The American Urological Association (AUA) continues to endorse the Association of American Medical Colleges Statement on the Physician Workforce [pdf]. The AUA believes the projected number of urologists-to-population ratio of the United States is inadequate to keep up with projected population growth. Existing shortages are exacerbated by inadequate numbers of residency positions and lengthening time of training. In order to meet urology's workforce shortage, it has become necessary to meet the triple challenge of providing more urology training positions with more extensive training in a shorter duration of time. Work must be done to move the national discussion away from focusing solely on primary care needs and advocate a new focus on the entire physician workforce.

The AUA makes the following declarations as they specifically pertain to the urologic workforce:

1. The projected number of urologists-to-population ratio of the United States is inadequate to keep up with projected population growth.
2. Existing shortages are exacerbated by inadequate numbers of residency positions and lengthening time of training. This has resulted in lack of workforce diversity, critical shortages in rural locations, and physician burnout. Instead of solely advocating for increased residency positions, a multifaceted approach is indicated, including improved training for advanced practice providers, exploring the use of telemedicine and tele-health technologies, improving diversity of the urology workforce, and increased utilization of part-time and less than full-time urologists.
3. In order to meet urology's workforce shortage, it has become necessary to meet the triple challenge of providing more urology training positions with more extensive training in a shorter duration of time. This requires developing a strategy to address the current unfunded urology training positions, resident faculty salary support and development of innovative teaching techniques.
4. Work must be done to move the national discussion away from focusing solely on primary care needs and advocate a new focus on the entire physician workforce.

In addition, the AUA supports the following American Medical Association (AMA) House of Delegates policy H-200.955 Revisions to AMA Policy on the Physician Workforce.

It is AMA policy that:

(1) Any workforce planning efforts, done by the AMA or others, should utilize data on all aspects of the health care system, including projected demographics of both providers and patients, the number and roles of other health professionals in providing care, and practice environment changes. Planning should have as a goal, appropriate physician numbers, specialty mix and geographic distribution.

(2) AMA encourages and collaborates in the collection of the data needed for workforce planning and in the conduct of national and regional research on physician supply and distribution. The AMA will independently, and in collaboration with state and specialty societies, national medical organizations, and other public and private sector groups, compile and disseminate the results of the research.

(3) The medical profession must be integrally involved in any workforce planning efforts sponsored by federal or state governments, or by the private sector.

(4) In order to enhance access to care, AMA collaborates with the public and private sectors to ensure an adequate supply of physicians in all specialties and to develop strategies to mitigate the current geographic misdistribution of physicians.

(5) There is a need to enhance underrepresented minority representation in medical schools and in the physician workforce, as a means to ultimately improve access to care for minority and underserved groups.

(6) There should be no decrease in the number of funded graduate medical education (GME) positions. Any increase in the number of funded GME positions, overall or in a given specialty, and in the number of US medical students should be based on a demonstrated regional or national need.

(7) AMA will collect and disseminate information on market demands and workforce needs, so as to assist medical students and resident physicians in selecting a specialty and choosing a career.

(8) AMA will encourage the Health Resources & Service Administration to collaborate with specialty societies to determine specific changes that would improve the agency's physician workforce projections process, to potentially include more detailed projection inputs, with the goal of producing more accurate and detailed projections including specialty and subspecialty workforces.

(CME Rep. 2, I-03, Reaffirmation I-06; Reaffirmation I-07; Reaffirmed: CME rep. 15, A-10; Reaffirmation: 1-12; Reaffirmation A-13; Appended Res. 324, A-17)

The revision above combined the following three "workforce-related" policy statements into one statement:

• Graduate Medical Education/Urology Workforce Shortage Policy
• Physician Workforce Planning and Graduate Medical Education
• Physician Workforce: Recommendations for Policy Implementation

Board of Directors, October 2018 (Revised)