Abstract
Projections to 2035 have demonstrated concern regarding a worsening urology workforce shortage. To project the size and demographic characteristics of the urology workforce per capita into 2060 and to anticipate the timing and degree of the impending urology workforce shortage. This population-based cross-sectional study used the 2019 American Urological Association Annual Census data and the Accreditation Council for Graduate Medical Education's Data Resource Book from 2007 to 2018. The cohort included practicing urologists in 2019. US Census data were used to approximate the projected US population. Data analysis was performed from June 2020 to March 2021. Continued growth stock and flow model of 13.8% and stagnant growth model of 0% increase of the incoming urology workforce with cohort projection per projected US population. The primary outcome was urology workforce projection per the population aged 65 years and older. Urology workforce projections per capita and demographic characteristics of the urology workforce up to 2060 were calculated under guided assumptions with 2 stock and flow models. In 2019, there were 13 044 urologists (11 758 men [90.1.%]; 1286 women [9.9%]; median age range, 55-59 years), with 3.99 urologists per 100 000 persons and 311 new urologists entering the workforce. In a continued growth model, 2030 will have the lowest number of urologists per capita of 3.3 urologists per 100 000 persons, and recovery to baseline will occur by 2050. There are 23.8 urologists per 100 000 persons aged 65 years and older in 2020, which decreases to 15.8 urologists per 100 000 persons aged 65 years and older in 2035 and never recovers to its baseline level by 2060. In a stagnant growth model, there will be a continued decrease of urologists per capita to 3.1 urologists per 100 000 persons by 2060. There is a continued decrease in per capita urologists at each time point, with 13.1 urologists per 100 000 persons aged 65 years and older by 2060. With the impending urology workforce shortage, there will be an exaggerated shortage of total urologists per persons aged 65 years and older in both models. This projection highlights the need for structural changes and advocacy to maximize the available urology workforce.
Highlights
Multiple estimates have found impending workforce shortages across surgical fields due to the Balanced Budget Act of 1997, which limits the funding necessary to train residents and caps the number of government-subsidized residency positions
With the impending urology workforce shortage, there will be an exaggerated shortage of total urologists per persons aged 65 years and older in both models
Current Practicing Urologists and US Population Data According to the 2019 American Urological Association (AUA) Census, which defines the urologist population by National Provider Identifier, valid medical licenses of both urologists and pediatric urologists, and American Board of Urology certification records, there are currently 13 044 practicing urologists, including 11 758 men (90.1%) and 1286 women (9.9%).[10]
Summary
Multiple estimates have found impending workforce shortages across surgical fields due to the Balanced Budget Act of 1997, which limits the funding necessary to train residents and caps the number of government-subsidized residency positions. This workforce shortage will be exacerbated by the silver tsunami, where by 2030, the youngest members of the Baby Boomer generation will be in the Medicare age group that heavily uses health care services.[1-3]. Despite growth of female representation in urology compared with other specialties, it continues to be a heavily male-dominated field with only 9.9% of practicing urologists being female.[8,9] Female urologists continue to be underrepresented relative to the 30% of urological patient population being female.[7]
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