A urologist, also known as a genitourinary surgeon, focuses on diagnosing and treating disorders of the urinary tracts of males and females, and on the reproductive system of males. This specialist manages non-surgical problems such as urinary tract infections and benign prostatic hyperplasia, as well as surgical problems such as the surgical management of cancers, the correction of congenital abnormalities, and correcting stress incontinence.
Specialty training required prior to certification: Five years
Urology is a surgical specialty that deals with diseases of the male and female urinary tract, adrenal glands and male reproductive organs.
There are a number of subspecialty areas within the field of urology, including pediatric urology, urologic oncology, renal transplantation, male infertility, calculi (stones in the urinary tract), urogynecology and neurourology, and trauma and reconstructive urology. Female urology (or urogynecology) includes treatment of female urinary incontinence and pelvic outlet relaxation disorders.
Neurourology uses sophisticated equipment to study bladder function in patients who have dysfunction such as female incontinence, but also in patients with neurologic conditions that affect the bladder. Trauma and reconstructive urologists treat strictures of the urethra, manage complex reconstructive procedures, and perform implant procedures such as the artificial urinary sphincter or penile implant for erectile dysfunction. Urologists also treat a significant number of congenital anomalies ranging from undescended testes to more complex diseases such as intersex disorders.
Urologic diseases affect patients of all ages, some with significant coexisting medical issues; therefore, a knowledge of internal medicine, pediatrics, gynecology and other specialties is required. Urologists perform a wide range of surgical procedures ranging from simple procedures such as vasectomies to more complex procedures such as cystectomies.
The breadth of the specialty provides urologists with a varied practice. It also affords them the opportunity to specialize in a particular specialty area of urologic surgery. This flexibility also enables the urologist to maintain a more tailored schedule than other surgical specialties. As a rule, urological emergencies are less time-consuming than emergencies in other specialties.
In addition, urology provides a surgeon with a unique blend of clinical and surgical practice. Urologists are involved with consultation and diagnostics in their clinic practices. They often take a leading role in initiating medical treatment and surgical recommendations, which can cultivate strong patient relationships. Because urologic conditions may sometimes be strong indicators of more serious problems (e.g., erectile dysfunction may indicate atherosclerosis), the urologist can take a central role in coordinating a patient’s care.
Urologists’ income varies according to region and individual practice. However, according to the Medical Group Management Association’s 2010 Physician Compensation and Production Survey, the median salary for urologists in 2009 was $390,678.
Certification by the American Board of Urology requires the completion of an ACGME-approved urologic residency program, with a minimum of five years in surgical postgraduate education. Of that, 12 months are spent in a general surgery program, 36 months in clinical urology, and the remaining 12 months divided between general surgery and urology or other urologically relevant disciplines. (The final 12 months of residency must be spent as a chief resident in urology in institutions that are an approved part of the residency program.)
The urology residency selection process is highly competitive, and residency program directors are interested in the quality and quantity of electives taken during the final year of medical school. It is recommended that medical students interested in urology spend a maximum of two months on urology electives, with one taken at the student’s home institution and the other as an “away” rotation.