Reversing the Decline in Urology Residency Applications: An Analysis of Medical School Factors Critical to Maintaining Student Interest

OBJECTIVE To identify institutional factors that predict medical student decision to apply for the urology match. MATERIALS AND METHODS American Urological Association (AUA) Match data from 2015 to 2019 were used to determine the number of applicants from each medical school who submitted rank lists. Associations between the applicant counts from each medical school and medical school characteristics were assessed using multivariable Poisson regression models. Data were obtained using publicly available datasets and a survey of urology program coordinators. RESULTS There were 1916 medical students from 199 medical schools who submitted rank lists to the urology residency match. After adjusting for class size, schools with a urology residency program produced significantly greater number of urology applicants (RR 2.7; 95% CI, 2.2-3.4, p<0.001). Additional predictors included a shorter preclerkship curriculum (less than 18 months; RR 1.2, 95% CI 1.09-1.35, P<.001), number of urology residents (RR 1.11, 95% CI 1.05-1.17, P<.001), urology faculty (RR 1.1; 1.04-1.2; P=.01; per 10 faculty), top 20 residency ranking on Doximity (RR 1.2; 1.1-1.4, P<.001), and presence of urology interest group (RR 1.3, 95% CI 1.1-1.6, P=.005). Approximately 28% of applicants were female, and the percentage of female urology faculty at their institution significantly correlated with number of female applicants (b=0.22, 95% CI: 0.01-0.44; P=.049). CONCLUSION To recruit more medical students into urology, departments should foster early preclinical exposure to specialty-specific interest groups, interaction with residents, and development of a diverse faculty. (C) 2019 Elsevier Inc.