To provide the first nationwide characterization of the clinical learning environment in American urological training programs.

A survey was sent to program directors (PD) at American Urological Association-accredited urological training programs after requesting their email address from each program coordinator. The 21-question survey was designed to ascertain key components of each training environment: demographics, training model, clinic structure, and resident perception.

The program coordinator of 131 American Urological Association-accredited training programs received an email for participation, yielding the PD email for 113 programs. 60/113 (53%) PDs responded to the survey. Residents participated in clinic at the following types of hospitals: Children's 51 (85%), County/Indigent 23 (38%), Private 29 (48%), University 56 (93%), Veterans Administration 38 (63%). Prevalence of clinical training models is presented in table 1. On average, PDs estimated their residents spend 2.6 half days in clinic each week (1-6). Thirteen programs (22%) reported a “clinic only” rotation, varying from 1 to 6 months total. PDs reported time constraint and schedule to be the biggest barrier to teaching in clinic and 40% felt residents see clinic as a valuable part of their training while 30% felt residents see clinic as a necessary exercise but with limitations to learning opportunities.

We present the first characterization of resident participation in the clinical learning environment. Structure is highly variable and directed effort is necessary to move toward improved assessment and monitoring of resident competency in clinic.