Consultant – Urology.

1. Position Details
● Job Title: Consultant – Urology
● Department: Urology
● Locations: Health City at Camana Bay and Health City East End, as applicable to the service
● Reports To: Medical Director
● Salary: Fixed Base -$6,000 + $8,000 USD per month + variable

2. Job Summary
The Consultant in Urology is a senior specialist surgeon responsible for diagnosis and medical / operative management of urological disease at HCCI.
The post-holder manages urinary tract obstruction, stone disease, prostate and bladder conditions, urological malignancy and acute urological emergencies, and performs endoscopic, open or minimally invasive procedures within granted privileges.
The role includes perioperative care, catheter and device safety, multidisciplinary oncology coordination, teaching, governance, audit and quality improvement.

3. Key Responsibilities
3.1 Urological Assessment & Management
● Assess and manage lower urinary tract symptoms, urinary retention, haematuria, recurrent infection, stone disease, prostate disorders and other urological presentations.
● Interpret urinalysis, renal function, PSA, ultrasound, CT and other relevant investigations and formulate evidence-based plans.
● Provide specialist consultation for inpatients, outpatients and emergency presentations.
● Identify high-risk haematuria, obstructed infected systems and suspected malignancy requiring urgent investigation or intervention.
3.2 Endourology, Surgery & Procedures
● Perform cystoscopy, ureteroscopic, transurethral, stone and other urological procedures within credentialed privileges.
● Perform open or minimally invasive urological surgery only within approved competence and service capability.
● Ensure consent, Universal Protocol, surgical safety checklist, antibiotic prophylaxis and device / implant traceability where applicable.
● Recognise and manage perioperative bleeding, infection, urinary leak, obstruction and other complications.
3.3 Urological Emergencies & Acute Care
● Provide senior management of acute urinary retention, obstructive uropathy, urosepsis, testicular torsion, priapism and traumatic urological injury within scope.
● Arrange urgent decompression, operative intervention or transfer when indicated.
● Coordinate resuscitation and critical-care support for septic or unstable patients.
● Ensure timely imaging and specialist decision-making for time-sensitive urological emergencies.
3.4 Oncology, Catheter / Device Safety & Follow-Up
● Participate in multidisciplinary oncology care for prostate, bladder, renal and other urological malignancies.
● Ensure safe catheter, stent, nephrostomy and urinary-device management and clear plans for removal / exchange.
● Provide follow-up for pathology results, cancer surveillance, stone prevention and functional recovery.
● Educate patients regarding hydration, medication, catheter / stent care, warning symptoms and follow-up.
3.5 Diagnostics, Prescribing & Medication / Treatment Safety
● Request and interpret investigations appropriately, based on clinical need, evidence, risk and cost-effectiveness.
● Prescribe and administer / authorise treatment safely within scope of practice, confirming patient identity, allergies, dose, route, interactions, contraindications and monitoring requirements.
● Recognise and manage adverse drug reactions, treatment complications and medication errors and report them in accordance with hospital policy.
● Support antimicrobial stewardship, formulary compliance and medication reconciliation where applicable.
3.6 Documentation & Medico-Legal Responsibilities
● Maintain accurate, complete and contemporaneous clinical records for every patient encounter in the hospital information system.
● Document assessment, clinical reasoning, consent, procedures, treatment plans, referrals, handovers and follow-up requirements clearly and promptly.
● Complete statutory, medico-legal and administrative documentation accurately and in a timely manner while maintaining strict confidentiality and data-privacy compliance.
● Report clinical incidents, near misses, adverse events and identified risks in accordance with hospital policy and participate in follow-up actions.
3.7 Supervision, Teaching & Team Support
● Supervise, mentor and support junior doctors, nurses, physician assistants and allied health professionals within the department and multidisciplinary team.
● Provide bedside teaching, case-based learning, competency support and structured feedback to trainees and students.
● Contribute to departmental induction, continuing professional development, simulation, journal clubs and educational activities as applicable.
● Promote a respectful, collaborative and psychologically safe learning and working environment.
3.8 Clinical Governance, Quality & Patient Safety
● Participate actively in clinical governance, incident reviews, morbidity and mortality meetings, and root-cause analysis as relevant to the service.
● Contribute to the development, review and implementation of evidence-based clinical pathways, policies and standard operating procedures (SOPs).
● Support monitoring and improvement of departmental key performance indicators (KPIs), including clinical outcomes, patient safety, timeliness and patient experience.
● Undertake clinical audit and quality-improvement projects and implement corrective and preventive actions arising from findings.
● Ensure compliance with hospital policies, applicable regulatory requirements and accreditation standards, including JCI requirements.
3.9 Communication, Patient Experience & Multidisciplinary Collaboration
● Communicate clearly, respectfully and compassionately with patients, families and carers, including during complex, distressing or end-of-life discussions.
● Work collaboratively across multidisciplinary teams and participate in handovers, safety huddles, case conferences and departmental meetings.
● Ensure informed consent and shared decision-making are supported by appropriate explanation of diagnosis, treatment options, benefits, risks and alternatives.
● Respond constructively to patient feedback and complaints and support service-improvement actions.
● Support interpreter, language, cultural and disability-access needs to promote equitable patient-centred care.
3.10 Infection Prevention & Emergency Preparedness
● Adhere to hand hygiene, PPE, aseptic technique and standard and transmission-based precautions at all times.
● Support safe management of isolation requirements, sharps, clinical waste and occupational exposure incidents in accordance with hospital policy.
● Apply antimicrobial stewardship principles and infection-prevention practices relevant to the specialty.
● Participate in emergency preparedness, major-incident and business-continuity arrangements relevant to the department.

4. Working Hours
● Contracted hours: 196 hours per month, or as specified in the employment contract
● Additional requirements: Participation in the departmental clinical roster, including on-call, weekend and public-holiday cover as required to ensure safe continuity of service
● On-call: Availability for specialty consultation, escalation, emergency response and inpatient / procedural cover in accordance with the departmental roster
● A typical monthly pattern may comprise a mix of scheduled clinical activity, inpatient / procedural responsibilities and on-call duties distributed equitably across the consultant team.

5. Qualifications & Experience
● Education: MBBS (or equivalent) with MS / DNB General Surgery followed by MCh / DrNB Urology, FRCS (Urol), or equivalent recognised specialist qualification / board certification.
● Registration / Licensure: Full registration and good standing with a recognised medical council, and eligibility for registration with the Cayman Islands Medical & Dental Council (CIMDC). GMC or equivalent recognised registration is desirable where applicable.
● Experience: Minimum 5+ years post-specialty qualification experience in Urology, including substantial independent consultant / specialist-level endoscopic and operative practice.
● Knowledge: Comprehensive knowledge of urological emergencies, endourology, urological oncology, perioperative care, device safety, infection prevention and clinical governance.

6. Essential Skills & Key Competencies
● Strong urological diagnostic, endoscopic and operative judgement.
● Competence in procedures within granted urology privileges.
● Ability to manage obstructive uropathy, urosepsis and other acute urological emergencies.
● Effective multidisciplinary oncology, teaching, audit and quality-improvement skills.
● Strong interpersonal and communication skills, with the ability to work effectively across multidisciplinary teams.
● Patient-centred, compassionate and culturally sensitive care; integrity, confidentiality, professionalism and sound ethical judgement.
● Commitment to patient safety, clinical governance, continuous professional development and evidence-based practice.
Desirable Certifications
● Advanced Cardiac Life Support (ACLS)
● Basic Life Support (BLS)
(Current certification, or willingness to obtain within hospital-policy timeframes, is required where the certification applies to the role.)

7. Additional Responsibilities
● Contribute to service development, new clinical initiatives, pathway redesign and departmental improvement projects.
● Mentor and support students, interns and junior staff as required.
● Provide flexible cover across clinical sessions, on-call, weekends and public holidays as required by the departmental roster and service needs.
● Support departmental leadership and colleagues in the effective running and continuity of the service when required.
● Perform additional duties reasonably assigned by the Medical Director within the post-holder's competence, privileges and scope of practice.