Disparities in urology match outcomes for osteopathic students and students without home residency programs in the southeastern section of the AUA

Suwanee, GA

Urology remains one of the most competitive specialties. Students at schools without home urology residency programs (NHPs) often have limited access to early clinical exposure, mentorship, and research, reducing their likelihood of applying and matching. Osteopathic (DO) students have historically faced additional barriers in surgical subspecialties, raising concerns about equity in access to fields like urology. We hypothesized that students at NHPs, particularly DO students, would apply and match at lower rates. Using SESAUA match data from 2020–2025, we analyzed applicant and match outcomes across medical schools in the region. Medical schools for unmatched applicants were identified using publicly available social media sources (Google, LinkedIn, X). Schools were grouped by the presence of a home urology program (HP) and degree type (MD vs DO). Statistical comparisons used unpaired t-tests assuming unequal variances. Fifty-one medical schools in SESAUA were included; 24 were HP (all MD) and 27 were NHP (11 MD, 16 DO). Four DO schools with no urology applicants were counted in applicant totals but excluded from match-rate calculations. Two new schools with no graduating classes were excluded. A total of 571 applicants in SESAUA across 2020–2025 were included. HPs had significantly more applicants (2.97 vs 0.88 per year, p< 0.001), more matches (2.36 vs 0.49 per year, p< 0.001), higher match rates (78.7% vs 57.7%, p=0.0011), and a greater percentage of their class matching into urology (1.54% vs 0.54%, p< 0.001) compared with NHPs. Among NHPs, MD schools had more applicants than DO schools (1.24 vs 0.64 per year, p=0.018). Compared to DO schools with applicants, MD schools had more matches (0.76 vs 0.31 per year, p=0.0061) and a higher percentage matched per class (0.82% vs 0.26%, p=0.0017), though match rates were not significantly different (62.7% vs 53.2%, p=0.198). Students at NHPs, particularly DO students, apply and match into urology at lower rates, reflecting disparities in mentorship and specialty exposure. Given their role in serving underserved communities, NHP students may benefit from targeted outreach, mentorship, and development of urology programs.