To examine associations between urologic subspecialization, surgeon gender and practice patterns among certifying urologists over the last 13 years.

Demographic data of certifying and recertifying urologists (2004 to 2015) were obtained from the American Board of Urology. We investigated gender-specific trends in self-reported practice type (academic practice, private practice), subspecialization, and employment as a full-time vs part-time physician, relative to certification year and cycle.

Of 9140 urologists applying for certification or recertification over the study period, 815 (8.9%) were women. The largest proportion of female surgeon candidates (65.0%) was first-time certifiers. Women represented 16.7% of first-time certifying urologists (P < .001) and reported practicing in academia more frequently (23.6%) compared with 13.7% of men (P < .001). Female surgeons identified as subspecialists in greater numbers (46.4%) than their male counterparts (23.4%) across all certification years and cycle cohorts (P < .001). Women reported subspecializing in female urology (24.2%) and pediatrics (10.2%) at higher frequencies than their male colleagues (4.6% and 3.1% respectively, both P < .001). Female and male surgeon candidates requested certification in equal proportion in andrology and infertility (P = .83) and endourology (3.6% female vs 5.8% male, P = .13), however differed in oncology (4.2% female vs 7.2% male, P = .001).

A growing proportion of certifying urologists are women, with the greatest enrichment among those seeking first-time certification. Since 2004, female surgeons account for a disproportionate volume of urologists who practice in the academic setting and identify as subspecialists.