FAQs: What the 2025 AUA Census reveals about the urology work force

The American Urological Association (AUA) has released its 2025 Annual Census report, providing an updated snapshot of the US urology work force and how urologists practice. Now in its 12th year, the Census tracks demographics, training, and practice patterns through core questions asked annually, alongside modules that explore emerging issues affecting the specialty. The 2025 findings point to persistent geographic gaps in access to urologic care, an aging and gradually diversifying work force, demanding workloads, and accelerating integration of artificial intelligence (AI) into practice.

"The AUA Annual Census remains a cornerstone for understanding the urology work force and how our specialty continues to evolve," said Hung-Jui (Ray) Tan, MD, MSHPM, chair of the AUA Data Committee and division chief of urologic oncology at the University of North Carolina in Chapel Hill, in a press release announcing the report.² "Each year, the Census provides critical insights into practice patterns, emerging challenges, and opportunities that help inform education, advocacy, and policy."

In the FAQs that follow, Tan adds perspective from an interview with Urology Times® on what the latest data mean for practicing urologists.

1. How was the 2025 AUA Census conducted?

The Census is a 2-part survey. Base questions are repeated each year to monitor cross-sectional and longitudinal trends, whereas supplemental questions change annually to address priority topics. In 2025, those topics included efficiency and care delivery models; structural approaches to coverage, including ambulatory surgery center (ASC) ownership; Quality Payment Program participation; emerging tools and innovations; and disability, parenthood, and reproductive considerations.

Data collection ran from April 28 to September 30, 2025. Of 4151 respondents, 1676 were confirmed practicing urologists in the US, an 11.5% response rate among the 14,609 practicing urologists in the US. Urologists in residency training were excluded. Responses were weighted by gender, geographic location, certification status, and years since initial certification to adjust for nonresponse bias, and estimates are reported with margins of error at a 90% confidence level. The report notes that Census data are self-reported and nonvalidated and may be subject to recall bias.

2. How is the urology work force distributed across the US?

There were 14,609 practicing urologists in the US in 2025, up from 11,990 in 2015; 84.5% were actively practicing, defined as devoting at least 25 hours per week to clinical activities. Despite that growth, the urologist-to-population ratio has held at 4.3 per 100,000 population since 2023. Among the 50 states, ratios ranged from 5.74 per 100,000 in New York to 2.21 per 100,000 in Wyoming.

At the county level, 1948 of 3144 US counties (62.0%) had no practicing urologist, and another 289 counties (9.2%) had just 1. Overall, 90.2% of urologists maintained their primary practice in a metropolitan area (population ≥50,000), whereas 9.8% practiced in nonmetropolitan areas and 0.5% practiced in rural areas (population <2,500).

"I think the 2025 census tells us that we are on solid footing, but that there are emerging challenges for us," Tan said. Pointing to the concentration of urologists in metropolitan areas, he framed the central question facing the specialty: "How can we ensure that we provide care to the whole entire country?"

3. How are urologists extending care beyond their primary practice locations?

More than one-third of urologists (34.6%) participate in in-person satellite clinics to increase patient access, and about one-quarter of those travel at least 50 miles from their primary practice to do so. The commitment is substantial: among satellite clinic participants, 26.4% reported spending 4 days per month traveling to satellite clinics, and 20.2% reported spending 5 or more days. Fewer than 10% of urologists (9.6%) reported working locum tenens to supplement their income.

Tan noted that telehealth, although not assessed in the 2025 Census, has been examined in prior Census surveys, saying, "We are seeing that as another lever that we're [using to try] to bridge that gap with respect to bringing urology care to places that don't necessarily have it.”

4. What role do advanced practice providers play in urology care?

Most urologists (83.2%) work directly with at least 1 advanced practice provider (APP), and 20.3% work with 10 or more. APP integration was near universal in academic medical centers (97.3%), compared with 75.2% in private practices and 73.5% in non-university hospitals. Urologists in metropolitan areas were also more likely to work with an APP than those in nonmetropolitan areas (84.8% vs 67.2%).

Urologists most often reported routinely working with APPs during outpatient office visits (71.7%), followed by inpatient care (47.6%), operating room assistance (20.7%), and outpatient procedures (12.4%). Many would like APPs to take on more, with 51.4% wanting APPs to perform more independent office visits, 40.4% wanting more APP inpatient management and care coordination, and 38.6% wanting more APP inpatient consults.

Wait times also differed by provider type. Three-quarters of urologists (75.4%) reported an average wait of less than 1 month for a new patient's first appointment with an APP, compared with 47.0% for a first appointment with a urologist. Another 44.6% reported a wait of 1 to 3 months to see a urologist, and 8.3% reported a wait longer than 3 months.

5. How are Census data used to inform advocacy and policy?

According to the AUA, Census findings are disseminated widely to inform health policy, work force planning, and research across the specialty. Tan pointed to access as a concrete example, noting that "this data about where our work force is and where there are potential gaps has been used by our advocates on Capitol Hill to advocate for [the] use of telehealth and continue reimbursement."

The data also guide the AUA's positions on proposed legislation.

Tan noted, "It also allows us to be informed when we're trying to decide whether we're going to support certain legislation, like the Spark Act that recently came out to provide loan repayment for those who are going out into the rural areas.”

6. What does the age profile of the work force signal for future capacity?

The median age of practicing urologists was 54 years, and nearly one-third (32.7%) were 65 years or older, compared with 26.5% younger than 45 years. According to the AUA, this distribution raises questions about future work force capacity.

The age data carry particular implications for underserved areas. Older urologists were more likely to practice outside metropolitan areas, with 11.7% of those 65 years or older maintaining a nonmetropolitan primary practice, compared with 4.4% of those younger than 45 years. Surgical capacity also declines with age: 63.4% of urologists 65 years or older performed major inpatient operative procedures, compared with 88.3% of those younger than 55 years.

7. How is the demographic composition of the specialty changing?

The proportion of female practicing urologists rose from 7.7% in 2014 to 12.9% in 2025. The shift is concentrated among younger urologists: 26.6% of urologists younger than 45 years are female, compared with 18.2% of those aged 45 to 54 years, 8.2% of those aged 55 to 64 years, and 1.7% of those 65 years or older.

Practice patterns differ by gender. Female urologists were more likely than male urologists to practice in academic medical centers (42.1% vs 29.7%) and less likely to practice in private settings (26.5% vs 45.7%). Male urologists reported more patient encounters in a typical week (74.0 vs 62.7), whereas female urologists reported spending more time with patients during a typical office visit (18.7 vs 16.0 minutes).

Racial and ethnic diversity has shifted more modestly. In 2025, 70.9% of practicing urologists identified as White, non-Hispanic; 13.7% as Asian, non-Hispanic; 5.0% as Hispanic or Latino; and 3.1% as Black or African American, non-Hispanic. The number of Black urologists rose from 275 (2.5%) in 2014 to 446 (3.1%) in 2025.

8. How do retirement expectations differ across the work force?

Gender differences in planned career length persist. Although 60.9% of male urologists plan to retire after age 65 years, only 19.7% of female urologists report the same intention. Nearly one-fifth of female urologists (19.4%) plan to retire before age 60 years, compared with 6.0% of male urologists, and the median planned retirement ages were 65 and 68 years for female and male urologists, respectively.

Tan described a broader generational shift in how urologists approach their careers, noting that younger urologists entering the field "have just different views about when they're going to retire, how long they're going to work for," as well as the intensity of work they want to take on. He added that these views may differ from those of colleagues who run practices and make business decisions, calling it "a really interesting evolution for us to watch."

9. How have career demands affected family planning?

Most urologists (89.4%) have children, and an additional 2.4% reported attempting to have children. Residency (51.3%) and the first 3 years after training (31.9%) were the most common career stages during which urologists had or attempted to have children, and 13.1% reported using assisted reproductive technology.

Career demands weigh heavily on these decisions. Overall, 42.3% of urologists reported delaying having or attempting to have children because of their medical training or career, including 70.5% of female urologists, compared with 38.0% of male urologists.

10. How demanding are urologist workloads?

Urologists reported a median of 55 hours worked in a typical week, and nearly one-third (32.5%) reported working more than 60 hours weekly. The median number of patient encounters was 70 per week, with 16.4% reporting more than 100 encounters. The median time spent with a patient during a typical office visit was 16.7 minutes.

Surgical volume is also substantial. Overall, 77.9% of urologists performed major inpatient operative procedures, and 31.6% reported performing 10 or more in a typical month.

11. How are practice settings and employment models shifting?

The proportion of urologists in private practice settings, which include solo practices, single urology groups, and multispecialty groups, declined from 64.1% in 2014 to 42.4% in 2024 and was largely unchanged at 43.2% in 2025. Over the same period, the proportion of employed urologists rose from 48.8% in 2014 to 70.4% in 2025. In 2025, 19.4% of urologists were partners in their practice, and 7.2% were sole owners.

The shift is most pronounced among younger urologists. Among those younger than 45 years, 30.3% practiced in private settings, compared with 52.9% of those 65 years or older. Nearly one-fifth of urologists (18.9%) reported an ownership interest in an ASC, and 43% of those with ownership interest performed more than half of their surgical volume at ASCs, compared with 15.7% of urologists without an ownership interest.

12. How are urologists incorporating AI into practice?

More than one-third of urologists (37.1%) reported routinely incorporating AI into their practice. The most common use cases were creating discharge instructions, care plans, or progress notes (13.9%); documenting billing codes, medical charts, or visit notes (13.6%); generating chart summaries (8.4%); and translation services (7.6%).

AI is also reshaping documentation support. AI-powered scribes had the highest access rate of any scribe type (38.1%), compared with in-person (19.6%) and virtual scribes (15.9%), although only 13.3% of urologists reported regularly using AI scribes. Among urologists with access to each type, satisfaction was highest for in-person scribes (60.9% satisfied vs 12.4% dissatisfied), followed closely by AI scribes (52.0% vs 19.1%), whereas virtual scribes had the lowest satisfaction (38.9% vs 22.2%).

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REFERENCES

1. The State of the Urology Workforce and Practice in the United States 2025. American Urological Association. Accessed May 29, 2026. https://www.auanet.org/documents/Data/census/2025_Census%20Report.pdf

2. New AUA Census Shows Shifts in Urology Workforce, Practice Workloads and AI Use. News release. American Urological Association. May 5, 2026. Accessed May 29, 2026. https://www.auanet.org/about-us/media-center/aua-press-center/new-aua-census-shows-shifts-in-urology-workforce-practice-workloads-and-ai-use