Attention: Restrictions on use of AUA, AUAER, and UCF content in third party applications, including artificial intelligence technologies, such as large language models and generative AI.
You are prohibited from using or uploading content you accessed through this website into external applications, bots, software, or websites, including those using artificial intelligence technologies and infrastructure, including deep learning, machine learning and large language models and generative AI.

UPJ INSIGHT Demographic and Practice Trends of Rural Urologists in the U.S.: Implications for Workforce Policy

By: Tullika Garg, MD, MPH; R. Matthew Coward, MD, FACS; Suzanne B. Merrill, MD, FACS; William C. Huang, MD, FACS; Arthur L. Burnett, MD, MBA, FACS | Posted on: 01 Sep 2022

Garg T, Meeks WD, Coward MC, Merrill SB, Huang WC, Burnett AL. Demographic and practice trends of rural urologists in the U.S.: implications for workforce policy. Urol Pract. 2022;9(5)481-490.

Study Need and Importance

Older Americans utilize urological services at 3 times the rate of other adult populations. The projected urologist shortage will disproportionately impact older adults, particularly those in rural areas, where only 0.4% of urologists practice. To prepare for future workforce needs, we describe the current demographics and practice characteristics of rural urologists using American Urological Association Census data from 2016 to 2020.

Figure. Distribution of rural urologists by county (2020).

What We Found

The rural urologist workforce is older, and mean age and years in practice have increased from 2016 to 2020. Rural urology practices have significantly more difficulty filling urologist vacancies. Rural urologists took more call nights per week and had consistently fewer practice resources such as advanced practice ­providers and nurses. The majority of U.S. rural counties have no urologists (see Figure).


There are known limitations to describing rurality using the U.S. Department of Agriculture urban-rural designations for zip codes. Our results were primarily descriptive. The American Urological Association Census data are limited for assessing trends over time as the respondent group varies each year.

Interpretation for Patient Care and the Specialty

The aging urology workforce coupled with the overall urologist shortage will disproportionately affect rural America. These findings highlight the need to develop new policies and initiatives that encourage urologists to practice in underserved rural areas.

“The aging urology workforce coupled with the overall urologist shortage will disproportionately affect rural America.”


We thank William D. Meeks for his contributions to study design, AUA Census data, conducting statistical analysis, creating the geocoded map, and drafting and editing the manuscript.