Before you make a firm commitment to Urology, make sure that it is the right career choice for you. You can begin by reading several commercially available books that discuss how to choose a specialty. Iserson's book Getting Into Residency and Anita Taylor's book Choosing a Specialty are highly recommended and read by most students. If you are in your preclinical years, you may want to even shadow a urologist for some time. Our department at BU has several excellent attendings that are very receptive to students. If you are in your clinical years, spend time in urology during your surgery rotation, do an elective, or talk to residents. Review as much material as possible and ask a lot of questions to make an informed decision regarding your career.

Applying to urology residency programs took quite a turn a few years ago. As a result of Medicare and government budget cuts, residency programs have been forced to reduce the length of training and have cut positions. The majority of programs have responded by dropping their research year or some combination of research and general surgery training. This has resulted in a drop in the length of residency from 6 to 5 years at many institutions.

Urology is an extremely competitive specialty. Of 521 students who registered for the 1999 AUA Match, approximately 400 submitted rank lists and 223 matched resulting in a match rate of 56.8%. All residency positions were filled through the match. The match rate will most likely continue to drop given the decrease in the number of residency spots and the increased interest in the field.

What does it take to get it? There are several factors that programs use to select their candidates. AOA membership and research publications are helpful but not strict requirements. Grades, board scores, and research are only part of the formula. It helps to honor 3rd year clerkships (especially Medicine and Surgery) and 4th year Urology electives but not a must. There are no cutoffs for the USMLE Part I but doing well is a plus. The majority of programs do not require Part II scores, but check with the individual programs. Some programs, such as MGH and UVA, request SAT and MCAT reports as well as undergraduate transcripts. Research experience is extremely valuable. This means publications, presentations, and abstracts that have been accepted at conferences. Many of the high-powered academically oriented programs may even require past research experience, although they will not tell you that outright. Letters of recommendation are extremely important as well; in many cases, the most important part of your application. Regardless of what you look like on paper, you must demonstrate that you are an honest, hardworking, mature, and stable person. Programs do not want an egotistical pain in the rear end! Programs have been selecting residents and know when they are dealing with a person with whom they would enjoy working. Remember, Urology residency training last at least 5 years; programs are not looking for head cases even if they are the brightest individuals in the applicant pool.

The Urology department at BU is extraordinary and extremely supportive of students interested in the field. The rest of the attending staff, especially Dr. Goldstein, makes an effort to help you get that ideal residency. Dr. Babayan is the new chairman and you should set up an appointment and inform him of your intention to enter the field. Later on, you can meet with him to discuss individual programs and the final rank list. The residents in the program are very approachable and an excellent source of information.

You can get credit for up to two rotations of clinical urology. You should take electives as soon as possible because Urology is an early match. Do a rotation at BU early and then consider doing one away. Your "outside" elective should be chosen carefully. Some programs (due to their reputation) get a flood of medical students within a few months. This may lead to 5-7 medical students on the same rotation that will limit your experience and the exposure to the person you want writing your letter. The programs that only allow two students per month are the most rewarding, but these fill quickly so plan ahead. My suggestion is to do a rotation at a second tier program that has a well-known chairman if all else fails. If you have your sights set on a specific program, then you should do a rotation there. In either case, you need a reference letter from this rotation so make sure the chairman has a good history of writing strong reference letters if you turn in a strong performance. As Iserson stated in his book, the gold standard is an excellent letter written by someone well known to the Urology community. Which programs are good to do electives at??? Ask both faculty and residents, although the residents will most likely offer the best advice.

Remember, Urology is an EARLY match!! In the early spring around May, contact the AUA in Houston, TX to obtain registration material. You can try the Internet to get more information about registration on the AUA website, which is http://www.auanet.org. Register and follow the timeline listed in the materials they send to you. These materials include a booklet that lists all the participating programs with their addresses and telephone/fax numbers. You will eventually have to contact each program individually to obtain application packets. There is no magic number but students typically apply to at least 30 programs and go to about 13-15 interviews. Make sure you send all materials by the deadline!!!! There is usually a residency coordinator or an administrative assistant who will not give your application to the committee until ALL THE REQUIRED DOCUMENTS ARE RECEIVED!! It is to your advantage to apply as early as possible. Try to have all applications out by the end of August since interview slots/dates are limited and fill quickly. Applicants who are invited for interviews early have a greater selection of dates and avoid being placed on waiting lists.

Most interviews are conducted during November and December although you may have some scheduled in October and January. The earlier two months is an ideal time to take a vacation block for interviews. The interviews are generally not very stressful and most are relaxed. Make an effort to be friendly to the host residents, secretarial staff, and other applicants. How you interact with others is observed. Following interviews, send individualized thank you letters to each program. They are not required, but it is generally a classy thing to do and all applicants send them. Following your interviews, it may be helpful to visit the program you are most interested in or will rank at the top of your list, the so-called "second look." Plan to spend a day at the program in the OR with the chairman and the residency coordinator. In your thank you letters, do not tell a program they are number one if they are not. Remember, Urology is a small community and you never know when a lie will come back to haunt you (fellowships, paper reviews, or even matching into a residency).

Deadline for submission of rank lists is in mid-January. Enjoy the entire process and your fourth year. The interview trail is lots of fun. You will meet interesting people from all over and see explore other parts of the country. Remember, when in doubt about something or a program, ask the residents...they give the best answers.

Contact the AUA residency matching program and register for the match (applications in Office of Student Affairs). Completed application + fee = personal identification number for match and references containing the individual programs participating in the match. All applications require an applicant photo. Find a good photographer and have a portrait taken as soon as possible. You will need approximately a 2 inch x 2 inch for each application. Get this done early; you do not want the lack of a photograph to hold up your application.

Using the information obtained from the AUA Residency Match Program, write or call the programs you are interested in and request an application. There is no magic number, but most students apply to at least 25 programs. Most applications are due in late September to early November but some can be as early as September 1 (University of Connecticut). It is to your advantage to apply as early as possible, interview slots/dates are limited and fill quickly. Applicants who are invited for interviews early will have a greater selection of dates. This will help you plan an interview tour that is most economical.

Most interviews are conducted during this period so be prepared to take time out. November or December is an ideal time to take a vacation block for interviews. The interviews are not very stressful, and most are very relaxed. Make an effort to be friendly to the host residents and other applicants. I believe how you interact with others is observed. If you have participated in a research project, prepare yourself to answer questions concerning background, results, significance of results and how this is important to urology. Following interviews, send individualized thank you letters to the interviewers. Thank you letters are not required, but it is generally a classy thing to do.

Preference list forms are mailed from the AUA to the applicants and the programs.

Deadline for submission of rank list. Two weeks before submitting a preference, write to the programs you are most interested in and let them know where they stand on your preference list, but be honest. Do not tell a program they are number one if they are not. Remember, urology is a small community and you never know when a lie will come back to hurt you (fellowships, paper reviews etc.)

Match results are faxed to the Office of Student Affairs and mailed to the applicant.