The making of a urologist: Factors influencing career decisions

Abstract

Objective: Recently, there has been increased competition for specialist urological training at National Selection. This paper aims to investigate potential factors that may contribute to individuals deciding to pursue a urological career. Materials and methods: Core trainee numbers and National Selection competition ratios for core training, general surgery, trauma and orthopedics, and urology were obtained from NHS England between 2016 and 2023. Trainees’ views about stress, burnout, teamworking, the training environment, and global satisfaction with training were extracted from General Medical Council survey data 2019–2024. NHSE data obtained 2010–2023 were analysed to assess urological consultant numbers and their work intensity. Results: Exposure to urology during core training increased by 165% between 2010 and 2023, accompanied by a 60% rise in applications for specialist training. Urology consistently demonstrated higher trainee satisfaction rates compared against general surgery and trauma and orthopedics. In addition, the evolution of consultant practice, a shift towards more outpatient-based activity, may further contribute to the specialty’s growing appeal to an increasingly female workforce. Conclusion: Multiple factors may contribute to the rising competition ratios observed in urological training. These include increased exposure to urology during core training, high levels of trainee satisfaction and the transition towards lower-intensity consultant practice. Level of evidence: Not applicable