Urology Resident Associate: A Promising Alternative for the Unmatched Urology Applicant

Background. Demand for urology residency spots frequently outstrips supply, with unmatched urology applicants having limited options while waiting for reapplication. We aim to demonstrate our experience with a year-long Urology Resident Associate (URA) position, which merges the role of junior resident and APP with the mission to reduce resident workload and further the training of an unmatched urology applicant. Methods. A year-long, non-Accreditation Council for Graduate Medical Education (ACGME) accredited URA position was created at our institution in 2023 and filled by an unmatched applicant to our program. The URA was given all the roles and responsibilities of a junior resident, with a primary focus on hospital floor work and consultations. Success of the URA position was gauged through a survey of the urology department, URA involvement in operating room (OR) case load, improvement in the number of residency interviews, and successful urology match. Results. From July 1, 2023 to June 14, 2024, the URA answered over 2000 pages, reducing resident workload by up to 2 hours per day. The URA covered 275 OR cases, 174 of which were not covered by another resident. A survey of the urology department was overall exemplary, with 77% of respondents rating the URA position as valuable or very valuable. The URA received 67% more interview invites compared to the previous residency application cycle, and successfully matched into urology. Conclusion. Overall, the URA position provided great value to both our institution and the previously unmatched urology applicant, and would be a good consideration for other institutions looking to assist unmatched applicants and improve resident workflow.