Home › Specialties › Urology

Urology Training Pathway

How to become a urologist in Australia — the RACS Surgical Education and Training program in Urology run with USANZ, how national selection and regional distribution work, the exams, and what the published ATO data shows urologists earn.

Urology is competitive but, on RACS's published numbers, with a higher offer rate than the very tightest surgical specialties. Selection is the bottleneck and the CV is expensive to build — there's no published rule that you must do unaccredited urology first, but the rotation and referee prerequisites effectively require sustained urology experience before you apply.

Why urology

You manage surgical disease of the urinary tract and male reproductive system — kidney stones, prostate disease and prostate cancer, bladder and kidney cancer, incontinence and reconstruction, andrology and paediatric urology — combining clinic and cystoscopy with a high-volume endoscopic and laser operating list and major open and robotic surgery. There's real acute work: obstructed infected stones and renal colic, acute urinary retention, testicular torsion (time-critical) and heavy haematuria. It suits people who like a technology-heavy procedural field — endoscopy, lasers and robotics — with a mix of cancer surgery, functional work and acute emergencies, and who are prepared for a competitive entry that rewards sustained urology experience and research.

Draws: Technology-rich procedural mix — endoscopy, lasers and robotic surgery, Higher published offer rate than the tightest surgical specialties, Strong earnings — its own ATO code sits above the blended surgeon average, Broad case-mix across cancer, stones, function and andrology.
Trade-offs: Still a competitive, expensive-to-prepare-for surgical selection, Rotation and referee prerequisites effectively require prior urology time, A mandatory research requirement before you can sit the Fellowship Exam, Real acute on-call (stones, retention, torsion, haematuria).
Subspecialties: Endourology & stone surgery, Uro-oncology (prostate, bladder, kidney), Robotic & laparoscopic surgery, Female, functional & reconstructive urology, Andrology & male infertility, Paediatric urology, Renal transplantation.

The training pathway

The same fellowship, two very different timelines. The fast route assumes everything goes right; most people land on the realistic one.

Fastest route

~7 years

The arithmetic floor — internship, then selected at the PGY2 entry minimum, with the five-level program completed on time. In practice almost nobody is selected this early.

Internship

PGY1

General registration. The GSSE and (currently) the RACS Clinical Examination are typically attempted before applying.

Residency / pre-SET requirements

PGY2

Applicants must be PGY2+ and have completed set rotations by the closing date: ≥26 weeks surgery-in-general, ≥10 weeks ED and ≥26 weeks urology.

SET selection (Urology)

from PGY2+

National USANZ selection. GSSE pass, RACS Clinical Examination pass and the 'Operating with Respect' module are prerequisites.

SET 1–3

Levels 1–3

Accredited training; ASSET and CCrISP courses before the end of SET1, and the Surgical Science Examination in Urology.

SET 4–5

Levels 4–5

Senior registrar training; the research project must be completed before sitting the Fellowship Examination.

Fellowship — FRACS (Urology)

Qualified · ~PGY7+

Specialist urology registration on passing the Fellowship Examination.

Realistic route

8–11 years

Typical — internship, residency and several unaccredited/service-registrar urology years to meet the rotation and referee prerequisites and build a competitive CV, before a five-level program. RACS/USANZ don't publish a required number of pre-SET years.

Internship & residency

PGY1–2

General registration plus general surgical experience; GSSE and the Clinical Examination usually attempted here.

Unaccredited / service-registrar urology

a few years

Most do unaccredited urology terms to meet the 26-week urology and referee requirements and build the CV. A peer-reviewed study found successful applicants spent on average about $50,000 building their CV over roughly three years — but no required number of years is published.

SET selection (Urology)

the hardest step

RACS publishes the numbers: recent intakes ran roughly 46–66 applicants a year for about 18–29 offers nationally — a higher offer rate than the tightest surgical fields, but still competitive. Up to four attempts are allowed.

SET 1–5

Levels 1–5

Five levels of accredited training (maximum seven years), including the Surgical Science Examination in Urology and a mandatory, BOU-approved research project.

Fellowship Examination — FRACS (Urology)

SET4–5 · ~PGY9–11

A written hurdle then clinical/viva segments; pass for specialist registration. Many then add a 1–2 year (non-accredited) subspecialty fellowship.

How competitive is it?

Urology is a competitive surgical specialty, but RACS's published figures show it isn't as tight at the offer stage as the very hardest. In its Guide to Surgical Selection, Urology (Australia) ran about 66 applicants for 29 offers in 2019, 51 for 21 in 2020, 47 for 18 in 2021, 46 for 18 in 2022 and 48 for 24 in 2023 — so depending on the year somewhere between roughly two in five and one in two applicants is made an offer (a ratio derived from RACS's two published figures), a higher offer rate than ENT, neurosurgery or cardiothoracic. Counted by commencement year, RACS lists around 16–24 new trainees a year. Interviews are scheduled at a published two-to-one ratio (two applicants interviewed per post). The national applicant-to-place ratio and the number of accredited posts aren't published as single figures, so the applicant-versus-offer counts above are the best published guide. For workforce scale, the RACS Activities Report recorded about 486 Australia-based urology Fellows and 101 active SET trainees in 2023, around 14% of Fellows female and about 85% in major cities — a small, heavily metropolitan workforce. The national split of urologists between public and private practice isn't published.

Unaccredited time: In practice, effectively yes — there's no formal rule, but the 26-week urology rotation and referee prerequisites mean almost everyone does unaccredited urology/service-registrar time before selection. RACS/USANZ don't publish a required or typical number of years.

Sources: RACS — 2024 Guide to Surgical Selection (2025 intake): Urology applicant vs offer chart, RACS — Urology specialty page (trainees appointed by year), RACS — Activities Report 2023 (Fellows & SET trainees by specialty), USANZ — SET Urology Selection Regulations (2026 intake).

Selection criteria & how to apply

Selection is national — delegated by RACS to USANZ's Board of Urology — and you apply in one country (Australia or Aotearoa New Zealand); successful applicants are then distributed to a training region (NSW/ACT, SA, QLD, VIC including Tasmania, or WA) by rank and post availability. USANZ publishes the scoring weightings: in the 2026-intake regulations the headline rubric is a structured CV (25%), structured referee reports (30%) and a semi-structured interview (45%). (The same regulations also express these slightly differently in places — a CV 25 / referee 35 / interview 40 split — so treat the percentages as the published headline rather than a single settled figure.) The GSSE and the RACS Clinical Examination are pass/fail eligibility gates, not scored components — and note RACS is phasing the Clinical Examination out as a selection requirement from the 2028 intake. The scored steps, with their published headline weightings:

Semi-structured interview45%

The single largest weighting. Conducted across four panels with applicants rotating between them; only applicants in the top two-to-one of the combined CV-plus-referee score are interviewed.

Structured referee reports30%

USANZ selects 9 referees (consultant surgeons plus an allied-health professional); the final score averages four valid reports. Individual referee scores aren't released to the applicant and can't be appealed.

Structured CV25%

Scored out of 53 raw points (then rescaled) across qualifications, professional development, publications and ongoing research, presentations, and rural/regional origin and experience — each with published maxima. Marked by two USANZ staff against a structured key.

GSSE, Clinical Exam & prerequisitesGate

Eligibility gates, not scored: a GSSE pass, the RACS Clinical Examination (being phased out from the 2028 intake), the 'Operating with Respect' module, and rotations of ≥26 weeks urology, ≥26 weeks surgery-in-general and ≥10 weeks ED.

Key documents: USANZ — SET Urology Selection Regulations (2026 intake), USANZ — SET Urology Training Regulations (2024), USANZ — application & selection overview.

How it works, region by region

Selection is national, but training is delivered in regions. USANZ runs one national process and ranks applicants; you're then distributed to a training region that employs and rotates you. Several regions pair jurisdictions — ACT sits with NSW and Tasmania with Victoria. Pick your state below for the regional picture and recent trainee numbers.

NSW NSW: 31 active SET trainees (2023)

Who runs selection: Part of the NSW/ACT training region. Selection is national (USANZ); the region employs and rotates you through accredited posts.