The following is a summary of “Experiences and Outcomes of the Society of Genitourinary Reconstructive Surgeons (GURS) Fellowship Training: Growth in Fellowships Mirrors the Evolution of the Discipline,” published in the September 2024 issue of Urology by Calvo et al.

This study evaluates the experiences and outcomes of the Society of Genitourinary Reconstructive Surgeons (GURS) fellowship match program, which has expanded significantly since its establishment in 2012, growing from 13 to 30 programs. The objective is to assess match success, procedural training, and post-fellowship career outcomes, reflecting the evolution of the field over the last decade.

A comprehensive review of GURS match statistics and surgical case logs from 2013 to 2024 was conducted. In addition, a 37-question survey was administered to fellowship graduates, exploring satisfaction with training, procedural competency, and employment outcomes. Linear regression was employed to analyze trends over time.

Results showed that program match success remained consistently high, averaging 94.7% (p=0.50), while applicant success improved over time, increasing to 63.3% (p=0.04). North American (72.8%) and female applicants (73.6%) had significantly higher match rates compared to international (35.5%; p<0.0001) and male candidates (60.0%; p=0.02). Analysis of case logs revealed a marked increase in surgical volumes for urethral reconstruction (mean=88.1; p=0.02), male sexual health (mean=32.7; p=0.03), genital reconstruction (mean=16.4; p<0.01), and abdominal reconstruction (mean=24.5; p=0.03), while female reconstruction procedures declined (mean=23.2; p=0.01). Male incontinence surgeries remained stable (mean=30.5; p=0.21).

The survey, with a 54.5% response rate (97/178), highlighted high levels of satisfaction, with 95.9% of respondents satisfied with their fellowship experience, regardless of gender (p=0.54) or training year (p=0.22). Notably, 97.9% of graduates felt competent to practice independently, 94.8% understood the relevant literature, and 96.9% were satisfied with their current reconstructive urology positions. However, nearly half (49.5%) reported encountering a different case mix in practice compared to fellowship, particularly in abdominal (44.9%) and genital reconstruction (16.3%).

In conclusion, the GURS fellowship program has experienced substantial growth, paralleling the expansion of genitourinary reconstructive surgery as a discipline. Graduates report consistently high satisfaction, robust procedural training, and readiness for independent practice, though there remains some variability in case mix between fellowship and clinical practice. This evolution reflects the dynamic nature of the field and the ongoing need for adaptability in training programs.

Source: sciencedirect.com/science/article/abs/pii/S009042952400829X