Factors Influencing Interest in Urology Among Osteopathic and Allopathic Medical Students: A Single-Institution Cross-Sectional Survey.

Background  Following the transition to a single-accreditation residency system, Doctor of Osteopathic Medicine (DO) and Doctor of Allopathic Medicine (MD) students now apply for the same urology residency positions. Despite this unification, disparities in match rates persist, and factors influencing student interest in and the perceived feasibility of pursuing urology remain unclear. Objective  To compare and explore differences in perceptions of pursuing urology between DO and MD medical students at a single institution, with primary outcomes including perceived attainability of a urology career, level of specialty exposure, and access to urology-specific resources. Methods  A 20-question cross-sectional survey was distributed to all enrolled DO (n = 1,636) and MD (n = 220) students at Nova Southeastern University in fall 2025. Participation was voluntary and anonymous. Survey items assessed specialty interest, exposure, resource access, and perceived feasibility of pursuing urology. Fisher's exact tests were used for DO-MD comparisons, and chi-square goodness-of-fit tests were used for within-group DO analyses. This study was conducted and reported in accordance with Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Results  A total of 113 responses were analyzed: 81 DO and 32 MD students. Among students interested in urology (28 DO, 11 MD), 32.1% of DO students (9/28) and 54.5% of MD students (6/11) perceived the specialty as a realistic career goal; this difference was not statistically significant (Fisher's exact p = 0.27). When all DO responses were collapsed into "Yes" versus "Not Yes," only 16 of 81 DO students (19.8%) endorsed urology as realistic, whereas 65 of 81 (80.2%) responded "No" or "Not sure" (p < 0.001). Exposure to urology during medical school was reported by 30 of 81 DO students (37.0%) and 16 of 32 MD students (50.0%) (p = 0.23). Overall, 24 of 81 DO students (29.6%) reported no exposure to urology before or during medical school. MD students consistently reported greater access to mentorship and specialty-specific resources, but these differences did not reach statistical significance. Students from both programs cited surgical variety and lifestyle as key motivations for pursuing urology and similarly valued degree-concordant mentorship. Conclusions  DO students in this sample were less likely to perceive urology as an attainable career and reported lower levels of specialty exposure and access to urology-specific resources. Although between-group differences did not reach statistical significance, the observed patterns raise the possibility that differences in exposure and resource availability, rather than motivation alone, may contribute to these perceptions. These findings are exploratory and hypothesis-generating and warrant further investigation in larger, multi-institutional cohorts.