The urology match: Shaping the future of our field

Every year, September through January is both an exciting and anxious time for fourth-year medical students and urology residency programs alike. With the conclusion of the 2016 urology match season this past January, I felt the same exhilaration that I did just 3 years ago. This year, however, I had the privilege to reflect on the demanding application process from the lens of an interviewer rather than that of an interviewee.

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Historically, urology has been considered a relatively competitive specialty. As the visibility and attraction of our field grow, so does the number of applicants, which increases the unmet demand for more spots. The AUA publicly displays online the urology match statistics over the last 5 years, with a detailed breakdown of this year’s match accessible here.

This year, 124 programs participated in the match with 295 total vacancies (9% higher than in 2011). Of 417 applicants who submitted lists (23% higher than in 2011), 294 matched this year, translating into a match rate of just over 70% (9% lower than in 2011, but certainly an improvement over the record-low match rate of 64% in the 2013 and 2014 seasons). Nearly one-fourth (22%) of applicants this year were female, while 7% were international graduates or students.

For aspiring medical students, the task of not only enticing programs but also evaluating and ranking them based on a variety of criteria seems daunting, not to mention financially and physically taxing. If the costs of schooling and extensive standardized testing aren’t enough by themselves, then add the cost of arranging external sub-internships (so-called “away rotations,” which are informally considered an audition by many), applying via the Electronic Residency Application Service (ERAS), and interviewing. In fact, each year has demonstrated a steady rise in the average number of applications per applicant, which amounted to 65 this year-perhaps a reflection of the perceived increase in competition for spots. Each applicant took an average of 10 interviews; recall that urology is an early match specialty, which means that the interview season is condensed into an exhausting (albeit fun) time frame spanning less than 2 months.

Next: Residency program

This process, however, is equally overwhelming for residency programs. The average number of applications received per program this year was 251, whereas the average number of interviews offered was 36 (14%), with the goal of filling anywhere between one and five spots per program. After interviewing several dozens of stellar candidates with astronomical scores and an array of impressive and unique backgrounds, it became evident that condensing each applicant’s remarkable profile into a single rank number is no easy task. And just as applicants learn to play the game of enticement and cordial correspondence, programs, too, may need to employ strategy in recruitment efforts while conforming to the rulebook.

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As a resident interviewer, I sought to evaluate each candidate as a potential colleague and junior resident of mine. In the process, I realized that each applicant brought a lifetime of amazing and diverse (often non-medical) experiences to the table-ranging from athleticism to previous careers, travel, music, philanthropy, and unique hobbies, to name just a few.

What role do these experiences play in medicine and urology? They shape perspective. They diversify our field. They help us relate with our patients. They offer creativity and facilitate innovation. They provide a conduit to decompress. Hence, it is important not to lose sight of these personal interests and hobbies throughout residency and beyond.

After meeting several top-notch applicants, I take solace in knowing that the future of our field is in good hands. Congratulations to the rising urology residents and to all of the programs on the match this year.