Discussion

This study is the first to comprehensively identify and characterize trends in the geographic and temporal distribution of in-person urologic conferences within the United States during the post-COVID-19 period, from 2022 to 2025. The analysis reveals marked geographic concentration in a limited number of states, seasonal clustering in the fall, and a modest decline in conference duration. These patterns have important implications for accessibility, workforce development, and sustainability within the specialty. There was a significant concentration of conferences in a limited number of states, with Texas, California, Arizona, Colorado, and Florida hosting the highest amounts. The uneven geographic distribution, with 20 states hosting no events, may limit opportunities for trainees and practicing urologists in underserved regions, particularly medical students without a home urology program who rely on conferences for mentorship and career exploration. Given that early mentorship is a well-established factor in influencing students to pursue urology [9-11], expanding conference accessibility to underrepresented areas could be a valuable strategy for addressing the ongoing workforce shortage in the specialty [12,13]. This may also contribute to a widening disparity in the geographical distribution of urologists across the United States, as younger urologists tend to concentrate in urban metropolitan areas in a select few states [14]. While further research is required to determine the correlative relationship between the distribution of practicing urologists and the locations of urologic conferences, the inequity is notable.

Conference scheduling showed a clear preference for the fall, with October and September hosting most events, while summer (particularly July) was largely avoided. This clustering may align with academic calendars, vacation patterns, and seasonal weather, but it can also create overlap that limits attendance at multiple meetings. Strategies, such as consolidating similar events or distributing them more evenly throughout the year, could improve efficiency and accessibility, although each approach carries trade-offs in variety, flexibility, and logistics. The mean conference duration was approximately three days, showing a slight increase from 2022 to 2025. This trend may indicate a preference for longer conferences to increase opportunities for in-depth learning and networking. However, shorter conferences reduce cost and time away from clinical responsibilities, ultimately highlighting the importance of intentional planning to balance efficiency with the overall value of the conference experience.

Lastly, given the increasing awareness of environmental sustainability in healthcare, the geographic clustering of conferences raises concerns about the cumulative carbon footprint associated with participant travel. Conferences that require long-distance or air travel contribute more to greenhouse gas emissions as compared to shorter travel distances [8,15]. While specific data quantifying the environmental burden is currently lacking, the impact is likely substantial. Consolidating conferences to reduce overall travel demand and offering hybrid or virtual attendance options are potential strategies for minimizing this footprint and promoting more sustainable practices within the field. [16,17] However, consideration should also be made for how this impacts trainees, who use conferences as a means of networking and camaraderie. [2] Ultimately, there is viability to the use of virtual or hybrid conferences as an alternative method [18]; preferences of all attendees should be taken into account to ensure equity and accessibility to the largest number of participants.

The primary limitation of this study is its reliance on publicly available online data sources. As a result, conferences that were not well advertised or lacked an online presence may not have been captured. Additionally, the retrospective design limited data collection to conferences with accessible documentation, such as organizational webpages or recorded materials, potentially excluding less formally documented events. Although a comprehensive search strategy was employed, including the use of multiple sources to verify conference occurrences, these inherent limitations of the study design may have influenced the reported findings.