Incidence and predictors of delays in commencing fellowship training in urology.

The completion of residency and start of fellowship training marks a critical transition for urologists in the pursuit of subspeciality training. Most graduating urology residents are under contract until June 30, and the majority of fellowships are scheduled to begin on July 1. There has been no investigation into the practical implications of fellowship delays in urology from a trainee perspective. Our research study aims to investigate the incidence and predictors of delays in fellowship starts.

Pediatric urology fellows that began their fellowship training from 2019-2023 and endourologic fellows that began their fellowship training from 2017-2022 were surveyed using SurveyMonkey®. A total of 250 endourology (EU) fellows and 90 pediatric urology (PU) fellows were contacted.

A total of 26.0% and 14.3% of EU and PU fellows, respectively, experienced a delay in their training, despite many leaving their residency positions early (33.8% vs. 44.9%, p=0.2097); 11.7% and 8.2% of EU and PU fellows, respectively, experienced delays they reported to be "very stressful" and 9.1% and 4.1%, respectively, found them "somewhat stressful. Delays of 2- 4 weeks were experienced by 5.2% and 6.1%, 4-6-week delays by 7.8% and 4.1%, and delays >6 weeks by 2.6% and 0% of EU and PU fellows, respectively (p=0.0007).

Delays in fellowship training do occur at a notable rate, despite nearly half of urology fellows leaving their residency training positions early, with unclear impacts on patient care and resident colleague well-being. This research highlights the importance of fellowship programs considering delaying fellowship starts to mid-July or August, with support of the prior fellow cohorts.

Canadian Urological Association journal = Journal de l'Association des urologues du Canada. 2024 Jan 30 [Epub ahead of print]

Callum A Lavoie, Nicholas Dean, Christine Do, Mitchell Huang, Perry Xu, Scott Sparks, Amy Krambeck

Division of Urology, Children's Hospital Los Angeles, Los Angeles, CA, United States., Division of Urology, Northwestern University, Chicago, IL, United States.