Residency Requirements

General Requirements

SurgeonsApplicants must be a graduate of a medical school approved by the Liaison Committee on Medical Education (LCME) or a school of osteopathy approved by the Commission on Osteopathic College Accreditation of the American Osteopathic Association, and have completed a urology residency program accredited by the Accreditation Council for Graduate Medical Education (ACGME) or Royal College of Physicians and Surgeons of Canada [RCPS(C)]. ACGME training programs in urology are described in the American Medical Association Graduate Medical Education Directory, Section II, “Essentials of Accredited Residencies in Graduate Medical Education: Institutional and Program Requirements.”

Postgraduate training requirements: The American Board of Urology mandates a minimum of 5 clinical years of postgraduate medical training. Training must include:

  • A PGY1 (URO 1) year in an ACGME or RCPS(C) approved surgical or urology program including the following rotations:
    • 3 months of general surgery
    • 3 months of additional surgical training. Recommended rotations include surgical critical care, trauma, colorectal surgery, transplantation, plastic/reconstructive surgery. Alternate rotations may be accepted on a case-by-case basis based on educational value.
    • Minimum 3 months of urology
    • 3 months of other rotations, not including dedicated scholarly activity. This time may include additional urology, other surgical rotations, or appropriate nonsurgical rotations such as interventional radiology, nephrology, and anesthesiology.
  • 4 years in an ACGME or RCPS(C) approved urology program, including at least 12 months as a chief resident in urology with the appropriate clinical responsibility and under supervision during the last two years of training. The resident must have a minimum total of 48 months dedicated to urology training. Up to 3 months of urology in the PGY1 year may be counted toward the 48 months.
  • For the above requirements, a month is defined as a calendar month. Up to 3 months of scholarly activity is allowed, excluding the PGY1 and chief years.
  • For residents who completed 3 months of urology in the PGY1 year, up to 6 months of dedicated scholarly activity is allowed, excluding the PGY1 and chief year.
  • A resident who has completed a PGY-1 year in a ACGME-approved general surgery program that included 3 months of general surgery and 3 months of additional surgical training as described above prior to entering urology residency training has fulfilled the "general surgery" requirements. A minimum of 48 months of clinical urology training must be completed in the urology residency.
  • All rotations must have been approved by the candidate’s program director.

Research rotations cannot interfere with the mandated 12 months of general surgery or the 48 months of clinical urology.

Residents must comply with the guidelines in place at the time he/she enrolled in the program.

All rotations listed above that are not part of the core urology training must have been approved by the candidate’s program director. As part of the core urology training, the candidate must have completed at least 12 months as a chief resident in urology with the appropriate clinical responsibility and under supervision during the last two years of training in an ACGME- approved program.

Canadian Medical School Graduates

Physicians who attended medical school in Canada and received all pre-urology and urology residency training in approved Canadian programs must satisfactorily complete the same training as listed above. Certification by the RPCS(C) is not required for the Qualifying (Part 1) Examination, but is required to be admissible to the Certifying (Part 2) Examination.

International Medical Graduate (IMG)

Exam applicants who graduated from medical schools outside the United States or Canada who provide an equivalent medical background and

  • A) Have completed an ACGME-approved urology residency and the prerequisite ACGME-approved pre-urology training in the United States may qualify for examination, or
  • B) Have completed a RCPS(C)-approved urology residency in Canada will be reviewed on a case by case basis. All such applicants must have a valid certificate from the Education Committee for Foreign Medical Graduates (ECFMG).

IMG Alternative Pathway to Certification

Entrance into the certification process differs for individuals that completed a urology residency program not approved by the Accreditation Council for Graduate Medical Education (ACGME) or Royal College of Physicians and Surgeons of Canada (RCPSC).  For these International Medical Graduates (IMG), an alternate pathway into the certification process is available.  Internationally trained urologists in very specific educational roles and with exceptional clinical skills may apply to the American Board of Urology for a variance to enter the certification and subspecialty certification processes.  The ABU views this situation to be extraordinary and will approve or disallow the variance for certification and subspecialty certification on a case by case basis.  The requirements for application and entrance into the certification process are listed below.


  1. Currently employed in the US at an academic center on the core teaching faculty of a urology residency program approved by the ACGME.
  2. At least 7 years of experience in a full-time faculty position in a program with a residency program accredited by the ACGME or the Royal College of Physician and Surgeons of Canada (RCPS-C) providing outstanding clinical and educational service in such a program, along with meaningful scholarship productivity.  This service could have been accumulated at more than one such program, including in Canada. 
  3. Subspecialty Application: An applicant who has achieved ABU certification through the Alternate Pathway and who has at least 75% subspecialty immersion in either pediatric urology or female pelvic medicine and reconstructive surgery may apply for subspecialty certification in the appropriate subspecialty.


  • The application must include a completed application form.
  • A cover letter must be included from the applicant detailing his/her contributions to urology in the areas of clinical practice, scholarship and resident education.
  • An updated CV
  • Six letters of recommendation from academic urologists in active practice attesting to the applicant’s contributions in the areas of residency/fellow education, scholarship and patient care.  These must include a letter from individuals in the positions listed below.   These letters should be sent directly to the ABU from the letter writer. No additional letters that are submitted will be included with the final application. (your department chair (or Division Chief), residency program director at your institution, two letters from ABU certified senior faculty members at other academic institutions attesting to the applicant’s contributions in the areas of residency/fellow education, scholarship and patient care, letter from the Chair or a senior faculty member at the international academic institution in which the applicant worked for at least 1 year prior to coming to the US.)
  • Other materials submitted such as patient testimonials, media reports or similar documents are not requested and will not be included in the application.


  • Applications and letters of recommendation and the application fee must be received by June 1 in order for the application to be considered at the meeting of the Trustees in August.  Applicants will be notified of the results of the approval process by September 15th of the same year, and if approved will be eligible to apply to take the qualifying examination the following year.
  • A fee of $500 must accompany the completed application.
  • The Board will request completion of confidential peer review questionnaires from the Chief of Urology and/or Surgery, the Chief of Anesthesiology, and the Chief of Staff (or Chief of Pediatrics/Obstetrics & Gynecology where applicable) for each facility in which the applicant performs at least 50 cases annually, documenting the applicant’s status in the medical community.  Greater than 50% response rate is acceptable for the candidate to proceed with the process.
  • The candidate must sign a waiver authorizing any and all third parties contacted by the Board to furnish to the Board such records and information, including confidential information related to the candidate’s abilities and reputation as a urologist, as the Board (in its sole discretion) may deem necessary or advisable.  Under no circumstances will the source of any peer review be revealed to any person other than Trustees and Staff of the Board.
  • The Board of Trustees will consider each individual application including the entirety of the application.  Final decision is up to the discretion of the Board. 

Transferring Between Programs

A resident may only transfer once during the urology portion of training and the last two years of residency training must be spent in the same institution. A resident who wishes to transfer must notify the ABU in writing six months in advance of the transfer and copy the current Program Director and Designated Institutional Officer. The Program Director from the recipient program must send a letter to the ABU verifying there is an appropriate residency slot in the program for the resident to fill.

Leaves of Absence

Leaves of absence and vacation may be granted to residents at the discretion of the Program Director consistent with local institutional policy and applicable laws.  Each program may provide vacation leave and family leave (any leave required to care for a family member) for the resident in accordance with institutional policy.  The ABU requires 46 weeks of full-time clinical activity in each of the five years of residency.  However, the 46 weeks may be averaged over the first 3 years of residency, for a total of 138 weeks required in the first 3 years, and over the last 2 years, a total of 92 weeks is required. 

Vacation or various other leave may not be accumulated to reduce the total training requirement. Should circumstances occur which keep a resident from working the required 138 weeks the first 3 years and 92 weeks the last 2 years, the Program Director must submit a request to the ABU for a variance of the current policy or a plan outlining how the training deficit will be rectified.  In certain cases an extension of the residency training may be required.

This policy is not retroactive and does not apply to leave taken prior to the 2021-2022 academic year.

Ninety-two (92) weeks of training is required for two-year fellowships, without the need to request a variance or submit a plan for making up a training deficit. 

Leave for educational/scientific conferences are at the discretion of the Program Director.

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