To determine how many urology residency training programs offer rural rotations. Given that 60% of US counties do not have a urologist and medium-range projected urology workforce shortages, we endeavored to understand this and the barriers and interest in developing such rotations.

A collaboration with the American Urological Association Leadership program and the Society of Academic Urology, produced a survey of urology residency program directors to assess current rural training opportunities, barriers, impact on residents, and desire for alternative training tracks.

Of the 151 training programs that received the survey, 64 responded (42.3%). Currently, 18.75% have a non-metropolitan resident experience, while 75% occur in the PGY-3 or 4 training year and range from 2-12 weeks. Case mix is broad encompassing nearly all aspects of urology. The most common barrier was managing call schedules (25%) and resident salary support (21%) during these rotations.

Nearly 1 in 6 responding programs have a non-metropolitan urology resident training rotation. Program directors perceive these to offer high value to trainees, though barriers to greater implementation exist. Such a rotation may help improve urology workforce distribution.