased the information I had learned during the daily sessions of oral presentations and poster sessions by talking with senior members and leaders in our field. I found that these people were more than willing to pass on their knowledge to younger members. Subsequently, I have tried to be available to younger members of various male reproductive organizations in order to pass on knowledge gained through experience over the years. Make an effort to speak to older members of your organizations. Most of them are very willing to discuss various aspects in their particular area of expertise with you. Later in life, remember such experiences and make yourself available to younger people in your field. While Dr. Martin Resnick was a visiting professor at the University of Louisville School of Medicine, I met him for the first time. At that time, he served as the chairman of the education division of the American Urological Association. Meeting Dr. Resnick resulted in me being asked to direct a course on Vasectomy Reversal at the 1981 annual meeting of the American Urological Association. I was able to continue directing this course at each annual meeting of the AUA for approximately 30 years. Other faculty members were brought into the course as the time allotted for the course was increased to include Sperm Retrieval Methods for IVF and ICSI as well as Genetic Aspects of Male Infertility. I was able to bring into the course Robert Oates, MD (director of the urologic residency program at Boston University) and Peter Schlegel, MD (Chairman of the Department of Urology at both Weill Cornell School of Medicine and New York Presbyterian Hospital as well as a past editor of the Journal of Andro