Presented by: Nicholas Dean MD
Northwestern University

Introduction

Most graduating urology residents are under contract until June 30^th and many fellowships begin on July 1^st. Fellowship training may require relocation, hospital credentialling, new medical licenses, and governmental clearances leading to possible delays in clinical starts. Our objective is to identify the incidence and predictors of endourologic fellowship delays.

Materials

We surveyed 250 Endourologic Society fellows (2017-2022). All statistical analysis was performed using Excel.

Results

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A total of 77 endourologists and current fellows responded. Most respondents (n=66/77, 85.7%) relocated for their fellowship training. Of those that re-located, 54.3% (n=25/46) left their residency training prior to the official end date. Delays in the commencement of fellowship clinical activity were commonly reported (28.6% n=22/77). Fellowship training in the COVID-era (2020-2022) and fellowships requiring international re-location were associated with more frequent (OR 4.9, p<0.01) and longer delay durations (>2weeks) (OR 17.4, p<0.01). Almost half of international fellows who experienced delays were prohibited from practicing medicine for greater than 4 weeks (41.7%, n=5/12). Fellows experiencing clinical delays considered these delays “stressful” (68.2%, n=15/22) and 40.9% (n=9/22) reported these delays as “very stressful”. Most respondents (80.9%, n=55/68) supported delaying the official endourologic fellowship start date.

Conclusion

 Almost one third of responding endourologic fellows experienced stressful delays in their fellowship training. Fellows requiring international relocation experienced more frequent and longer fellowship delays. It is unknown how these unproportionate fellowship delays affect the diversity of fellowship candidate selection and training experience. Adjustments in the time from resident completion to fellowship initiation could help to alleviate delays in training and the associated stress on the trainees.

Funding

None

Co-Authors

Mitchell Huang, MD
Northwestern University

Matthew Lee, MD
Ohio State University

Mark Assmus, MD, MPH
University of Calgary

Perry Xu, MD
Northwestern University

Jenny Guo, MD
Northwestern University

Amy Krambeck, MD
Northwestern University