Donato Umberto M, Ebedes Dominique M, Nelwan David, Imam Ahmad, Patel Trushar
Health Outcomes and Behavior Lab, Moffitt Cancer Center, Tampa, USA.
Pediatric Oncology, Tampa General Hospital, Tampa, USA.
Cureus. 2025 Mar 13;17(3):e80508. doi: 10.7759/cureus.80508. eCollection 2025 Mar.
This study assesses the unbalanced expansion of medical education institutions in the United States regarding the growth of urology residency programs. We assessed the prevalence of medical schools offering urology residencies to identify potential barriers for students pursuing a urology residency.
Data concerning year of establishment (YOE), number of urology residency positions, American Urological Association (AUA) section, and National Institutes of Health (NIH) funding were collated from online resources, including the Association of American Medical Colleges. This information was stratified based on the YOE: pre-2000 (YOE <2000) and post-2000 (YOE ≥2000), and by the presence or absence of urology residencies.
A total of 218 medical schools were identified, consisting of 159 Doctor of Medicine (159 N, 72.9%) and 59 Doctor of Osteopathic Medicine (59 N, 27.1%) schools, alongside 148 urology residencies (148 N, 67.9%). Since 2000, 76 new medical schools (76 N, 34.9%) have been established. The proportion of medical training sites with an associated urology residency has decreased from 79.6% (113/142) prior to the year 2000 to 67.9% (148/218) at present. Significant disparities in NIH funding were identified between medical programs established before and after 2000. Among the 204 medical schools (204 N, 93.6%), 143 (70%) were established before 2000, while 58 (28.4%) were established after. Schools with a YOE <2000 were substantially more likely to receive NIH funding (83% N, 118/143) compared to those with a YOE ≥2000 (28%, 16/58, p<0.001). Schools established before 2000 received significantly higher funding (p<0.001). NIH funding distribution across the established AUA sections was also analyzed. Pearson's chi-square test showed no significant differences in funding receipt among sections (p=0.326). A detailed breakdown of funding percentages, mean amounts, and standard deviations for each section highlighted regional variations in funding allocation.
The observed disparity in the growth of medical schools compared to urology residency programs may represent a significant barrier for prospective urology residents. Given the crucial roles of research/mentorship in medical training, it is essential to develop and implement accessible programs at both the AUA section and national levels for aspiring students, especially in schools without a urology residency program.
本研究评估了美国医学教育机构在泌尿外科住院医师培训项目增长方面的不均衡扩张情况。我们评估了提供泌尿外科住院医师培训的医学院校的普遍性，以确定学生追求泌尿外科住院医师培训的潜在障碍。
从包括美国医学院协会在内的在线资源中整理了有关成立年份（YOE）、泌尿外科住院医师职位数量、美国泌尿外科学会（AUA）分会以及美国国立卫生研究院（NIH）资金的相关数据。这些信息根据成立年份分为：2000年前（YOE<2000）和2000年后（YOE≥2000），并根据是否设有泌尿外科住院医师培训项目进行分层。
共确定了218所医学院校，其中包括159所医学博士（159所，72.9%）和59所 osteopathic 医学博士（59所，27.1%）院校，以及148个泌尿外科住院医师培训项目（148个，67.9%）。自2000年以来，新成立了76所医学院校（76所，34.9%）。设有相关泌尿外科住院医师培训项目的医学培训地点的比例已从2000年前的79.6%（113/142）降至目前的67.9%（148/218）。2000年前和2000年后成立的医学项目在NIH资金方面存在显著差异。在204所医学院校（204所，93.6%）中，143所（70%）在2000年前成立，而58所（28.4%）在2000年后成立。成立年份<2000的学校比成立年份≥2000的学校获得NIH资金的可能性要大得多（83%，118/143），而后者为28%（16/58，p<0.001）。2000年前成立的学校获得的资金显著更高（p<0.001）。还分析了NIH资金在已成立的AUA各分会中的分配情况。Pearson卡方检验显示各分会在资金获取方面无显著差异（p=0.326）。各分会资金百分比、平均金额和标准差的详细分类突出了资金分配的区域差异。
观察到的医学院校增长与泌尿外科住院医师培训项目之间的差异可能对未来的泌尿外科住院医师构成重大障碍。鉴于研究/指导在医学培训中的关键作用，在AUA分会和国家层面为有抱负的学生制定和实施可及的项目至关重要，尤其是在没有泌尿外科住院医师培训项目的学校。
