The impending urologic workforce shortage has been a key focus of the AUA and a priority issue when we meet with congressional leaders at the annual AUA Advocacy Summit in Washington, DC (Figures 1 and 2). Several factors have led to the physician workforce shortage where the current supply of urologists is unable to meet the demands of a growing and aging population. The supply of urologists is impacted by limited Medicare funded residency positions, a long pipeline to replace urologists, a preference for practicing in metropolitan locations, prevalent burnout among urologists, and an aging workforce where 40% of urologists will reach retirement age (65 years or older) in the next decade. This comes at a time when the US population is growing and aging with an estimated 11,500 individuals turning 65 each day. Those over 65 years old utilize urological services at a rate 3 times that of the general population.

Our work used the AUA Census, the Accreditation Council for Graduate Medical Education Data Resource Book, and US Census data to anticipate the timing and degree of the urologist shortage through 2060.^1-3 Our models begin with the current urologist workforce and account for both incoming urologists, those graduating residency or fellowship and joining the workforce, and urologists exiting the workforce through retirement. These models show that without growth in urology residency positions, we will have a continued decline in the number of urologists per capita. This decline can be offset by increasing the number of urology residency positions to increase the supply of urologists, but it would take more than 20 years to see the impact of this growth.

An inadequate supply of the urologic workforce will result in limited access to urological care for patients. There will be delays in care that may result in more advanced disease and prolonged suffering for patients. As the workforce contracts, rural and underserved communities will be disproportionately impacted, with longer travel times to receive care. Currently, only 38% of US counties have a practicing urologist.

Increasing demand from a growing and aging population and an increased rate of retirees exiting the workforce are nonmodifiable factors affecting the physician workforce. However, there are modifiable factors that can be addressed to create and maintain a robust and resilient urologic workforce. Among these are increasing urologic residency positions, reducing burnout, reducing administrative and regulatory burdens on urologists, and enhancing support of the entire care team to aid in the seamless delivery of high-quality patient care.

Some policy solutions to address the impending urologist shortage have bipartisan support. Recent legislative successes include policies that reduce administrative burdens in prior authorization and health care documentation, and policies that improve access to care and treatments (eg, Inflation Reduction Act). During our time at the AUA Advocacy Summit in Washington, DC this year, we brought legislative asks to members of the House and Senate. Members of the AUA met with members of Congress to garner support for the Resident Physician Shortage Act, the Conrad State 30 and Physician Access Reauthorization Act, and the Specialty Physicians Advancing Rural Care Act, all of which strive to increase and retain urologists in the workforce. We also discussed the CONNECT for Health Act, which will provide permanent support for telehealth access and reimbursement. Finally, we asked for support of the Preserving Seniors’ Access to Physicians Act of 2023, which aims to increase Medicare physician reimbursement.

The AUA Advocacy Summit brings together urologists across the training spectrum, from those who have been in practice for many years to those who are in medical school and considering a career in urology. We highly encourage you to attend the 2025 AUA Advocacy Summit next spring so that you can be a part of ongoing work to support patient care and the future of urology through policy and advocacy.