Matthew Bultitude.
Can you tell us a little bit about what led you into the field of urology and what have been the highlights so far?
Thank you and that is a very interesting question given that my father was a urologist which must have had some influence! However, I was not certain I even wanted to do medicine at school and was not pushed to do so by my father, although I think he was secretly pleased when I did. Through training I always thought I would be an orthopaedic surgeon and did two six-month attachments as a senior house officer in orthopaedics. My final attachment on my basic surgical training rotation was urology, and it was during that time that I was offered a research post in urology. I had no ‘next job’ to go to, so gladly accepted that role, and looking back it was a one-way street from that moment. I certainly don’t have any regrets.
In terms of highlights, firstly spending a fellowship year in Melbourne as part of my higher surgical training was definitely a highlight and I would highly recommend this to anyone who can take such an opportunity. This gave me a chance to increase my independent practice and surgical logbook (this was easily the highest volume year of my training), as well as experience a different health system and make new friendships and connections that have remained ever since. Of course, getting your substantive consultant job is a major life event and highlight, as this is what one has been working towards since qualification, in my case 14 years earlier. So, this was a very proud moment when I joined the consultant staff at Guy’s and St Thomas’.
It came as a surprise when I was asked to join the Editorial Board of the BJUI by Professor Prokar Dasgupta. This period was hard work but a highlight looking back on it now. As Associate Editor with responsibility for the website, we completely re-vamped the website and our use of social media (with Declan Murphy as Associate Editor), we really led the way at the time and many other journals have subsequently followed. From a clinical perspective, working with fantastic colleagues in the stone unit at Guy’s is a definite highlight and makes the day job enjoyable.
Who has inspired you in your career and why?
Gosh. Where to start?! One of the advantages of training is rotating through different units and learning different ways of doing things. So, I have picked up lots of things along the way. I will never forget Tim O’Brien waiting for me to scrub in as an SHO for a cystoscopic case and then grilling me to see if I really knew what was going on. Suffice to say, I was soon taking my gloves off, but that taught me a very valuable lesson early on in my career about being prepared and knowing your patients. Tim has remained an inspiration to me, and I am sure many others, through his leadership at Guy’s. Robert Morgan and Richard Tiptaft, both taught me ‘tricks of the trade’ which I still remember and utilise in my practice. I remember being SHO to Richard Tiptaft in 2000 and thinking what a fantastic service the stone unit was at Guy’s and how I would love to do that job – funny how things turn out! I could mention so many other trainers, and I think we often forget what a privilege it is to be allowed to operate, and often, how much easier it would be for the trainer just to do the case themselves.
What has been the best piece of advice that you have received in your career and what advice would you offer to those following in your footsteps?
I was told years ago that you have to take your opportunities when they arise, and I have certainly pursued that philosophy throughout my career, and that was a theme of my RSM presidential address. So much of my career was unplanned, and my advice to others is you must take opportunities when they are offered. It is easy to feel that you are too busy at that moment in time to do something, but if you say no, you are unlikely to be asked again.
What one paper or book would you recommend every urologist should read?
Hmmm. That’s not an easy one. From a clinical perspective, I would say one of the classic papers in urology. So much stuff that we discuss in modern practice was all done before, and it is amazing how medicine just re-invents itself. So, I think we can learn a lot from history, and whether that is lithotripsy for ureteric stones, heat issues with laser technology in the kidney or yet another way to attack the benign prostate – these things have all been discussed and often tried before.
Last year I read Mike Swinn’s book Hitting Your Head Against A Brick Wall and I think this is an important book as many of the issues resonate with lived experiences in the NHS. It has certainly helped focus me to try and avoid similar situations in my workplace.
Do you think more needs to be done to make urology, and other surgical specialties, more inclusive?
Things are better than before but driving inclusivity will always be an important topic and I don’t think we can ever take our foot off the pedal with this one. It is always so revealing to hear stories of perspectives from others – whether that is by gender, race or disability. I have learnt a lot simply by listening to colleagues and their lived experiences.
We know that there is gender disparity in different surgical specialties, and although things have improved, a lot of work is still needed as this does not match medical school entry. Of course, it was only in 2023 that the Royal College of Surgeons published their report on sexual misconduct in surgery – so clearly, we still have a problem in that area. And in 2025, we still see meetings with all male or white speakers . . . so yes, a lot of work needs to be done in terms of awareness and behaviours.
I undertook reverse mentoring back in 2021 at Guy’s, and hearing the perspectives of a black, low-banded member of staff on the way he was treated was eye-opening. I was truly shocked that behaviours like that still went on in the modern NHS. I think the only thing he learnt from me was that he needed to drink a lot more water to prevent kidney stones!
You have just taken on the position of President of the RSM Urology Section – many congratulations! What would you like to achieve during your time in the role?
So, this is a great honour and slightly surreal now it has officially started. Imposter syndrome – tick. The RSM has so much history and the educational offerings we give are truly fantastic. But education has changed with many expecting this to be free and online, and of course there are a lot of competing educational offers. I have tried to focus on single disease / topic meetings and pack them full of high-quality education. This started recently with an all-day meeting on ‘Infections in Urology’. This is such an important area for everyone, and the meeting was a real success with a lot of interest from attendees. So, I hope I deliver high quality, interesting education that makes people want to attend. The Section also runs a popular winter meeting, and I have rebadged this as ‘Urology Updates’ with a slightly cheaper price point, and I hope this creates a sustainable model for the future and a meeting that people want to attend. My theme for the year is ‘AI in Urology’ and all meetings will feature this somewhere. My President’s Day on 22 May 2026 will be all about AI in urology as there is so much interest in this, and such a fast-changing area. So, I hope to handover in a year, with the section in good shape, with an educational template that others can follow, and of course with the finances in positive balance!
Would you encourage your colleagues to get involved with the RSM?
Absolutely. I joined the RSM in 2005 and have never regretted it. I had no idea that 20 years later I would be President of the Section – so of course this can happen to anyone if they want to get involved. Back then, a big draw was the library, and whilst it continues to have a fantastic library, I suspect this is less important for many these days. As a club facility, it certainly offers a base (for drinks, dinner, onsite accommodation) especially for those living outside of London. The RSM is making significant changes, and from January, attending academic meetings will be a member-benefit, so members can attend meetings (not just urology) for minimal cost. I think this could be a game-changer for the RSM and suddenly make membership costs seem quite modest. So, I would absolutely urge people to look at membership and the benefits it can bring.
Do you enjoy being involved in training newer members of the profession?
Absolutely and it’s a really important area. We were all trained once, and without training there won’t be doctors in the future. I took a lot from my fellowship when I was allowed to develop in many areas, and so I have always tried to ensure maximum training opportunities for our resident doctors.
I have also really enjoyed organising education which includes the RSM Endourology Meeting for many years now, three years on the BAUS Endourology Executive putting together the endourology sessions for BAUS, and most recently as a member of the Scientific Congress Office of the EAU compiling the stone sessions for the EAU. This seems to have become an important part of my career.
And finally, if you have any spare time, how do you like to relax?
Spare time . . . what’s that? As a father of two fast-growing girls (now aged 10 and 12), they keep me busy at other times. I used to play football five-a-side twice a week as goalkeeper (I hope everyone remembers London South winning the BAUS five-a-side competition when that used to happen!), but as goalkeeper, I was getting too many finger injuries to keep playing. I started biking to work because of Covid and I continue to really enjoy this. I also think medical history is such an important area that shouldn’t be forgotten. I seem to have built up quite a collection of art of Guy’s or St Thomas’ Hospitals and enjoy researching relevant historical areas – hence the theme of my Presidential Address ‘From Cheselden to Thomas Guy … treading the stone path from St Thomas’ to Guy’s’.
I suspect when I have more time, I will start playing golf again, but who knows when I will find the time for that. On a serious note, I do think many of us need to address our work-life balance, definitely something for me to look at in the future.
Many thanks for your time!
https://www.rsm.ac.uk/sections/urology-section/
