I crawled back into bed at 2 a.m., maneuvering around my wife with her pregnancy pillow and my cat who had claimed the warm spot as soon as I left for the hospital to stent an infected stone patient. As I got under the covers with the precision of a seasoned, stent-placing samurai, it suddenly hit me–I have no idea how to go about getting a job as a urologist.

Should I already have a job lined up? Should I be scouring websites like LinkedIn or Doximity? Should I be looking at craigslist? As these thoughts raced through my mind, I did resist the urge to browse craigslist ads seeking urologists, which would have undoubtedly resulted in many interesting stories. However, I was still left with the insomnia-inducing thought: this is the least prepared I have ever been when looking for a job.

As I prepare to move my entire family across the country for my oncology and robotics fellowship, it is hard to repress the sheer anxiety of the fact that I have no idea what comes next. While this may just be the “natural” angst that one feels as they move on to the next level in their professional life, it is hard to ignore the juxtaposition of simultaneously feeling the most trained I have ever been for a job, while having no idea how to find it.

Of course, cursory research will reveal resources such as the AUA JobFinder or other job boards that are associated with individual professional societies. But these are far from comprehensive. There are also the 25+ emails a day that slip through the spam filter of my inbox from recruiters describing the “perfect” job in an ambiguous, quaint town that is always less than 2 hours away from a regional airport. The fact that a lot of the time I cannot differentiate these emails from the ones I receive from imprisoned Nigerian princes really does not inspire confidence.

A very nonscientific survey of previous graduates from my program revealed the one method that an astonishing majority used to find their current jobs–word of mouth. Relatively speaking, urology remains a pretty “small” specialty with a vibrant, active community. While this is truly an amazing aspect of our profession, it has also contributed to the fact that one of the most technologically advanced fields still mainly relies on tactics from medieval times to employ its members.

While I am painting a grim picture of the current state of new graduates, one would still struggle to find a urologist who is unemployed solely because they could not find a job. We are making strides to fill this void in the transition from trainee to independent practitioner. From resident-led initiatives, such as that of my colleague, Dr. Theo Cisu, who created a blog/job board called peepeeMD.com, to national organizations such as the AUA and LUGPA putting on seminars on career building, the volume of resources is certainly increasing. While we still have a long way to go, I am confident that the same people who figured out how to harness the power of lasers and robots to alleviate human suffering can also figure out how to organize a classifieds section.

In the meantime, does anyone know anyone that is looking for a urologist? Asking for a friend.