In September 2023, 3 members of the AUA’s Advanced Practice Provider Committee presented a webinar on advancing your career in the field of urology. Corinna Hughes, Jennifer Lewis, and I provided information for advanced practice providers (APPs) based on our years of experience in health care and urology. Strategies were provided for providers in their early career, middle career, and advanced career, including retirement. The goal of this webinar was to reach out to APPs who work in urology, or are interested in urology, and provide information that would benefit their careers.

Corinna has been working at the Mayo Clinic in Minnesota for 3 years. She was able to enter a urologic fellowship program after receiving her Doctor of Nursing Practice degree that provided her with 1 year of postdegree training prior to entering practice. She feels that this training was a huge benefit and gave her opportunities to explore all subspecialties in urology. Urology has great patient variety, and she enjoyed the ability to perform procedures. She had a lot of peer support and discussed how quickly her knowledge base expanded over a very short period. Lack of knowledge and confidence were her biggest hurdles, and she recommends grabbing knowledge at every opportunity, finding mentors, and allowing confidence to grow over time. Corrina encourages APPs to embrace opportunities for learning and not be afraid to ask questions. Self-care will allow APPs a good work-life balance. It can be easy to become overwhelmed early in a career, and taking time away from work will ultimately help your work life.

The University of Oklahoma has been Jennifer’s home for the past 12 years. She is a certified urology nurse practitioner, and she also works with the department of nursing. She previously spent some time working in urology as a registered nurse and the opportunity to work there as a nurse practitioner “fell into her lap.” Urology resonated with her, and she enjoys the diversity and varied opportunities that her practice has provided. She is an active researcher and enjoys the network of people that she collaborates with. She describes urology as “fun” and loves the educator aspect of her job. Some of the struggles she encounters include poor recognition for the APP role, role ambiguity (are you a nurse, a doctor, a medical assistant?), and a lack of opportunity for advancement. Once APPs pass the 10- to 15-year mark, there may be limitations to advancement, whether this is financial or personal. Jennifer’s suggestions for APPs at this stage of their career include believing in yourself, being aware of your self-worth, and advocating for yourself. Be available to as many people as possible, which increases your credibility, expertise, and ability to impact patients and your professional team. Do not overcommit, and negotiate for yourself. She would like to have gotten involved in my more “extracurricular” activities sooner, like AUA, Society of Urologic Nurses and Associates, and local organizations. Finally, enjoy the ride! Urology is a fun field!

I worked as an APP for 23 years at Augusta University/Medical College of Georgia, spending my last 8 years in the field of urology. I transitioned because of becoming stagnant in my previous department. The opportunity arose and I grabbed it. I enjoy working in both medicine and surgery, so urology was a great fit. I had extensive women’s health experience, which was beneficial for my transition. Urology afforded me more independence and vast opportunities for growth, which included performing procedures. The biggest challenge was how busy the practice was. Urology has a shortage of providers and clinics are always full, with waiting lists for appointments. APPs almost always take on additional nonclinical tasks. A licensed provider is needed to order tests, fill prescriptions, sign documents/orders/paperwork, call peer-to-peer requests, and answer complex patient questions. Seasoned APPs can multitask very well and often juggle multiple things at one time. They are often the “go-to” person, sometimes without knowing when, or how, to say no. While I enjoyed being in demand, the burden does put a strain on an APP’s workload. Insist on administrative time! One cannot be expected to be in a clinic/operating room/hospital every day without time for nonclinical tasks that must be handled. Find a niche and be the expert for your group. This may not be exactly what you want, but it will be exactly what is needed. If you want to do procedures, request the opportunity to learn those skills. Be sure you are included in all team/department activities. If you have been with a department for more than 15 years, you are a very valuable member of that team. Finally, when it’s time to leave/retire, don’t be afraid to do it. You will know when it’s time to go, trust me.

In summary, we all agree that we love urology. We find it fun, we like diversity, we enjoy procedures and expanding our knowledge. We realize that we need to take care of ourselves and that we need peer support and administrative time. We encourage APPs to give urology a try, and once you get there, to grow and develop your role in the practice. Find yourself a niche, hopefully one that you truly enjoy, and become that valuable member of the team that staff will look to because of your expertise. Get involved in local or national organizations and realize that the sky really is the limit.