Tag Archive: Spotlights: Urology

Spotlight Interview: Why Did You Choose Urology? (USC Resident)

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Choosing a Specialty, Urology, Why did you choose....?

June 4, 2012

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A Urology Resident’s Perspective: From an interview with a urology resident from the University of Southern California (USC) Medical Center in Los Angeles, California.

Part of an interview series entitled, “Specialty Spotlights“, which asks medical students’ most burning questions to physicians of every specialty.  See what doctors from every specialty had to say about why they chose their specialty and how to match in their residency.

 

  • What attracted you to Urology?

Many factors attracted me to Urology…

1) Surgery – If you are interested in surgery then definitely consider urology. Urology has a very broad range of surgeries ranging from microsurgery to complex open abdominal cases with extensive reconstruction. If you are into technology, urology is often on the forefront of new surgical modalities such as robotic surgery.

2) Clinic – Many urologic issues are often dealt with in an outpatient clinic. There is definitely continuity of care as many urologic issues aren’t resolved with one clinic visit. Whether it is a patient with recurrent kidney stones that needs a metabolic work up, or a post surgical cystectomy patient for bladder cancer that you are surveying.  Also many urologic procedures can also be done in an office setting such as cystoscopy, ureteral stent placement, vasectomy, prostate biopsies, plus much more.

3) People – Your work environment and colleagues are an important factor in choosing a specialty. Although it is a stereotype, it is often true; urologists are known to be fun, down to earth, and happy surgeons. Also, urology is a small field. You will find when you go on interviews, you will get to know the majority of your interviewing cohort by the end of the interviewing season. Similarly, most academic urologists know the other academic urologists across the whole country. Everyone is familiar with one another and this lends to a tight knit group of specialists.

4) Lifestyle/Flexibility – This is definitely a factor to consider when choosing a specialty. Not only are urologists relatively well compensated as it is a surgical specialty, the field also lends itself to a relatively nicer lifestyle if that is what you are looking for. Although training is rigorous, once you are practicing there are generally very few urologic emergencies. Urology also allows you to be flexible with how you want to practice. You could do very well practicing as a general urologist. You can also choose to sub-specialize by pursuing one of a number of fellowships. These include urologic oncology, endourology/stone disease, pediatric urology, transplant, reconstruction, female/neuro urology, minimally invasive surgery, and andrology/infetility.

  • Describe a Urologist’s typical work day?

This can vary widely depending on if you are in academics or private practice, but in general urologists operative 2-3 days a week. The rest of the week is split between research and clinic.

 

  • What type of lifestyle can a Urologist expect?  

Few urologic emergencies lend to a nicer lifestyle for urologists. The field is flexible and you can generally choose to be as busy as you would like. Because it is a surgical field you can still expect relatively early mornings.

 

  • What is the average salary of a Urologist?

See the excellent positings on this blog for average salaries. [Link from the Editor: The Ultimate Guide to Physician Salaries]

 

  • What is the job market like for Urology?

In general, very good. Very few urologists are trained each year (approximately 270). This leads to a shorter supply for a growing field. Definitely keep in mind that in more desirable locations, jobs may be more difficult to find, and you will take a substantial pay cut than if you practiced in a more rural setting.

 

  • What can you tell us about Urology Sub-specialties?

Urologic oncology – 1-3 extra years of fellowship (accredited vs non accredited). Lifestyle is more varied as your patients are, in general, more sick. Variety of surgery from robotics to massive abdominal surgery.

Endourology/stone disease – 1-2 years of fellowship. Master endscopic/percutaneous management of stone dsease.

Female urology – 1-2 years of fellowship. Nice lifestyle, very good job market as they are in high demand.

Neurourology – 1-2 years of fellowship. Urodynamic evaluation of patients with voiding disorders.

Infetility/Andrology – 1-2 years of fellowship. Very few fellowship spots available. Very nice lifestyle, more competitive job market.

Pediatrics – 2-3 years of fellowship. Also competitive job market especially for major cities.

Transplant – 1-2 years of renal transplant fellowship. Varied lifestyle depending on seniority/call schedule.

Reconstruction – 1-2 years of fellowship. Nice lifestyle.

 

  • What are the potential downsides of Urology that students should be aware of?

It is not a field to go into if you are not into surgery. The surgical training is very rigorous. Most programs are 5-6 years in length, and you can expect early mornings and late evenings. Although times are changing, urology is still a male dominated field which can be a deterrent to many women who may be interested. The good news is that there is a rise in female applicants each year and there is a growing need and demand for urologists who are female.

 

  • What else would you tell medical students who are considering Urology?

If you are at all interested in surgery, definitely consider exposing yourself to urology by doing a rotation in medical school. Most medical students have little to no exposure to urology and much of this exposure is all in the classroom setting. Many people (including patients, medical students, and practicing physicians) have little knowledge of the field and what we do. Although it is a unique specialty, you can tailor your practice to your own wishes and desires: more clinic, more in-office procedures, more big whacks, etc.. Definitely check out www.urologymatch.com, which is surely the best resource for medical students and has many articles as well as an active message board. Also check out the official American Urologic Association at www.auanet.org.

 

Editor's Note: For more help choosing a specialty in medicine, I highly recommend one or both of these two great books. I found both very useful.

 

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Spotlight Interview: How to Match in Urology (USC Resident)

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Choosing a Specialty, How to match in....?, The Match, Urology

June 3, 2012

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A Urology Resident’s Perspective:  From an interview with a urology resident from the University of Southern California (USC) in Los Angeles, California

Part of an interview series entitled, “Specialty Spotlights“, which asks medical students’ most burning questions to physicians of every specialty.  See what doctors from every specialty had to say about why they chose their specialty and how to match in their residency.

 

  • How competitive is the Urology match?

It is considered a competitive specialty to match into. The website www.auanet.org has some statistics that can help you out. In general there is an approximately 70-80% match rate for students coming directly out of medical school. This number is substantially lower for graduates that did not match the first time around, graduates that took time off after medical school, and international medical graduates. The good news is the number of positions are increasing each year, while the number of applicants has stayed approximately the same. This does vary year by year.

 

  •  What must a student do to match well in Urology?

Be very well rounded. Step 1 scores aren’t everything, but many programs will use this score as a screening tool to offer you an interview. Unlike most other specialties, urology does not publish data on average Step 1 scores of matched applicants. There is a generalization that scores above 230 are considered competitive and will get you interviews at most places except for possibly top tier institutions. There are definitely exceptions, and unfortunately these date are not publicized by institutions. Research is not a must, but can definitely set you apart from others, especially if you have presented the research at a meeting or as a published article. This will give you more to talk about during your interviews. Great letters of recommendations from urologists are also important. Having a letter from a well known urologist can really help your application and increases your chance of matching well. Urology is a small field, and most academic urologists know each other well, so a strong letter of recommendation from a leader in the field can take you far.

 

  • What are residencies looking for in a Urology applicant?
Stong work ethic. Personable applicants. Great board scores. Strong letters of recommendations. Great clinical knowledge.

 

  • What should students look for in a Urology residency?

Satisfaction – how happy are the residents? Operative experience – do the residents get autonomy when they operate or are they mainly assisting attendings? There are some programs where you will be assisting even as a chief resident. Research – is there a research year built into the program? What opportunities are there for clinical/translational/basic science research? do the residents publish? Location/Social life – although you will be busy, the days you are free you want to be able to have something to do. Do the residents have fun outside of the hospital? Staff – how are they to work with?

 

  • Do you have any advice on the application, letters of recommendation, personal statements, or how to rank programs?

1) Submit your application early! If possible this means the day ERAS is open for application submission (For the 2013 match this date is September 15th, 2012). You can fill out the majority of ERAS ahead of time. Also make sure all your letters of recommendation’s are ready by the time you can finalize and submit your ERAS.

2) In general, only obtain letters of recommendations from urologists. 3 is enough. One is usually from the chairman of your urology department (and often the most important letter), and the rest are from either away institution urologists or a particular attending you worked with extensively and knows you well.

3) The personal statement is more likely to hurt you then to help you. Very rarely do personal statements stand out, and if they do stand out it may not be a good thing. In general be sincere, honest, and to the point in your personal statement.

 

  • What do you wish you knew before application/interview season?  

1) If you know you have a possible interest in urology, do a rotation as early as possible in your 3rd year. This will give you time to get to know the urology department at your university and will help you find a research project. Also, meet with your school’s dean regarding your competitiveness. Start talking with the urology residents at your institution and their experiences with applying.

2) Away rotations are important for urology. Not only does it give you an opportunity to see what other programs are like, this is also your chance to show them what can’t be expressed on your application. Start researching the programs where you might want to do an  away rotation early on, as applications for away rotations are generally due by February/March of your 3rd year. Importantly, an away rotation can help you just as much as it can hurt you. Think of it as a month long interview. While the month can be extremely stressful, it can also give you the best chance of matching at an institution you might not have thought you had a chance at. Most urology applicants do 1-2 away rotations.

3) If your USMLE Step 1 score is not as strong, consider taking Step 2 early. A substantial increase in your step 2 score can definitely help you.

4) Keep in mind that as of the 2012 match, the urology match is still an early match and it is separate from the regular match. This means that you need to expedite your application as well as letters of recommendation. As soon as your application can be finalized and submitted on ERAS (generally beginning of September), do this. This means your letters have to already be uploaded at this time. Many programs start offering interviews within a week of application submission. Interviews in general start at the end of September and last through mid December. The peak of interviews is during the month of November. On the bright side, all this hard work also means that you also get to match mid-January.

5) Spend lots of time on www.urologymatch.com. There is plenty of good information that can help prepare you for every aspect of urology.

6) Take everything you read on www.urologymatch.com with a grain of salt. The best way to really get to know a program is gathering information from multiple sources (first hand experience with an away rotation, talking to the residents/attendings, reading various opinions online).

 

  • What other advice do you have for students applying to Urology residency?

After your interview season is over, consider doing a second look if you have the time/money. A second look is a 1 or 2 day return visit to a program so that you can see first hand what they are all about. This is definitely not a must, however it can help you with making your match list. I suggest this particularly for programs that you think you will rank high, as this will allow you to experience first hand what the program is like. If you really like a program, try to find out during your first interview if second-look day is something that many people do. Again as much as a second look can help you with how you rank a program,  remember that it is the second-look at your for the program as well.  Do a second look if you really want to discover more about a program, not to show a program you’re really interested.

 

Editor's Note: Applying for residency or preparing for your interviews? I highly recommend First Aid for the Match, The Successful Match: 200 Rules to Succeed in the Residency Match, and The Residency Interview: How To Make the Best Possible Impression .


 

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Spotlight Interview: Why Did You Choose Urology? (OSU Resident)

Categories:

Choosing a Specialty, General Surgery Rotation, Urology, Why did you choose....?

June 1, 2012

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A Urology Resident’s Perspective: From an interview with a urology resident The Ohio State University Medical Center  in Columbus, Ohio.

Part of an interview series entitled, “Specialty Spotlights“, which asks medical students’ most burning questions to physicians of every specialty.  See what doctors from every specialty had to say about why they chose their specialty and how to match in their residency.

 

  • What attracted you to Urology?
I knew that I was attracted to surgery, but I was not interested in living a “surgeon lifestyle.”  Many doctors, including surgeons in other specialties, recommended during medical school that I check out urology.  Urology was not on my differential and the thought of dedicating my life to the urinary tract did not seem appealing.  I was convinced to do a 2 week surgery subspecialy rotation in urology.  I was amazed at the breadth of surgical procedures they performed.  I also enjoyed all the different equipment (or toys) that they utilized.  There was also a lot of variety in clinic between medicine and office procedures.  I appreciated the fact that urologists worked hard, but most days were still done at a reasonable hour.   This allowed the urologists to maintain a healthy balance between work and life outside the hospital.  Probably, the deciding factor was how genuinely happy the urologists were and when asked, all of them stated they would choose urology if they had to do it all over again.

 

  • Describe a Urologist’s typical work day?

The work week is usually split fairly evenly between clinic and OR.  I would say that most urologists have around 2 OR days and 3 clinic days, although many clinic days may have time dedicated to office procedures.  Obviously, the clinic days are going to be more routine office hours.  OR days vary a lot depending on what type of cases you perform.  Most procedures are outpatient and relatively short.  If you plan to do a lot of cancer surgery then you will do some longer cases and therefore will have some evenings spent operating.

 

  • What type of lifestyle can a Urologist expect?  

It is still a surgery field which means you still have early rounds due to early OR cases.  I feel that residency hours are comparable to other surgery fields, with the main difference maybe being home call for urology versus in-house call for many other fields.  I feel there is a light at the end of the tunnel though.  In practice, most days will have office-hours type of schedule.  A lot depends on what types of cases you decide to do and how the call is split up.  In general, there are less emergent surgeries in urology than most other fields.  If you are at a busy hospital there still may be ER consults and inpatient catheter issues that will need to be addressed in the middle of the night.  I think that most nights, even on call, you can expect to get a decent amount of sleep.  Relative to some surgery fields, you should have adequate time to spend with family and doing hobbies during the evenings and weekends.

 

  • What is the average salary of a Urologist?

Overall, probably between $200,000 and $600,000 with starting salary between $200,000 to $400,000.  A lot has to do with private practice versus academics and how saturated the specific market is.  I think most academic urologists will make between $200,000 to $300,000, but with certain bonus/incentive packages may eventually make more.  If you are starting off in a bigger practice in a more competetive location, you will likely start off closer to the $200,000 range, but with time can build up your practice and eventually be making greater then $500,000.  There has also been a trend towards hospital employed urologists.  These hospitals will often provide higher starting salaries (e.g. closer to $400,000), but may have more of a ceiling on how much you can earn from there.

 

  • What is the job market like for Urology?

Most of the big, destination type cities are relatively saturated.  Having said that, you can likely get a job just about anywhere but you may just have to take a big pay cut.  There are many relatively rural hospitals that are desperate for urologists and will pay good money to lure you out there.  I would say in general that the job market is good, but you may need to have some flexibility on where you want to end up practicing.

 

  • What can you tell us about Urology Sub-specialties?

Urology fellowships are 1-2 years.  As opposed to the trend in many other surgical fields, you definitely do not need a fellowship to get a good job.  Most residents will only do a fellowship if they want to do academics or if there is a specialty field that they feel they did not get adequate exposure to during residency and they desire extra training in.  In some big cities, fellowships may give you a marketable skill, but most fellowship trained urologists will still practice general urology with maybe a slant towards that specialty.  If you really just want to do one specialized field and not other parts of urology, then academics is likely your best option.

 

  • What are the potential downsides of Urology that students should be aware of?

Urology is a tough surgical residency.  With any type of surgery comes complications and stress.  Although call may be better than some surgery fields, there are still going to be emergent cases or patients crashing in the middle of the night and on weekends.  You are dedicating yourself to the urinary tract which means a lot of bloody urine and prostate exams.  Everytime you tell people what field you’re in you have to answer the question, “why urology?”

 

  • What else would you tell medical students who are considering Urology?

If you want variety and enjoy being busy then this is a good field to consider. Compensation is definitely on the higher end which is a bonus!

 

Editor's Note: For more help choosing a specialty in medicine, I highly recommend one or both of these two great books. I found both very useful.

 

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Spotlight Interview: How to Match in Urology (OSU Resident)

Categories:

Choosing a Specialty, How to match in....?, The Match, Urology

June 1, 2012

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A Urology Resident’s Perspective:  From an interview with a urology resident from The Ohio State University in Columbus, Ohio

Part of an interview series entitled, “Specialty Spotlights“, which asks medical students’ most burning questions to physicians of every specialty.  See what doctors from every specialty had to say about why they chose their specialty and how to match in their residency.

 

  • How competitive is the Urology match?

Urology is one of the more competitive fields.  I think it’s similar to neurosurgery and ENT.  More competetive than general surgery but probably not as competetive as ortho, plastics, or dermatology.

 

  •  What must a student do to match well in Urology?

The usual stuff like high board scores, honors in your clinical clerkships, and AOA are very common amongst the residents matching in urology. Lacking in one or more of these areas, though, is not a deal breaker.  If you can show programs that you are passionate about field and a hard worker then you still have chance of matching.  This is done with good letters, research in the field, and possibly away rotations (as long as you impress on the away rotation).

 

  • What are residencies looking for in a Urology applicant?
They are looking for someone who is smart, hard-working, and passionate about urology.   Urology used to have a reputation of being an “all male” club, but that is definitely not the case anymore.  Many females are now going into urology.   Many programs seem to have a lot of residents that are regional, but this may be just due to them receiving more applications from regional medical schools.  This also may be due to the fact that faculty will know regional faculty members better and so letters of recommendations from these faculty members may be more meaningful.

 

  • What should students look for in a Urology residency?

In general, most people feel that all urology residency programs are going to give you adequate training.  There are some programs that are 6 years versus 5 years.  The 6 year programs either have an additional year of general surgery (so 2 years altogether) or else a year of research.  If you dread doing an extra year of general surgery or research then this is something to consider.  Because it is competetive and there are not a million programs, you do have to be willing to go to programs or cities that you maybe would not consider if you were applying to a less competitive residency.  I think most urology applicants have the “I’m just happy I matched” attitude.

 

  • Do you have any advice on the application, letters of recommendation, personal statements, or how to rank programs?

With the early match, you have to start early.  Unlike other fields, many urology applicants are trying to squeeze in urology rotations and letters out of end of 3rd year and early 4th year.  Make sure you schedule away rotations early, because some fill up, especially in the Summer and early Fall.  At the beginnning of each away rotation let the chair know that you intend to get a letter of recommendation.  It may actually look bad if you do an away roatation and do not get a letter of recommendation out of it.  You do not necessarily have to send the same letters and other information to every program.  I think you are allowed 3-4 letters in your official application, but you can have different letters available to different programs.  So for instance if you have a letter from a former resident at a program, make sure to include that letter to that program.  There are also tricks to get extra letters sent directly to the program if you think that would be beneficial.  Do not hesitate to mail updated CV’s or research information after the application has been sent out directly to programs.  It gives them more information about you and also shows some extra dedication and interest in their program.  I would rank as many programs as you interview with, unless you truly would rather not match than go to a certain program.

 

  • What do you wish you knew before application/interview season?  

I wish I knew what I was getting into.  Letters, applications, interviews, traveling…there is no way to understand the best way to do it until you actually do it.  Good Luck.

 

  • What other advice do you have for students applying to Urology residency?

Bring it!

 

Editor's Note: Applying for residency or preparing for your interviews? I highly recommend First Aid for the Match, The Successful Match: 200 Rules to Succeed in the Residency Match, and The Residency Interview: How To Make the Best Possible Impression .


 

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