Evaluation of the urology specialty training recruitment process, applicant experience and perceived stress: A BSoT national survey

Objectives: To evaluate applicant experiences, success factors and psychological burden associated with the UK Urology ST3 national recruitment process. Materials and methods: A national cross-sectional survey of Urology ST3 applicants was distributed by the BAUS Section of Trainees. Data collected included applicant characteristics, application history, portfolio outcomes and perceived challenges with the recruitment process. Psychological burden was assessed using the 10-item Perceived Stress Scale, with scores categorised as low, moderate or high stress. Results: A total of 108 responses were analysed, with 71.9% ultimately securing an ST3 post. Over half (55.6%) of successful applicants had applied more than once. Success was associated with completion of UK Core Surgical Training and attendance at interview preparation courses. Administrative challenges were common, with 41.7% reporting difficulties using the application platform and over half appealing portfolio scores. Overall, 71.3% of applicants reported moderate or high stress on the 10-item Perceived Stress Scale. Item-level analysis demonstrated that stress was predominantly characterised by feelings of loss of control and uncertainty rather than workload alone. Conclusion: Urology ST3 recruitment is associated with high levels of psychological burden, driven in part by modifiable system-level factors including portfolio scoring inconsistency and administrative inefficiencies. Improving transparency, standardisation and communication may reduce stress and enhance applicant experience, with implications for trainee well-being and workforce sustainability. Level of evidence: This research represents level 4 evidence.