To demonstrate the distribution and impact of fellowship-trained andrology and/or sexual medicine urological specialists (FTAUS) on resident in-service examination (ISE) performance.
Residency program websites were accessed to create a database of FTAUS in the United States between 2007 and 2017. This database was reviewed by three separate FTAUS and cross referenced with membership lists to the Sexual Medicine of North America Society (SMSNA) and the Society for the Study of Male Reproduction (SSMR). De-identified ISE scores were obtained from the American Urological Association from 2007-2017 and scores from trainees at programs with a FTAUS were identified for comparison. Resident performance was analyzed using a linear model of the effect of a resident being at a program with an FTAUS, adjusting for post-graduate year.
ISE data from 13,757 residents were obtained for the years 2007-2017. The number of FTAUS in the United States increased from 40 to 102 during this study period. Mean raw scores on the “Sexual Dysfunction, Endocrinopathy, Fertility Problems” (SDEFP) section of the ISE ranged from 52.1% ± 17.7% to 65.7% ± 16% (mean ± SD). Throughout the study period, there was no difference in performance within the SDEFP section (p < 0.01). Residents at a program with a FTAUS answered 0.95% more questions correctly in the SDEFP than those without a FTAUS (p < 0.001). For these residents, there was an improvement of approximately 0.66% on the percentage of questions answered correctly on the ISE overall (p < 0.001). Performance improved significantly as residents progressed from PGY-2 to PGY-5.
There is a small but statistically significant improvement in overall ISE and SDEFP sub-section performance.

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