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What's known on the subject? and What does the study add? Dedicated training hours for surgeons are falling as the complexity of techniques and patient expectations are increasing. Urologists therefore need to train in more sophisticated and effective ways. This article looks at past and current urological training and suggests emerging and innovative ways to teach the next generation of urologists. Since 2004 the estimated available training time, for all doctors, has dropped from 30, 000 h to ≈ 8, 000h. By decreasing the initial stages of the learning curve, medical simulation has the potential to compensate for the reduced time available to train urologists. The current urological training pathway consists of 2 years of foundation year training, 2 years of core surgical training, followed by 5 years of specialty training. Training time pressures and the expansion of treatment techniques have led to a trend towards increased sub-specialization in urology. To optimize patient care, training programmes must evolve, taking into account several key issues and in accordance with advances in urological care.

What's known on the subject? and What does the study add? Dedicated training hours for surgeons are falling as the complexity of techniques and patient expectations are increasing. Urologists therefore need to train in more sophisticated and effective ways. This article looks at past and current urological training and suggests emerging and innovative ways to teach the next generation of urologists. Since 2004 the estimated available training time, for all doctors, has dropped from 30, 000 h to ≈ 8, 000h. By decreasing the initial stages of the learning curve, medical simulation has the potential to compensate for the reduced time available to train urologists. The current urological training pathway consists of 2 years of foundation year training, 2 years of core surgical training, followed by 5 years of specialty training. Training time pressures and the expansion of treatment techniques have led to a trend towards increased sub-specialization in urology. To optimize patient care, training programmes must evolve, taking into account several key issues and in accordance with advances in urological care.