Urology · 2026
National Trends in Urology Fellowship Training and Subspecialization: A 10-Year Analysis of the AUA Census.
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Yong Courtney, Meeks William, Galen Emily, Sundaram Chandru P
Аннотация
OBJECTIVE: To describe trends in urologic fellowship training and subspecialization nationwide and to identify areas of need in the national distribution of subspecialists.
MATERIALS AND METHODS: Data from the American Urological Association Annual Census of United States Practicing Urologists from 2014-2024 was analyzed using weighted responses to account for non-response bias. Trends regarding fellowship training, subspecialization, and practice patterns were examined. The analysis was descriptive to identify shifts over time.
RESULTS: From 2014 to 2024, an average of 2088 urologists practicing in the United States completed the census yearly with an average response of 16.3%. The proportion of fellowship-trained urologists has increased over time (4 0% in 2014 to 46% in 2024) while the proportion of general urologists has decreased (63% in 2014 to 54% in 2024). Urologic oncology is the most common specialty (13% in 2024) and there have been increasing trends in several other specialties such as urogynecology, urologic reconstructive surgery, and robotics. There has been a decrease in urologists in private practice (64% in 2014 to 42% in 2024) and an increase in academic and hospital employment. Subspecialized urologists are more likely to practice in academic settings (66% in 2024). Fellowship-trained and subspecialized urologists are more likely to practice in metropolitan areas.
CONCLUSIONS: Subspecialization and fellowship-training has increased among urologists practicing in the United States with a corresponding decrease in general urology practice. Subspecialized urologists more often practice in urban and academic settings. This trend may affect nationwide access to urologic care.
MATERIALS AND METHODS: Data from the American Urological Association Annual Census of United States Practicing Urologists from 2014-2024 was analyzed using weighted responses to account for non-response bias. Trends regarding fellowship training, subspecialization, and practice patterns were examined. The analysis was descriptive to identify shifts over time.
RESULTS: From 2014 to 2024, an average of 2088 urologists practicing in the United States completed the census yearly with an average response of 16.3%. The proportion of fellowship-trained urologists has increased over time (4 0% in 2014 to 46% in 2024) while the proportion of general urologists has decreased (63% in 2014 to 54% in 2024). Urologic oncology is the most common specialty (13% in 2024) and there have been increasing trends in several other specialties such as urogynecology, urologic reconstructive surgery, and robotics. There has been a decrease in urologists in private practice (64% in 2014 to 42% in 2024) and an increase in academic and hospital employment. Subspecialized urologists are more likely to practice in academic settings (66% in 2024). Fellowship-trained and subspecialized urologists are more likely to practice in metropolitan areas.
CONCLUSIONS: Subspecialization and fellowship-training has increased among urologists practicing in the United States with a corresponding decrease in general urology practice. Subspecialized urologists more often practice in urban and academic settings. This trend may affect nationwide access to urologic care.