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UPJ INSIGHT Demographics and Career Trends of Urology Fellowship Directors in the United States
By: Nathan VanderVeer-Harris, BS, Herbert Wertheim College of Medicine, Florida International University, Miami; Chase Mallory, MD, University of Florida, Gainesville; Daniel Boaretto, BS, Herbert Wertheim College of Medicine, Florida International University, Miami; Maria Kolesova, BS, Herbert Wertheim College of Medicine, Florida International University, Miami; Vincent Bird, MD, University of Florida, Gainesville | Posted on: 20 May 2024
VanderVeer-Harris N, Mallory C, Boaretto D, Kolesova M, Bird V. Demographics and career trends of urology fellowship directors in the United States. Urol Pract. 2024;11(3):587-595. doi:10.1097/UPJ.0000000000000541
Study Need and Importance
Fellowship directors (FDs) play pivotal roles within academic urology, yet pathways to these positions remain poorly understood. We characterized urology FDs across 6 subspecialties.
What We Found
In a cohort of 219 FDs, 20% were female (Table). Female representation was highest in Female Pelvic Medicine and Reconstructive Surgery (FPMRS; 61%) and Pediatrics (31%). Female FDs were younger than males at 49 and 53 years, respectively. Female FDs exhibited stronger correlations between age vs H-index, and time since fellowship graduation vs H-index, than male FDs. The median H-index for all FDs was 23.5, differing between females (14.0) and males (26.0). The median H-index was highest in Urologic Oncology and Endourology/Minimally Invasive Surgery at 29.5 and 29.0, respectively. FPMRS showed the strongest correlation between age vs H-index, while Urologic Oncology demonstrated the strongest correlation between time since fellowship graduation vs H-index. Among 200 FDs with fellowship training, over half completed fellowship at one of 14 institutions. Approximately 21% of FDs worked at their former residency institution and 19% at their former fellowship institution, the latter trending more prominently among FPMRS and Pediatrics.
Table. Gender, Age, and H-Index Distributions of Urology Fellowship Directors by Subspecialty
| Total | Endourology/ Minimally Invasive Surgery |
Female Pelvic Medicine and Reconstructive Surgery |
Genitourinary Reconstructive Surgery |
Male Sexual Health |
Urologic Oncology |
Pediatric Urology |
||
|---|---|---|---|---|---|---|---|---|
| Gender, No. (%) |
All | 219 (100) |
53 (100) |
41 (100) |
28 (100) |
37 (100) |
34 (100) |
26 (100) |
| Female | 43 (19.6) |
6 (11.3) |
25 (61.0) |
1 (3.6) |
2 (5.3) |
1 (2.9) |
8 (30.8) |
|
| Male | 176 (80.4) |
47 (88.7) |
16 (39.0) |
27 (96.4) |
35 (94.6) |
33 (97.1) |
18 (69.2) |
|
| Age, median (Q1-Q3), y |
All | 52.0 (46.0-58.0) |
54.0 (48.0-60.0) |
51.0 (45.75-55.5) |
49.5 (45.25-55.5) |
58.5 (49.5-62.25) |
49.0 (47.0-53.0) |
50.0 (46.5-55.0) |
| Female | 49.0 (43.0-52.0) |
45.0 (39.25-50.0) |
51.0 (45.0-52.75) |
49.0 (49.0-49.0) |
38.0 (38.0-38.0) |
43.0 (43.0-43.0) |
49.0 (46.0-50.5) |
|
| Male | 53.0 (47.0-59.0) |
55.0 (49.5-60.0) |
54.5 (46.5-57.75) |
50.0 (45.0-56.0) |
59.0 (51.0-62.5) |
49.0 (47.0-53.0) |
53.0 (47.5-57.0) |
|
| H-index, median (Q1-Q3) |
All | 23.5 (14.0-37.0) |
29.0 (18.0-45.0) |
16.5 (10.75-26.25) |
21.5 (14.0-28.25) |
25.0 (12.0-41.0) |
29.5 (22.25-44.75) |
17.0 (14.0-24.75) |
| Female | 14.0 (8.0-22.75) |
24.5 (13.75-42.75) |
12.5 (7.75-17.5) |
24.0 (24.0-24.0) |
4.0 (4.0-4.0) |
44.0 (44.0-44.0) |
14.0 (10.5-19.0) |
|
| Male | 26.0 (16.0-39.0) |
29.0 (19.0-43.0) |
23.0 (17.5-32.75) |
21.0 (14.0-28.5) |
27.0 (13.5-43.5) |
29.0 (22.0-45.0) |
19.5 (15.0-26.5) |
Limitations
This cross-sectional study relied on online data. Inclusion of FPMRS FDs with obstetrics/gynecology or urology training may limit its generalizability to urologists alone. Our analysis used a binary gender categorization. H-index may not encompass all facets of academic impact and scholarly activity.
Interpretation for Patient Care
FDs play important mentorship roles influencing advanced urological training and patient care. This study offers a baseline for future gender-inclusive initiatives and can aid those aspiring to leadership roles in academic urology.
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