Experiences and Outcomes of the Society of Genitourinary Reconstructive Surgeons Fellowship Training: Growth in Fellowships Mirrors the Evolution of the Discipline.

Abstract

Objective: To describe experiences and outcomes of the Society of Genitourinary Reconstructive Surgeons (GURS) fellowship match. In 2012, GURS developed a centralized fellowship match which has grown from 13 to 30 programs.

Methods: GURS match statistics and case logs were reviewed from 2013-2024. Additionally, a 37-question survey evaluating satisfaction, procedural competency, fellowship experience, and employment opportunities were sent to graduates. Linear regression was performed to examine trends over time.

Results: Over the study period, program match success remained stable (94.7%; P = .50) while applicant success (63.3%) increased over time (P = .04). North American and female applicants experienced higher match success (72.8% and 73.6%) compared to their international (35.5%; P <.0001) and male counterparts (60.0%; P = .02). On case log analysis, mean surgical volumes per year increased in urethral reconstruction (mean=88.1; P = .02), male sexual health (n = 32.7; P = .03), genital reconstruction (mean=16.4; P <.01) and abdominal reconstruction (mean=24.5; P = .03). Male incontinence surgeries remained stable (mean=30.5; P = .21) while female reconstruction declined (mean=23.2; P = .01). With a survey response rate of 54.5% (97/178), training satisfaction was 95.9% which did not differ by gender (P = .54) or year of training (P = .22). Around 97.9% felt competent to enter unsupervised reconstructive practice, 94.8% reported an understanding of the relevant literature and 96.9% were satisfied with their job as a reconstructive urologist. Around 49.5% identified a different case mix in practice compared to fellowship, most commonly related to abdominal (44.9%) or genital reconstruction (16.3%).

Conclusion: GURS fellowships have grown organically over the last decade and mirror the growth and evolution of the discipline with sustained high levels of graduate satisfaction, surgical experience, competence, scholarly inquiry and employment.