Generational differences have long been quoted as a driver for population trends, not just by those in the medical community but by the public as a whole. The concept of “generations” as we define them today was popularized in 1991 by William Strauss and Neil Howe when they theorized a cycle of recurrent generational types.¹ In their book, they defined social generations as an aggregate of people born over a span of approximately 20 years that had experienced key historic events at similar stages in life leading to shared beliefs and behaviors as well as a perceived membership in the generation. Strauss and Howe characterized each generational persona with broad generalizations and assigned them archetypal roles. See the Table for the definitions of each generation based on year of birth, their respective ages in 2024, and their core values as defined by the authors. Quite controversially, they argue that these generational cohorts are more deterministic than any other social grouping, including economic class, race, sex, religion, and political party. The book has received criticism for its lack of empirical evidence; however, as the concept of generations has become more widespread, there has been an influx of sociological studies to suggest that there may be scientific merit in the generational approach to understanding society.²

Table. Definitions of the Generations Based on Year of Birth and Age in 2024 as well as Defining Core Values

For the first time, there are 5 generations of urologists working side by side: traditionalists, baby boomers, gen X, millennials, and gen Z. Differences run deep, whether it is with regard to influences, values, or life experiences. Some in the urology community have posited that these differences contribute to the shifting practice patterns that have emerged as the workforce ages and the younger generations enter practice. Consequently, understanding generation gaps may help us predict the future direction and character of the urology workforce and contribute to the foundation of a cohesive workplace.

Dr Kobashi’s interest in this subject was piqued by the unique insights of the newer generations that she worked with over the course of her career. As a culmination of this curiosity, she gave a grand rounds presentation on this subject that established a framework to initiate discussion and generated days’ worth of conversation within our hospital’s urology department. Despite a clear interest in the topic, however, she was surprised to find that there was really very little empirical evidence within the urological literature on this concept. With serendipitous timing, the AUA Data Research Program presented itself as a perfect opportunity to address our questions.

The AUA Data Research Program is a $2000 grant that supports projects using the AQUA Registry patient cohort data and AUA Census data to “address key knowledge gaps and emerging research questions related to urological care delivery, workforce development and health policy.”³ Past projects have answered important questions, such as telemedicine utilization relative to urological cancer mortality, cost/trends of ambulatory urology service, impact of the Choosing Wisely Urology Care on medical care, etc.³ Independent of the program, the AUA Census data have already been used to great effect to evaluate gender and race distributions and trends within the urology workforce.^4–6 As we went about designing our study, we felt that the census data lend itself perfectly to analysis by generational cohort and were thrilled to have been selected for the 2024 Data Research Program Award. Our study will utilize the census data to investigate differences between urologists across generational cohorts in 4 topics: demographic information, practice characteristics, integration of clinical technology, and burnout/wellness. We’re hopeful that, through this award, we will initiate conversation about intergenerational differences that can be impactful and generate awareness of how to care for and maximize the efficacy of our workforce.