The surgeon for kidneys, bladders and prostates. Thirteen years of training, then some of the best pay in medicine.
Click through it
Pay, the path, pros and cons and the facts on one printable page. Good for a wall or a guidance counsellor.
Or read the whole thing here
What you earn and what it costs to get there.
Median
$265,930
Bottom tenth
$69,170
Top tenth
$452,360
The national median is $265,930 a year and the bottom tenth sit near $69,170. That is the published figure for the urologist profile inside the broader Physicians, All Other survey group. It counts only urologists who are employees. Urologists who own part of a practice are not in it, and they usually earn more.
$529,140
Average annual compensation reported for urology in Doximity's 2024 physician compensation report
That report is built on more than 33,000 physician surveys of full-time doctors. It sits well above the federal median because it captures partners and production bonuses, not just salaried staff. Treat the true middle as somewhere between the two.
About $65,000 to $80,000
Resident pay, rising a little in each of the five residency years
Residents are salaried hospital employees, so it is real money, but you are carrying medical school debt at the same time and working 60 to 80 hour weeks. The figure moves with the cost of living in the city.
Tuition, fees, exams and kit. Not rent, food or travel
There is no cheap door. The low end is two years at a community college then two at an in state public university for the bachelor's degree, the Medical College Admission Test at about $350 with $1,000 to $3,000 in applications, four years of public in state medical school at roughly $30,000 a year, and the United States Medical Licensing Examination steps at about $675 each for the first two. The high end is four full years of in state university at $12,000 a year and medical school at $45,000 a year. Private medical schools cost more again. Residency and the urology training years are paid work, not tuition. Most graduates owe well over $150,000.
File the FAFSA (Free Application for Federal Student Aid) every year. Most medical students finish owing well over $150,000. If you work at a nonprofit or government hospital, Public Service Loan Forgiveness can cancel the balance after 10 years of payments, and residency years count toward those 10.
Malpractice insurance paid for you
Employers almost always cover it. Buying surgical coverage yourself is expensive.
Signing bonuses and loan repayment
Hospitals outside big cities routinely offer both because urologists are scarce.
Ownership income
Partners in a urology group can share in a surgery center or a lab, on top of their clinical pay.
Job security
Every hospital needs a urologist on call, and there are not enough to go around.
The exact path from high school to qualified.
Thirteen years after high school, and urology is one of the harder specialties to match into.
High school
Grades 11 and 12
Top grades in biology, chemistry, physics and math. You are aiming at a competitive pre-medical undergraduate spot.
Bachelor's degree
4 years
Any major, but you must finish the pre-medical science courses. Keep a high GPA, get research and clinical experience, and write the MCAT (Medical College Admission Test).
Medical school
4 years
Two years of science, then two years of clinical rotations. Do a urology rotation early: this specialty is decided on relationships and letters.
Urology residency
5 years
Five years, starting with a year of general surgery before you move into urology proper. Long hours, heavy call, operating from early on.
Board certification
1 to 3 years after residency
The American Board of Urology requires a written qualifying examination, then a certifying examination taken after you have been in practice.
Biology and chemistry
Required for every pre-medical program.
Physics
Tested on the MCAT (Medical College Admission Test), and useful for imaging and laser work.
Calculus and statistics
You will read clinical studies for the rest of your career.
English
Half of surgery is explaining a frightening diagnosis to a person who is not listening well.
To practice you need a medical license from the state medical board where you work, earned by finishing medical school and passing all three steps of the United States Medical Licensing Examination. Board certification in urology is separate and comes from the American Board of Urology, which runs a qualifying examination and then a certifying examination and requires you to keep proving competence for the rest of your career. Hospitals will not give you operating privileges without both.
Things you don't need, but that help.
Urologic oncology
Kidney, bladder and prostate cancer surgery. One to two extra years.
Pediatric urology
A subspecialty certification offered by the American Board of Urology.
Endourology and stone disease
Minimally invasive work through scopes and lasers.
Urogynecology and reconstructive pelvic surgery
A second subspecialty certification, shared with gynecology.
Research during medical school
Urology applicants are expected to have published something.
Robotic surgery experience
Urology led the way on robotic surgery and most programs now train on it.
Rural or underserved commitments
State loan repayment programs will pay a large part of your debt for a few years of service.
Good hands and steady sleep habits
Both matter more than people admit.
Day to day, pros and cons, where you'd work.
Operating days start about 7am: kidney stones, prostate procedures, cancer surgery, often on a robotic system. Clinic days are 25 to 35 patients, mostly older men and women with problems they are embarrassed to describe. In between, scans to read, results to call, and a ward round. You take call in rotation, and a blocked kidney at 2am is a real emergency.
The good
The hard parts
Things people don't tell you.
Much of the work goes in through natural openings with a scope, or through keyhole ports on a robotic system. Patients often go home the same day from an operation that used to mean a week in hospital.
Roughly one in ten Americans will have a kidney stone in their lifetime, and rates have climbed for decades. Stone work alone keeps urology departments busy.
A large share of practicing urologists in the United States are over 55, and residency spots have grown slowly. That shortage is the reason rural hospitals offer such large signing bonuses.
Last checked September 2026. Pay figures are typical full-time annual amounts in United States dollars, based on Bureau of Labor Statistics wage data and published pay scales. They vary by state, employer and experience. Tuition is for in-state students at public schools unless the card says otherwise.