Visiting Sub-internship Practices and Preferences: a National Survey through the Society of Academic Urologists

Urology visiting sub-internships are increasingly important in residency selection, yet practices remain poorly characterized. We aimed to delineate current sub-internship practices in selection, structure, and evaluation methods between programs.

A 16-question cross-sectional survey of sub-internship practices was distributed to faculty at 157 Society of Academic Urologists (SAU) institutions in October and November 2024 via Qualtrics. Responses were included if complete and unique to a single program. Data were analyzed qualitatively and stratified by monthly sub-intern volume (low: 0-2; moderate: 3-4; high: ≥ 5 sub-interns per month).

Sub-internship leadership from 50 programs (31.8%, 50/157) completed the survey. Most programs had low (34.0%, 17/50) or moderate (52.0%, 26/50) monthly sub-intern volume. Clerkship grades, letters of recommendation, personal statements, and medical school attended were most frequently ranked criteria for selecting sub-intern applicants. Programs with high monthly sub-intern volume more frequently considered research experience among their top three selection criteria (85.7%, 6/7). Respondents most frequently cited teamwork (26.0%, 13/50), professionalism (24.0%, 12/50), communication (14.0%, 7/50), and situational awareness (12.0%, 6/50) as the most desirable qualities in sub-interns. Programs with high monthly sub-intern volume more frequently reported standardized evaluations by attendings (85.7%, 6/7) and residents (57.1%, 4/7) compared to programs with moderate (46.2%, 12/26; 26.9%, 7/26) and low (29.4%, 5/17; 17.6%, 3/17) monthly sub-intern volume, respectively.

Sub-internship priorities, expectations, and evaluation methods varied across programs and by sub-intern volume. These findings provide a foundation for future efforts to standardize and improve sub-internship clerkships, which are critical to student development and residency selection.

The online version contains supplementary material available at https://doi.org/10.1007/s40670-026-02733-4.