Although the urology residency application process has recently undergone several promising changes—the transition to virtual interviews in 2020, the introduction of “preference signaling” in 2021—the persistent and widening disparity between per-applicant application volumes and available training positions warrants concern and attention. Since the 2019 AUA Match, when applicants averaged 71 applications and nearly $1,500 in submission fees,1 applicants have continued to submit more applications each subsequent year despite minimal change in the average number of interviews per applicant. The financial impact of rising application volumes and associated expenses is not theoretical; the present report estimates the future value of loan debt due to 2022 submissions fees at more than $1.68 million. The mounting costs associated with the de facto system of virtually unlimited application volumes are problematic because costs are neither equally distributed among applicants nor shouldered by applicants alone. First, while application fees may in theory discourage or deter excessive submissions, not only do applicants appear unlikely to curb scattershot submission based primarily on the ability to pay, but furthermore those who are least able to absorb the expense of both the rising floor and ceiling of submissions are frequently the ones most disadvantaged in the application process, whether due to structural, demographic, or educational barriers.
Elizabeth N. Bearrick、Kevin Koo
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Department of Urology Mayo Clinic Rochester, Minnesota
NSTL
