Urology Training Across Borders: An International Survey of Residents’ Experiences, Perceptions, and Expectations

Background/Objectives: Urology residency training widely varies across countries, and evidence comparing residents’ experiences at an international level is limited. This study reports the results of an international survey of urology residents from different countries worldwide, aiming to characterize training environments, educational exposure, and trainee expectations across diverse healthcare systems. Methods: A 39-item online survey was administered to urology residents during the Société Internationale d’Urologie (SIU) Regional Meeting (Florence, November 2024), assessing demographics, training exposure, educational resources, workload, satisfaction, and career perspectives. The results were compared between trainees at different postgraduate years (PGYs) to explore associations for key outcomes. Results: Overall, 208 urology residents from 21 countries completed the survey. Most residents were actively involved in research (76.4%), although confidence in independent scientific production was moderate (significantly lower among junior trainees). Surgical exposure increased with PGY, with good experience in endoscopy but limited hands-on exposure and expected autonomy in laparoscopic, robotic, and major open surgery. Despite high overall satisfaction with urology, residents described heavy workloads, inconsistent access to structured teaching and international fellowships, and a long-term shift in career expectations toward private practice. Conclusions: Urology residents worldwide report high engagement in research, strong satisfaction with their specialty choice, and interest in international mobility. Nonetheless, persistent disparities in surgical exposure, research confidence, workload, and gender representation highlight the need for competency-based curricula, structured mentorship, and improved training organization to promote equitable and high-quality urology education globally.