Assessment of Urological Training Gaps Among Primary Care Residents: A Cross-Sectional Survey Study

IntroductionAging global populations are driving an increased demand for urological care, yet the healthcare system faces a projected decline in urologist availability per capita. This shift positions primary care providers as the essential frontline for initial evaluation and management. This study aimed to assess clinical exposure, knowledge, and self-reported comfort levels regarding common urological conditions among family and internal medicine residents.MethodsA 76-item cross-sectional survey was administered between August 2023 and June 2024 to family medicine and internal medicine residents (n = 74) at 5 residency programs in the greater Los Angeles metropolitan area, spanning community, safety-net, and academic training environments. The survey evaluated four domains: prior training, current clinical procedural and diagnostic experience, comfort levels, and perceived importance of urological topics. Responses were summarized descriptively.ResultsNotable training gaps were identified; 78% of primary care residents did not complete a clinical urology rotation during medical school. Primary care residents reported limited experience and low comfort across most procedural and diagnostic categories. High discomfort was noted in managing penile lesions (70.3%) and chronic prostatitis (63.5%). Conversely, residents reported the greatest experience interpreting urinalysis (94.6% had interpreted more than 20) and the highest comfort managing urinary tract infections (UTIs; 75.7% "very comfortable").ConclusionsIn this single-region, small sample, residents reported substantial gaps in urological training and in comfort managing common non-surgical conditions. Given the evolving specialist workforce, a range of educational strategies-including optional rotations, eConsult platforms, telementoring, and genitourinary fellowships- merit formal evaluation as a means of supporting primary care providers in managing common, non-surgical urologic conditions.