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UPJ INSIGHT: Urological Education in United States Medical Schools: Where Are We Now and How Can We Do Better?
By: Jessica E. Kreshover, MD, MS; Alex J. Vanni, MD; Kevan M. Sternberg, MD; Naeem Bhojani, MD; Kathleen C. Kobashi, MD, FACS | Posted on: 01 Nov 2022
Kreshover JE, Vanni AJ, Sternberg KM, Bhojani N, Kobashi KC. Urological education in United States medical schools: where are we now and how can we do better?. Urol Pract. 2022;9(6):581-586.
Study Need and Importance
It is well documented that urological education in United States medical schools is decreasing over time despite the growing burden of urological conditions in an aging population. With this, there will be inevitable gaps in urological education for the commonest urological conditions. Additionally, more care will fall to non-urologists, increasing the need for this knowledge. We sought to determine if, where, and how the content for common urological conditions is being taught.
What We Found
We conducted a survey of medical students to elucidate the current status of urological education. Of 879 invitations sent, 173 responded (20%) representing 92 (54%) of the 171 Association of American Medical Colleges accredited medical schools. Only 4 students (2%) reported that their school had a required clinical urology rotation. Kidney stones (98%) and urinary tract infections (100%) were the most frequent topics taught. Students reported the lowest exposure to infertility (20%), urological emergencies (19%), bladder drainage (17%), and erectile dysfunction (13%; see Figure). Videos and case vignettes were the preferred learning modalities and the majority (84%) of respondents were familiar with the AUA’s medical student curriculum material.
Limitations
Our study population was primarily comprised of students with an interest in urology. This creates 2 potential limitations. The first is that it may not represent true curricula as medical educators were not surveyed. The second is that this cohort presumably had more exposure to urology than the “typical” medical student. This could conflate the amount of exposure, which arguably strengthens the conclusions of our study.
Interpretations for Patient Care
With the aforementioned changing medical landscape, this study demonstrates the need for urologists and the AUA to continue to advocate for urological education in medical schools. This is particularly true for urological emergencies, bladder drainage, and erectile dysfunction—topics that will commonly be encountered regardless of chosen medical discipline.
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