By Kamal Buba Danladi
Amina Buba is the first female urologic surgeon from Northern Nigeria, and we got the opportunity to have a quick chat with her after achieving another milestone by being awarded the Mbonu/Anugwu prize as the best candidate in the West African College of Surgeons Urology Fellowship Examinations. This also makes her the third female urologist to be awarded the Urology prize in the college’s nearly 60-year history.
Can you share some insights into your journey to becoming a urology specialist?
Interestingly, my journey into Urology was never planned. In fact, throughout medical school, I never contemplated specialising in Urology. I wanted to become a gynaecologist. I attended conferences and even won a prize for my work in obstetrics and gynaecology as a medical student. However, when I qualified as a doctor and did a rotation in gynaecology, I quickly realised that the surgery attracted me to that speciality. I also didn’t quite enjoy the immense pressure that obstetricians faced (with respect to my O&G colleagues). Long story short, I began my surgical training by writing the Membership examinations of the Royal College of Surgeons, England. Then, I returned home to start my residency at the University of Abuja Teaching Hospital, Gwagwalada, to become a Breast/Oncoplastic surgeon.
My first rotation as a surgical trainee was in Urology, and I fell in love with this speciality. I worked in a team where, despite the challenges of practising in Nigeria, people gave their best care to patients. I love that there are so many subspecialties in Urology and that it is constantly evolving. I owe a lot of my success to the people who taught and inspired me at the University of Abuja Teaching Hospital, where I started and completed my surgical training.
What challenges did you encounter during your urology fellowship preparation, and how did you overcome them?
Training to become a fellow is a lengthy process that requires tenacity, physical and mental strength, and God’s guidance. It is also a great lesson in the power of patience and perseverance. Willpower and unshakeable faith are what got me through. I always “prayed like I didn’t work hard and worked like I didn’t pray.” I am so thankful to God for His continuous grace, mercy, and guidance.
Throughout my training, I was very fortunate to have had a solid support system, which superseded the noise of the few people who tried to discourage me. I always give credit to my family, friends and bosses. My parents never questioned my decision to specialise in a male-dominated speciality; instead, they constantly motivated me. My mum is a nurse by profession, so she understands medical terminology. Sometimes, I would sit her down and explain what I have studied during my exam preparation. She would ask me questions and challenge me.
My mum would surprise me with study desks and chairs when she noticed my posture changed because of long study hours. My dad would sometimes stay up late to wake me up to study, and my two older sisters are priceless! They were always at the other end of the phone, full of encouraging words. I also have a very small but close network of friends on speed dial. I cannot even begin to speak about the immense support I had from certain colleagues and bosses. There are too many names to mention, but I am sure they’ll know I am talking about them when they read this.
I found studying for a major examination difficult while still working full-time. I would sometimes function on 4 hours of sleep at night. I quickly learnt how to utilise every single minute of the day. I also learnt that the fellowship examination tests cumulative surgical knowledge gained over several years of training. Preparing for the fellowship exams starts on day 1 of surgical residency. I think I calmed down a bit with “burning the midnight oil” when I recognised this.
How does it feel to be recognised as the Best Candidate in Urology by the West African College of Surgeons?
It’s very humbling! I feel deeply honoured, and I don’t think words can adequately capture how it feels to have one’s work recognised like this.
As the third woman to win the Urology prize in the West African College of Surgeons history, what message do you have for other aspiring female surgeons?
Do not be blinded by the ‘female surgeon’ title. As my colleagues would say, ‘We are all surgeons, and there is no woman in surgery’. Your patients depend on you just as they do your male colleagues, so do not expect any special treatment because of your gender. After all, when you are standing in the operating room, knife in hand, those bleeding blood vessels do not bleed less ‘because the surgeon is a woman’. However, they bleed less in the hands of a skilled surgeon who dissects with care and sticks to the right surgical planes. Surgery is an apprenticeship; mastery is key, so work hard, and your work will speak for itself by God’s grace. I am still a work in progress, and I am constantly learning. I believe the only way to achieve prowess is through hard work. There are no shortcuts in surgery. Strive for excellence and do not accept mediocrity.
What advice would you give to medical students or young professionals interested in pursuing a career in urology?
Believe in yourself. I do not have two heads. If I can do it, so can you. Remember, dishonesty is the greatest disservice you can do to yourself, so be honest with yourself. And carefully introspect – why do you want to do this? Do you enjoy helping people? Do you have the tenacity? Can you work under stress and pressure? If yes – then go for it and give it your best. Maintain a good work-life balance whilst at it. Make sure you have a life outside of Surgery, identify good mentors, work hard and pray hard.
How do you plan to continue contributing to the urology and surgical education field in West Africa?
I plan to assume clinical, teaching and managerial roles in shaa Allah. I would like to see universal health coverage in Nigeria being established in my lifetime. Like I always say, our leaders ought to focus more on healthcare. The knock-on effects of neglecting healthcare systems are numerous. For example, regarding surgical training, you need patients to train appropriately. Patients are unwell and need to be treated whilst surgeons need to operate. The more surgeries a surgeon performs, the better they get. Where will you get the caseload/volume from if people are too poor to go to hospitals because they cannot afford to pay out of pocket, as seen today in most parts of the country? Let’s not even talk about the detrimental human, personal and economic effects of a lack of universal health coverage.
What role do you see for women in urology in the future, both in West Africa and globally?
Globally, women are doing great things in Urology. For example, one of the global experts in Holmium laser enucleation of the prostate is an American female urologist called Amy Krambeck. Canadian and Swedish studies published in reputable journals have found patient outcomes to be better when operated on by female surgeons. As stated by Prof McNally in an article published recently, “Those women who have gone through the extraordinarily complex, difficult hurdles to become surgeons are the best of the best”.
Here in West Africa, we slowly embrace the idea that women in surgery are here to stay and that we can only grow from strength to strength. I soon saw women in urology become experts in their chosen subspecialties, delivering world-class surgical care and taking on teaching, leadership, and managerial roles as they changed the narrative and inspired future generations. Remember that women are natural multi-taskers!