Doctors of Osteopathic Medicine (DOs) and Doctors of Medicine (MDs) are both recognized and accepted as physicians in all 50 states with the same practice rights. With the completion of the merger of residency training programs into a single accreditation in 2020,¹ DOs and MDs now train side by side in urological residency and undergo the same rigorous board certification through the American Board of Urology.² However, does this mean they are viewed as equals in the urology community and all the previous stigma associated with DOs are now a thing of the past?

Osteopathic medical students now comprise 25% of all medical students in the United States.³ In an AUANews article published in April 2023, Louters et al listed many of the challenges and barriers that DO applicants face when applying to the urology match.⁴ Some of these challenges include poor exposure to urology during medical school, where most osteopathic medical schools do not have home urology residency programs, and limited mentorship and networking opportunities for students seeking research opportunities. There are efforts throughout the AUA and specialty societies to improve awareness and the need for involvement by both MDs and DOs.

These challenges certainly can seem discouraging and difficult to overcome, particularly for incoming and young DO urologists to the field. However, strides have been made within the AUA and various subspecialties to be more inclusive. For instance, the American Academy of Pediatrics Section on Urology recently changed their bylaws to allow DOs who completed an AOA (American Osteopathic Association)-accredited residency and an ACGME (Accreditation Council for Graduate Medical Education)-accredited pediatrics fellowship to become fellows in the society. Previously, the section only allowed urologists who completed ACGME-accredited residency training and were board-certified with the American Board of Urology to become fellows. Other subspecialty organizations are also inclusive to all fellowship-trained urologists irrelevant of the medical school degree such as the Society of Urological Oncology and the Societies for Pediatric Urology. The Society of Urological Oncology and the Societies for Pediatric Urology have engaged DOs in many of their programs as presenters, panelists, and moderators on the podium. Within the AUA, there is an osteopathic representative on the Young Urologists Committee to represent the interests of DOs within the AUA. At the annual meeting, the Young Urologists Committee hosts a myriad of activities and mentoring sessions such as “Meet the AUA Leaders” and resident speed mentoring, which any budding DO urologist can attend for free.

A growing number of DOs are now residency program directors, associate residency program directors, or fellowship directors. Now, more than ever, there are more DOs serving as faculty in residency training programs, as well as fellowship training programs, across the entire country. Many of us now find ourselves in a position of influence where we can truly make a difference in recruiting more DO students into urology. This also allows for many academic MD urologists who weren’t familiar with DOs to learn firsthand about the training, school, and caliber of DO students. Recently, a group of osteopathic urology residents across the country harnessed the power of social media platforms and donated their time to provide mentorship and interview advice to DO applicants for the 2023 application cycle. This concept of leading by example is a first step for many university systems to take a stand and show their support of equality between DO and MD urologists.

This article is an awareness and push that the time is now to continue to engage all urologists in organizations and get them involved. A urologist is a physician and surgeon despite the letters behind their name, and it is time for the AUA and all urological organizations to engage DO urologists right along with their MD counterparts. Leaders will be leaders, and urology as a field and profession must provide the platform for DO and MD urologists to become the natural-born leaders often sought in organized medicine and administration.

The onus is on us to be visible on regional and national stages and represent our field so that we are accessible and exemplary to the upcoming generations of DO urologists. Whether one has a DO or MD, we should keep in mind that the goal for all of us should be focused on caring and treating our patients, not which 2 letters are behind our names.