Like many other medical students, my exposure to and knowledge of urology prior to starting my rotation was fairly limited. Urinary tract infection in a sexually active female—Staph saprophyticus. Sustained erection after taking Trazodone—priapism. Flank pain radiating to the groin—kidney stones. These were the buzzword scenarios I had seen repeatedly during Step 1 studying that formed the base of my limited understanding of urology. Working as a scribe in a nephrology clinic for 2 years before medical school, I would often see patients be referred to urology for bothersome lower urinary tract symptoms or obstructive stones. But I didn’t fully understand what happened beyond the referral. Having now completed a 4-week urology rotation, my eyes have been opened to an entirely fascinating, challenging, and rewarding specialty that I feel more medical students should have the opportunity to learn about.

I arrived on my first day of the rotation with an open mind and no expectations besides an eagerness to learn and the hope that I wouldn’t scrub in with a shoe cover for a scrub cap. I jumped into a radical orchiectomy, and I was immediately impressed by the friendly nature and eager-to-teach attitude of the attending and resident. We discussed testicular cancer, lymphatic drainage, and the preferred surgical approach for an orchiectomy. At the end of my rotation, in a full circle experience, I was able to follow up with this same patient, reassuring him that the cancer appeared to have been caught at an early stage and explaining the principles of active surveillance.

My second day of the rotation was a busy clinic day. I felt like a deer in headlights with the amount of terminology, acronyms, and procedures I had never heard of. I opened what felt like 20 tabs to google things like “URS/LL” and “PCNL.” Luckily, the American Urological Association (AUA) has a very helpful PDF of common urology acronyms available on their website. This is also when I stumbled across the AUA medical student curriculum, which I found immensely helpful throughout my rotation. On this same clinic day, I helped to order suprapubic catheter supplies for a patient with neurogenic bladder, I talked to a patient about prostate cancer screening, and I observed how a transrectal prostate biopsy is performed. The following day in the operating room, we were able to perform a cystolitholapaxy for a patient who had an entombed ureteral stent. We also performed a vaginal repair for a patient with severe pelvic organ prolapse that was causing significant discomfort and urinary incontinence.

Urology offers such a wide variety of pathologies, a diverse patient population, and the opportunity to make a significant impact on a patient’s overall quality of life. It also allows for great continuity of care and meaningful long-term relationships with patients. After scrubbing into a prostatectomy during my second week, we followed up with this patient regularly in clinic to discuss his Gleason score, monitor his postoperative progress, and discuss future surveillance. Given that many urological cancers (such as prostate and testicular) are often detected early and have high 5-year survival rates, urology provides the opportunity to develop long-lasting, unique relationships with patients as you guide them through their cancer diagnosis, treatment, and subsequent follow-up over many years.

Over the course of my rotation, I came to develop a genuine respect and curiosity for urology—a field that most medical schools provide minimal exposure to. Urology is a specialty that offers extensive variability and a distinct mix of cutting-edge surgical, medical, and in-office procedures. This, combined with the opportunity to provide preventative care and develop long-term patient relationships, makes it a very appealing field that I would encourage fellow students to explore.

If your medical school does not have a home urology residency program or has limited educational exposure to urology, know that you are not alone! You can reach out to nearby programs via email to express interest and to get involved in research. You may also be able to take a urology elective or create an individualized clinical opportunity during your clerkship years. As many medical schools transition to an 18-month preclinical curriculum, there is greater time to explore the field through shadowing or research opportunities before applying to residency. Moreover, networking and mentorship through conference attendance and social media are highly valuable tools to establish connections within the tight-knit field of urology—make sure to keep your CV updated! If your school has an academic advising department, meet regularly with an advisor, who can help you seek out opportunities and plan your fourth-year acting internship experiences with other urology departments.

At the medical school level, I believe there is further opportunity to increase early exposure to the field of urology. Urological topics are often sprinkled into preclinical courses during Renal or Reproduction blocks, but I believe greater clinical emphasis can be placed on urology as a distinct specialty with increased awareness of the variety of conditions a urologist treats. Additionally, there is opportunity for growth in the clinical skills portion of medical school curricula to expand training for medical students on essential skills such as Foley catheter placement, basic suturing, knot tying, and performing testicular and digital rectal exams. With all of this in mind, below are resources I found particularly helpful during my own rotation that I will continue to utilize during other clerkships. Beyond these resources, I would strongly encourage students to seek out clinical experiences in urology because firsthand exposure truly does make a vast difference.

Helpful Urology Resources for Medical Students

• AUA Medical Student Curriculum (also available in App store): https://www.auanet.org/meetings-and-education/for-medical-students/medical-students-curriculum.
• AUA Medical Student Resources: https://www.auanet.org/meetings-and-education/for-medical-students/medical-student-resources.
• AUANet Common Urology Acronyms: https://www.auanet.org/Documents/education/medical%20student%20curriculum/Urology-Abbreviations.pdf.
• AUA Inside Tract Podcast (also available on Apple Podcast): https://www.auanet.org/meetings-and-education/podcast.
• AUA University Podcast (also available on Apple Podcast): https://auau.auanet.org/podcast.