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The recent publication of the 'Shape of Training Review' by Professor David Greenaway has re-ignited the debate about the direction of UK postgraduate training in an era where there is significant challenges delivering high-quality care to an ageing population. This article sets out a vision of how BAUS believes that care should develop to meet the anticipated increase need for urological care, ensuring the right balance between specialist and generalist care.

The management of male-factor infertility (MFI) is one component of the UK urological training curriculum. Sub-specialising gynaecologists, training in reproductive medicine, are also expected to achieve similar competencies. This study aimed to determine UK urology trainees' views on the quality of their training in managing the infertile male. Methods: All UK urological trainees, identified through the British Association of Urological Surgeons (BAUS) or Joint Committee on Surgical Training (JCST) databases were e-mailed and invited to partake in an online survey, accessed through SurveyMonkey TM . Results: 176 (51.6%) urological trainees responded. Only 3.6% were assured of exposure to training in MFI investigation and management and <35% had any exposure to vasectomy reversal. 61.3% wanted infertility to make up some part of their work as a consultant but only 27% rated their training as adequate. 79.9% felt threatened by the potential loss of skills and patients to gynaecologists with sub-specialist interests in reproductive medicine. Conclusions: UK urological trainees reported that exposure to dedicated training in MFI is suboptimal and ultimately, insufficient to equip them for the consultant practice they desire. Urology training needs re-structuring to ensure retention of this skill set and to support the aspirations of interested urological trainees.