Urogynecology / Female Pelvic Medicine & Reconstructive Surgery (FPMRS) — Specialty Profile

Subspecialty fellowship of OB/GYN (also enterable from Urology); jointly boarded (ABOG/ABU).

Exploratory, not prescriptive. This profile blends hard data (pay, match rates, burnout, demographics — each sourced and dated) with generalizations and synthesized online opinion about culture and "who fits." It's here to help you get curious and go find out for yourself — not to tell you who to become. Numbers marked ⟳ verify change every year; check the linked source before you quote one. Last reviewed: 2026-07-25.

Also called: FPMRS, urogyn, and, since the boards renamed it in the early 2020s, Urogynecology and Reconstructive Pelvic Surgery (URPS). A fellowship you enter after completing an OB/GYN residency (most common) or a Urology residency, not straight from medical school. Organ system: the female pelvic floor, meaning bladder, urethra, vagina, uterus and vaginal apex, rectum, and the muscles and connective tissue that support them.

The 30-second version

Urogynecology is the surgical subspecialty of the pelvic floor and, for a lot of OB/GYNs, the way to keep the operating room while walking away from delivering babies at 3 a.m. Urogynecologists treat pelvic floor disorders: prolapse (when the bladder, uterus, or vaginal walls drop), urinary and fecal incontinence, overactive bladder, fistula, and recurrent UTIs, in a mostly older, overwhelmingly female patient population. These are quality-of-life conditions rather than life-threatening ones, and that single fact shapes the whole field: the surgery is planned and elective (prolapse repairs, slings, sacrocolpopexy, often robotic), the clinic is procedure-rich (urodynamics, cystoscopy, pessary fittings, Botox for the bladder), and the call is light. You trade obstetrics' chaos for a schedulable surgical life.1

The honest framing you'll hear from the field itself: this is one of the few genuinely balanced surgical careers in medicine. You keep the OR and the procedures, you build long relationships with patients, you earn a surgical-subspecialty income, and you get most of that without L&D's punishing, unpredictable hours. The trade is three more years of fellowship after an already-long residency, and a patient population and pathology that some people find quietly rewarding and others find repetitive.12

Quick dashboard (details and sources below)
Training after med school OB/GYN residency (4) + FPMRS fellowship (3) = 7 yrs after med school [or via Urology: 5 + 2]
Total from college start ~15 years (4 undergrad + 4 med school + 4 OB/GYN residency + 3 fellowship)
Competitiveness (as a subspecialty fellowship) Moderate — ~94.6% of positions fill, ~1.4 applicants per spot, ~31% of applicants go unmatched (NRMP, 2026 appointment year) ⟳
Typical full-time pay ~$400,000–$460,000 total comp (OB/GYN track); ~$500k+ (Urology track) — estimated; no clean free survey ⟳
Pay range (structure) MGMA-referenced ~$208k (low) · median ~$376k · ~$606k (high); 2024–26 sources cluster higher ⟳
Lifestyle Elective, scheduled OR + clinic, ~8–5 with light call — the "escape from OB call"
Burnout Lower-intensity than frontline OB/GYN, which runs 45.7% against a 41.9% all-physician average (AMA 2025); real but treated as a relief valve ⟳
% women 83.4% of OB/GYN-track fellows and 75.0% of urology-track fellows (ACGME AY2024-25) ⟳
DO / IMG accessibility Modest DO (~9.7% of applicants); minimal IMG (~8% of applicants, 1 matched for 2026) ⟳

What they actually do

Urogynecologists and FPMRS specialists manage disorders of the female pelvic floor: pelvic organ prolapse, stress and urgency urinary incontinence, overactive bladder, fecal and anal incontinence, genitourinary fistula, mesh complications, and recurrent urinary tract infections. The practice is a deliberate blend of operating room and clinic. You are a surgeon, but a large share of the work happens awake, in the office, with a patient in a clinic chair. The pathology is high-prevalence and quality-of-life: it rarely kills anyone, but it can quietly govern whether a patient will leave the house, exercise, or feel like herself. Much of the field's satisfaction comes from treating conditions patients have often suffered with silently for years because of stigma.12

The surgery is overwhelmingly elective and scheduled rather than emergent, which is the structural reason the lifestyle works. On the OR side, the signature operations are prolapse repairs (native-tissue and mesh-augmented, including sacrocolpopexy done robotically or laparoscopically), mid-urethral slings for stress incontinence, sacral neuromodulation (InterStim), Botox injection for overactive bladder, and fistula and reconstructive surgery. On the clinic side, the ancillary-procedure menu, a real revenue driver in private practice, includes urodynamics, cystoscopy, pessary fitting and management, percutaneous tibial nerve stimulation (PTNS), bladder instillations, and pelvic-floor physical-therapy referrals.12

Representative procedures: vaginal and robotic/laparoscopic prolapse repair · sacrocolpopexy · mid-urethral sling · sacral neuromodulation (InterStim) · intravesical Botox for overactive bladder · pessary fitting and management · urodynamic testing · cystoscopy · fistula and reconstructive pelvic surgery · PTNS · bladder instillations.

A day in the life: A representative urogyn week alternates clinic days and OR days on roughly standard business hours, think ~8:00 a.m. to 5:00 p.m. Clinic is procedure-rich and relationship-heavy: pessary fittings and checks, urodynamics, cystoscopy, Botox, new consults for prolapse and incontinence, and a lot of longitudinal follow-up with older women you may care for over years. OR days are planned reconstructive cases you scheduled weeks earlier. Because the pathology is quality-of-life rather than life-threatening, true emergencies are rare and call is light and predictable compared with general OB/GYN or general urology. There's still post-op management and the occasional complication, since it is a surgical field, but the ceiling on unpredictability is far below obstetrics.2

The training path & time to completion

Medical school (4 yrs) → OB/GYN residency (4 yrs) → Urogynecology/FPMRS fellowship (3 yrs) → jointly board-certified by ABOG/ABU. That's ~7 years after medical school on the most common route, and roughly 15 years from the start of college.3

The dual-entry story is a defining feature of the field. Urogynecology is one of the very few subspecialties you can reach from two different primary residencies:3

  • Via OB/GYN (the common route): 4-year OB/GYN residency → 3-year FPMRS fellowship. OB/GYN-trained physicians certify through the American Board of Obstetrics and Gynecology (ABOG).
  • Via Urology (the smaller route): 5-year Urology residency → 2-year FPMRS fellowship (shorter because urology residency already covers much of the reconstructive/urologic base). Urology-trained physicians certify through the American Board of Urology (ABU).

The subspecialty is jointly boarded: the certificate in Urogynecology and Reconstructive Pelvic Surgery is offered jointly by ABOG and ABU, and the subspecialty exam is administered jointly, with OB/GYN grads sitting it through ABOG and urology grads through ABU.3 The two parent fields quietly share (and occasionally spar over) ownership of the pelvic floor.

  • The name change: the field was long called Female Pelvic Medicine and Reconstructive Surgery (FPMRS); in the early 2020s the boards renamed it Urogynecology and Reconstructive Pelvic Surgery (URPS), partly to be clearer to patients about what it actually is. Older data (ACGME, NRMP pre-2023, journals) uses "FPMRS"; you'll see all three names used interchangeably.34
  • Total from the start of college: ~15 years via OB/GYN (4 + 4 + 4 + 3); ~15 years via Urology (4 + 4 + 5 + 2).

How competitive is it? (as a subspecialty fellowship)

Urogynecology/URPS fills through the NRMP Specialties Matching Service (SMS), which pools the OB/GYN-based and Urology-based positions into one match. It reads as moderately competitive: nearly all positions fill, mostly with U.S. MDs, but a meaningful minority of applicants who rank programs still go unmatched.4

Most recent full published report, the 2026 appointment year (NRMP titles the report by its match year, 2025, and gives the appointment year in its own header; match day was 6 August 2025):4 ⟳

  • 66 certified programs · 74 positions offered · 70 filled → 94.6% fill rate, with 4 programs unfilled.
  • 102 certified applicants for 74 spots → ~1.4:1 applicant-to-position ratio.
  • 70 applicants matched (68.6%); 32 went unmatched (31.4%).

Applicant pool by degree type (2026 appointment year): U.S. MD 83 (80.6% of the pool), of whom 62 matched (74.7%); U.S. DO 10 (9.7%), 6 matched; IMG ~8% combined (US-citizen IMG 3 + non-US IMG 5), with only 1 IMG matched; 1 Canadian-pathway applicant.4

The year before it was tighter, and the difference is worth seeing: the 2025 appointment year filled all 70 of its positions, 100.0%, left no program unfilled, drew 92 applicants of whom 22 went unmatched (23.9%), and matched 3 IMGs.5 ⟳

What that means for you: this is a fellowship U.S. MD graduates dominate, and it fills reliably, but "nearly full" is not "easy," since about a third of the people who rank programs don't get a spot. IMG penetration is very low. For accreditation-footprint context, ACGME accredits URPS programs on both parent sides and counts them separately: 59 under obstetrics and gynecology and 16 under urology in AY2024–25, up from 54 and 15 five years earlier. NRMP's "66 participating programs" is a combined count, 50 on the OB/GYN side and 16 on the Urology side.6 Everything above except the comparison paragraph is the 2026 appointment year. NRMP publishes each year's SMS results in February, at nrmp.org/match-data.4 ⟳

Compensation — the robust version

Here's the honesty caveat first, because it matters more than usual for this field: there is no single clean, free, survey-grade national compensation figure for urogynecology. The authoritative source, the AUGS–MGMA Urogynecology Compensation Report (2025 edition, 2024 data), which benchmarks total compensation, professional collections, work RVUs, total RVUs, and comp-to-wRVU ratio, is paywalled. And several consumer salary aggregators return badly low numbers for "urogynecologist" because they conflate physician pay with NP/PA/staff postings. So the figures below are triangulated from secondary sources of varying reliability, each flagged.7

National number. The most defensible estimate for a practicing OB/GYN-track urogynecologist is roughly $400,000–$460,000 total compensation, rising to $500,000+ for the Urology-track urogynecologist (who benefits from urology's higher base). This sits above generalist OB/GYN ($372k–$390k), as you'd expect for a surgical subspecialty.7 ⟳

The spread (from MGMA, older data via Physicians Thrive): low end ~$207,972 · median ~$375,704 · high end ~$606,136. True 10th/25th/75th/90th percentiles live in the paywalled AUGS–MGMA report and aren't public.78 ⟳

The current-but-crowd-sourced anchors. Physician Side Gigs put urogynecology at $402,000 (2024); Marit Health's real-time crowd data listed $452k for the OB/GYN track and $538k for the Urology track (2026), the most current numbers, though self-reported rather than surveyed.78 ⟳ Do not cite ZipRecruiter ($253k), Glassdoor ($335k, n=1), or Salary.com ($187k) as physician total comp, since all are unreliable for this niche and understate it badly.7

Where urogyn sits among OB/GYN subspecialties. Mid-to-upper. Physician Side Gigs (2024): MFM ~$513k > REI ~$461k > Urogynecology ~$402k > OB hospitalist ~$297k, with generalist OB/GYN around $372k–$390k. Below the top OB/GYN subspecialties, clearly above generalists and hospitalists.7 ⟳

Academic against private (OB/GYN proxy, since no urogyn-specific split is public). Using Physician Side Gigs' OB/GYN database: academic ~$382k · private-practice overall ~$406k · private employed (non-partner) ~$365k · private partner/owner ~$445k. Academic pays a lower base but adds protected research/teaching time and benefits; private-practice partners top the range, driven by surgical volume, ownership, and in-office ancillary revenue.9 ⟳

How you're actually paid: the revenue engine. Urogyn comp is built on a surgical + procedural base rather than obstetrics. High-wRVU operative work (prolapse repair, sacrocolpopexy, slings, neuromodulation) is the main driver; in private practice, in-office ancillaries such as urodynamics, cystoscopy, pessary management, and PTNS add a second revenue stream that employed and academic settings often don't capture. Contracts typically blend base salary, wRVU productivity, and quality or ancillary bonuses, with partners adding practice profit. The paywalled AUGS–MGMA report specifically benchmarks work RVUs and comp-to-wRVU ratio, the metrics that actually set employed urogyn pay.7

Geography. No urogyn-specific geographic survey is public. The general physician pattern applies: total comp tends to be highest in the Midwest and South and in lower-cost, underserved regions and lower in the coastal Northeast and California (Doximity documents this for physicians broadly). State income tax adds a real after-tax swing, and no-tax states (TX, FL, NV, etc.) keep meaningfully more of a given salary than California, roughly a ~9% difference on a $300k reference in one model.1011 ⟳

The trend that colors all of it. Two tailwinds. First, generalist OB/GYN comp rose ~5% in 2025 to ~$390k (Medscape 2026), and urogyn rides above that base. Second, and bigger for job security, demand is structurally rising: pelvic-floor-disorder prevalence is projected to grow from 28.1 million U.S. women (2010) to 43.8 million by 2050 as the population ages, which supports a durable, geographically flexible job market and upward pressure on pay.812 A caveat on the money mood: only ~53% of OB/GYNs feel fairly paid, and a gender pay gap persists in OB/GYN broadly (~18%, women ~$368k against men ~$436k full-time) and is likely present in urogyn.712 ⟳

Lifestyle & the "escape from OB call" bargain

The single most-cited reason OB/GYNs pursue this fellowship: no OB call. Obstetrics, meaning the unpredictable middle-of-the-night deliveries, drives much of general OB/GYN's brutal hours, and urogynecology removes it almost entirely. What's left is a clinic-plus-OR surgical practice where the surgery is overwhelmingly elective and scheduled, so you can plan your life around it.12

Schedule control is genuinely good for a surgical field. A representative practice runs roughly standard business hours (~8–5) with dedicated clinic days and OR days; because the pathology is quality-of-life rather than life-threatening, true emergencies are rare and call is light and predictable compared with general OB/GYN or general urology.2 The trade-off is real but modest: it's still surgery, so there's OR time, post-op management, and occasional complications to handle. The ceiling on unpredictability is just far lower than obstetrics, stone and trauma urology call, or general surgery.

Lifestyle rating: 4/5. Genuinely one of the more controllable surgical careers, with schedulable elective operating and light call; short of a 5 only because it's still a surgical field with post-op responsibility and the occasional complication.

Wellbeing — the part to take seriously

Burnout runs comparatively lower, a relief valve rather than a burnout-free zone. General OB/GYN is one of the most burned-out specialties in the country (the AMA's 2025 survey puts it at 45.7% against a 41.9% all-physician average, fourth of the nine it names), and urogynecology is widely read as an escape from the highest-intensity OB drivers into controllable, elective work.13 But "lower" isn't "none": there is a dedicated FPMRS burnout literature (Sassani et al. 2021; AUA News, "Shedding Light on Physician Burnout in FPMRS," April 2024) documenting that burnout is real in the field and actively discussed. No urogyn-specific burnout prevalence is publicly available: the 2021 FPMRS survey is the one dedicated dataset and it is paywalled, so any single percentage circulating for this field should be read with caution.1415 ⟳

Satisfaction and would-choose-again run high, with strong self-selection. People generally arrive here on purpose, usually after tasting general OB/GYN and deciding they want the OR without L&D, so the population is self-selected toward liking the work. The satisfaction drivers are consistent: tangible quality-of-life outcomes (restoring continence, activity, and dignity to patients who often suffered silently for years) combined with durable, longitudinal relationships with older women you follow over time. That mix of continuity plus visible surgical wins is unusual.12

Career longevity is excellent. Elective, schedulable surgery with limited emergent call is far more sustainable into later career than obstetrics or high-acuity surgical fields. Physicians can dial the OR-to-clinic mix over time and practice well into their later years, a genuine contrast with the early-attrition pattern in the most intense specialties.1

Who's in the field (demographics)

  • Women: strongly female-predominant, and the subspecialty's own figure is published. ACGME's Table C.21 gives the OB/GYN-track fellowship 59 programs and 175 active fellows, 146 of them women (83.4%), and the urology-track fellowship 16 programs and 40 fellows, 30 women (75.0%) — 176 of 215 across both, 81.9%, in AY2024-25. The entry pathway is why: OB/GYN residents are ~88.6% women, and most urogyn fellows come from OB/GYN, while female urologists are a minority overall even though this is among the more female urology subspecialties. Winkelman et al., Obstet Gynecol 2022, publishes a peer-reviewed FPMRS figure behind a paywall for anyone who wants a second reading.161718 ⟳
  • DO: modest, at ~9.7% of 2025 applicants (10 applicants, 6 matched).4 ⟳
  • IMG: minimal, at ~8% of applicants combined, with only 1 IMG matched in 2025. NRMP flagged urogyn among the five subspecialties with the highest share of positions filled by U.S. MD graduates.4 ⟳
  • URiM: NRMP publishes no field-specific URiM percentages. The number lives in Winkelman et al. 2022, the same paper as above.17 ⟳

Culture, personality & the online stereotypes

Who gravitates here. Two feeder populations. Most are OB/GYNs who love the operating room and the patient relationships but are done with obstetrics and want a controllable life, and pelvic reconstruction lets them stay surgical without L&D. A smaller share are urologists drawn to female pelvic reconstruction, incontinence, and neurourology. The common thread: people who want surgery plus a controllable life without OB call, are comfortable with an older, predominantly female patient base, and are motivated by high-prevalence, under-treated, quality-of-life conditions rather than acuity or glamour. The field tends to draw pragmatic, patient-centered, relationship-oriented personalities, and plenty of people don't fit any tidy mold.2

The stereotypes. community reputation, not fact. Each with a kernel and an unfair edge:

  • "The controllable-lifestyle surgical exit from OB." The kernel is true and it's the field's whole selling point, but framing urogyn purely as an escape undersells that it's a real subspecialty people choose toward rather than just away from L&D.
  • "Underrated / sleeper quality-of-life surgery." Reality: unglamorous conditions and deeply grateful patients; the reconstructive work is genuinely satisfying, and outsiders overlook it precisely because the pathology isn't flashy.
  • "Tame. No acuity, no drama." Reality: that's the point for the people who pick it, but if you need trauma-level stakes or L&D adrenaline, the day-to-day will read as repetitive.
  • "Aging population = job security." This one is less caricature than demographic fact, and the demand curve is built in.

What people say online (synthesized and paraphrased, not quotes): Across trainee and physician forums, urogyn is repeatedly floated as the lifestyle escape hatch for people burning out on call, with the recurring caution that you must genuinely enjoy operating and clinic on pelvic floor disorders in an older population, or it gets repetitive. Among urologists, FPMRS is seen as a legitimate but smaller pathway, with some good-natured turf talk about OB/GYN against urology ownership of the field. Among students and applicants it reads as an "underrated" or "sleeper" subspecialty, with solid pay, good lifestyle, and growing demand, that students rarely consider early because the patient population and pathology aren't flashy, and those who rotate through it often come away pleasantly surprised. The through-line: it's described as a nice corner of medicine with grateful patients, not a prestige-chasing culture.12

Voices from the field. Paraphrased from public writing, with links to the originals:

  • A UConn Today profile of a urogynecologist frames the field as giving women their quality of life back by treating conditions that affect roughly 1 in 4 women (more common than commonly discussed) but are badly under-treated due to stigma.1
  • A "Day in the Life of a Urogynecology PA" piece (AAPA) gives concrete daily texture: clinic-dominant, procedure-rich (urodynamics, pessaries, bladder instillations, Botox), consistent ~8:00–5:00 hours, and a predominantly older female patient panel.2
  • An AUA News feature on FPMRS burnout signals that the field takes wellbeing seriously and that burnout, while lower-intensity, is an active topic within urogyn.15
  • The dedicated FPMRS professional-burnout survey (Sassani et al., 2021) is the field's own attempt to measure and name the problem in its own workforce.14

Why people choose it / why people leave

Why choose it: keep surgery and drop obstetrics, for a controllable, largely elective schedule with light call · strong, durable job market driven by an aging population · high satisfaction from tangible quality-of-life outcomes · durable, longitudinal relationships with patients · excellent career longevity, sustainable into later career · surgical-subspecialty pay, generally at or above generalist OB/GYN · reachable from mainstream residencies (OB/GYN or Urology).

Why leave or avoid it: you must genuinely enjoy operating and clinic on pelvic floor disorders in an older, predominantly female population, and if that pathology bores you the day-to-day feels repetitive · it's not high-acuity or "heroic," so people who need trauma- or oncology-level stakes or L&D adrenaline may find it tame · 3 more fellowship years after an already-long residency · complications and reoperations (mesh-related issues historically) carry medico-legal and emotional weight.

Best fit if: you're an OB/GYN (or urologist) who loves the OR and patient relationships but wants out of unpredictable obstetric and emergent call · you want a genuinely balanced surgical career, a rare combination · you find deep meaning in restoring dignity and function for underserved, stigmatized conditions · you like a clinic-plus-OR rhythm you can schedule your life around.

Not for you if: you need acuity, drama, or prestige from your specialty · you dislike clinic-heavy practice or an older patient panel · you want continuity-free shift work with no post-op tail · you aren't willing to add fellowship years for the lifestyle payoff.

The FLI angle — Urogynecology for first-gen, low-income & immigrant students

Urogynecology is a genuinely strong FLI play, because it stacks three things FLI students rarely get in one specialty, and it does it through mainstream residencies you're already likely to match into rather than an ultra-competitive early commitment.

Where urogyn fits FLI realities well:

  • Surgical-subspecialty pay without the punishing schedule. Median compensation lands in the mid-$300ks to ~$450k+ depending on source and setting, generally at or above generalist OB/GYN, and you earn it without the family-hostile, unpredictable call of general OB/GYN or general surgery. For anyone who is also a breadwinner or supporting family, predictable hours have real financial and caregiving value.
  • A controllable lifestyle you can actually build a life around. Elective, scheduled surgery with light call is rare in a surgical field. That predictability is worth money and stability, especially if you're supporting others.
  • Durable, growing demand. The aging-population tailwind (pelvic-floor disorders projected to rise to ~43.8M U.S. women by 2050) means strong job security and genuine geographic flexibility, including in underserved and lower-cost areas where pay and need are often highest.
  • Reachable via a mainstream path. You get here through OB/GYN (or urology), residencies FLI applicants match into every year, rather than a hyper-competitive field you must gun for from day one of med school.

Risks to name honestly:

  • The extra fellowship time isn't free. Three more years after a 4-year OB/GYN residency is three more years of trainee pay and delayed full attending income, a real cost if you're carrying loans or supporting family and need to start earning fast.
  • IMG access is thin. Only 1 IMG matched for the 2026 appointment year, and 3 the year before; if you're an international graduate, the OB/GYN-then-fellowship path is a long and IMG-unfriendly road for this specific subspecialty.
  • The pay data is genuinely murky. The authoritative survey is paywalled and the free aggregators are unreliable for this niche, so go in with realistic, range-based expectations rather than a single headline number.

Bottom line: urogynecology is one of the few genuinely balanced surgical options in medicine, with real surgical income, a controllable and sustainable schedule, and rising demand, reachable through mainstream residencies rather than an ultra-competitive gauntlet. The catch is the extra fellowship years and a patient population and pathology you have to actually like. Rotate through a urogyn clinic and OR before you commit; the people who do often come away pleasantly surprised.

Related & adjacent paths

Urogynecology/URPS sits at the crossroads of two parent fields, which shapes how you map the terrain:

  • OB/GYN (the main parent) and its other subspecialties: Maternal-Fetal Medicine (MFM), Reproductive Endocrinology and Infertility (REI), Gynecologic Oncology, Complex Family Planning, and the OB hospitalist track.
  • Urology (the second entry point) and its own reconstructive, neurourology, and female-urology interests, which overlap heavily with FPMRS.
  • Related societies to explore: AUGS (American Urogynecologic Society) on the OB/GYN side and SUFU (Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction) on the urology side.

Sub-subspecialties & fellowships

Urogynecology sits between two parents, which is unusual enough to be the defining structural fact about it.

  • Two residencies lead in. It is reachable from OB/GYN, alongside maternal-fetal medicine, REI and gynecologic oncology, and also from urology.
  • It is jointly boarded. Certification runs through ABOG and ABU together rather than through one of them, which is rare in American medicine.
  • Nothing sits beneath it. What varies is whether a given practice leans toward the reconstructive operating list or the office-based continence side.

Fun facts

  • Pelvic floor disorders affect roughly 1 in 4 women, reportedly about twice as common as breast cancer, yet remain badly under-discussed because of stigma.1
  • The demand curve is built in: Wu et al. project U.S. women with at least one pelvic floor disorder rising from 28.1 million (2010) to 43.8 million (2050), with urinary incontinence up 55% (18.3 to 28.4 million) and fecal incontinence up 59% (10.6 to 16.8 million).812
  • It's one of the few subspecialties reachable from two different residencies, OB/GYN or Urology, and the two fields quietly share (and occasionally spar over) ownership of the pelvic floor.3
  • The field renamed itself from "FPMRS" back toward "Urogynecology and Reconstructive Pelvic Surgery" in the early 2020s, partly to be clearer to patients about what it actually is.4
  • Its signature procedures of mid-urethral slings, sacrocolpopexy, pessary management, Botox for overactive bladder, and sacral neuromodulation are largely planned and elective, which is why the schedule-friendliness is structural rather than luck.2

Sources

Last reviewed: 2026-07-25.

Footnotes

  1. Field overview, quality-of-life framing, and "1 in 4 women" prevalence — Jennifer Walker, UConn Today, "New Specialty Helps Women Get Back Quality of Life" (2022), https://today.uconn.edu/2022/04/new-specialty-helps-women-get-back-quality-of-life/. ↩ ↩2 ↩3 ↩4 ↩5 ↩6 ↩7 ↩8 ↩9 ↩10

  2. Day-in-the-life texture, procedure mix, ~8:00–5:00 hours, light call, elective/scheduled surgery — Sharon Dann, PA-C, "A Day in the Life of a Urogynecology PA," AAPA (2023), https://www.aapa.org/news-central/2023/08/a-day-in-the-life-of-a-urogynecology-pa/. ↩ ↩2 ↩3 ↩4 ↩5 ↩6 ↩7 ↩8 ↩9 ↩10 ↩11

  3. Dual-entry pathway (OB/GYN 4+3 vs Urology 5+2), fellowship length, and joint ABOG/ABU board certification — ACGME Program Requirements for GME in FPMRS (2023), https://www.acgme.org/globalassets/pfassets/programrequirements/221-495_femalepelvicmedicinereconstructivesurgery_2023.pdf; ABOG, https://www.abog.org/; ABU, https://www.abu.org/. Joint-exam administration details come from ABOG and ABU directly. ↩ ↩2 ↩3 ↩4 ↩5

  4. Competitiveness (66 programs / 74 positions / 70 filled / 94.6% fill; 102 applicants; ~1.4:1; 68.6% matched), degree-type applicant pool, and name change — NRMP, "Match Results Statistics — Urogynecology & Reconstructive Pelvic Surgery, 2025" (Aug 2025), https://www.nrmp.org/wp-content/uploads/2025/08/2025-Urogynecology-and-Reconstructive-Pelvic-Surgery-MRS-Report.pdf; ABOG name change, https://www.abog.org/. Corrected 2026-08-17: every figure in this block was right and the year on all of them was wrong by one. The report's own header reads "Appointment Year 2026 / Match Day: Aug 6, 2025" while its title carries the match year, 2025, and this page had labeled the whole block, the dashboard row and the FLI bullet as the 2025 appointment year. The mislabel was not cosmetic: the real 2025 appointment year filled 100.0% of its positions and left no program unfilled, against 94.6% and four here. ↩ ↩2 ↩3 ↩4 ↩5 ↩6 ↩7 ↩8

  5. The 2025 appointment year, for comparison — NRMP, Results and Data: Specialties Matching Service, 2025 Appointment Year, Table 1A: "Female Pelvic Medicine and Reconstructive" 92 applicants, 70 positions, 70 filled (100.0%), 0 programs with an unfilled position; 22 applicants unmatched (23.9%). Table 2, composition of the 70 filled positions: MD 62 (88.6%), DO 5 (7.1%), Canadian 0, U.S. IMG 2 (2.9%), non-U.S. IMG 1 (1.4%). https://www.nrmp.org/wp-content/uploads/2025/02/SMS_Results_and_Data_2025.pdf The five-year table in the 2026 edition, https://www.nrmp.org/wp-content/uploads/2026/02/SMS_Results_and_Data_Report2026.pdf, prints the same pair, 70 positions at 100.0% for 2025 against 74 at 94.6% for 2026. Note the column order: the 2025 edition runs MD, DO, Canadian, U.S. IMG, non-U.S. IMG, and the 2026 edition moves the Canadian column last, so the two cannot be read positionally against each other. ↩

  6. ACGME-accredited URPS program counts. ACGME, Data Resource Book, Academic Year 2024-2025, Table A.4, "Number of Programs by Specialty and Subspecialty and Academic Year, 2020-2021 to 2024-2025", which carries a "Urogynecology and reconstructive pelvic surgery" row under each parent: under obstetrics and gynecology, 54 · 55 · 57 · 58 · 59 (+9.3%); under urology, 15 · 16 · 17 · 16 · 16 (+6.7%). https://www.acgme.org/globalassets/pfassets/publicationsbooks/2024-2025_acgme_databook_document.pdf . Corrected 2026-08-17: this page gave "57 accredited FPMRS/URPS programs in AY2022–2023", cited to the 2022–2023 edition. The number is right for that column and two editions stale, and it was also the OB/GYN-side row alone, set against NRMP's combined 66 as though the difference were a definitional one. On the current edition the two sides are 59 and 16. The second half of the sentence was checked and holds: the match report splits its 66 certified programs into 50 on the OB/GYN side and 16 on the Urology side. ↩

  7. National comp estimate, percentile spread, subspecialty ranking, gender pay gap, and data-quality caveats (paywalled AUGS–MGMA; unreliable aggregators) — Physicians Thrive, "Urogynecologist Salary" (MGMA + BLS data, ~2022–23), https://physiciansthrive.com/physician-compensation/urogynecologist/; Barton Associates OB/GYN Salary Guide (Physician Side Gigs 2024, Medscape 2025, Doximity 2025, BLS May 2024), https://www.bartonassociates.com/ob-gyn-physician-salary-guide/; AUGS–MGMA Urogynecology Compensation Report (paywalled, 2025/2024 data), https://www.augs.org/augs-mgma-report/. ↩ ↩2 ↩3 ↩4 ↩5 ↩6 ↩7 ↩8

  8. Current crowd-sourced comp anchors (Marit ~$452k OB track / ~$538k urology track, 2026) and AUGS demand projection — Marit Health, https://www.marithealth.com/o/-/urogynecologist-obgyn/salary and https://www.marithealth.com/o/-/urogynecologist-urology/salary (⟳ verify — robots-blocked, from site listing); Physicians Thrive (AUGS demand data), https://physiciansthrive.com/physician-compensation/urogynecologist/. On Marit Health: it publishes a panel of self-reported physician salaries, and displays MGMA and AMGA benchmarks beside them that are masked unless you create an account. The figure quoted here comes from the self-reported panel, not from either benchmark. Read it as crowd data: unweighted, of unstated sample size, and directional. ↩ ↩2 ↩3 ↩4

  9. Academic vs. private vs. partner comp (OB/GYN proxy) — Physician Side Gigs, "Private Practice vs. Academic Physician Compensation by Specialty" (mid-2023–mid-2025 database), https://www.physiciansidegigs.com/private-practice-vs-academic-physician-compensation-by-specialty. (⟳ OB/GYN proxy, not urogyn-measured) ↩

  10. Broad physician geographic pay pattern — Doximity 2025 Physician Compensation Report (2024 data), https://www.doximity.com/reports/physician-compensation-report/2025. ↩

  11. After-tax geography swing (modeled on a $300k reference, BLS OES May 2024 basis) — SalaryDr, "Urogynecology," https://www.salarydr.com/careers/urogynecology. (⟳ verify — modeled on generic $300k, not measured urogyn comp) SalaryDr has no urogynecology panel — its urogynecology page reports a median of $0 — so this is its generic after-tax model applied to a $300,000 reference income, not a measurement of urogynecologist pay. It is kept only as a relative geographic illustration and carries no urogyn-specific dollar figure. ↩

  12. OB/GYN comp trend (+~5% to ~$390k, 2025) and compensation-satisfaction figures — Medscape OB/GYN Compensation Report 2026 (via Nuaxia), https://www.nuaxia.com/post/medscape-ob-gyn-compensation-report. ↩ ↩2 ↩3

  13. General OB/GYN burnout, the baseline urogyn is read against. AMA Organizational Biopsy 2025 (~19,000 physician responses, 106 health systems, 38 states) puts Obstetrics and gynecology at 45.7% against a 41.9% all-physician average, fourth of the nine specialties it names as most burned out, https://www.ama-assn.org/practice-management/physician-health/these-9-physician-specialties-report-highest-burnout-rates. Corrected 2026-08-17: the dashboard, the body and the wellbeing figure now lead with the AMA row rather than Medscape's ~53%. AMA is the instrument this page prefers wherever it publishes a row, because it is free, primary and current. The two baselines are seven points apart and never share a sentence. The Medscape reading kept beside it: OB/GYN ~53% against a 49% all-physician average, Physician Burnout & Depression Report 2024, via Healthgrades, https://resources.healthgrades.com/pro/the-most-and-least-burned-out-physicians-by-specialty. ↩

  14. Dedicated FPMRS burnout dataset — Sassani et al., "Professional Burnout Survey for Practicing Female Pelvic Medicine and Reconstructive Surgeons: A Cross-sectional Study," Female Pelvic Med Reconstr Surg (2021), https://pubmed.ncbi.nlm.nih.gov/32740467/. (Exact prevalence % behind paywall — ⟳ verify.) ↩ ↩2

  15. FPMRS wellbeing as an active topic — AUA News, "Shedding Light on Physician Burnout in Female Pelvic Medicine and Reconstructive Surgery" (April 2024), https://auanews.net/issues/articles/2024/april-2024-extra/shedding-light-on-physician-burnout-in-female-pelvic-medicine-and-reconstructive-surgery. ↩ ↩2

  16. Female predominance via entry pathway (OB/GYN residents ~88.6% women, 2024–25) — AMA (AAMC/AMA National GME Census), "These physician specialties have the biggest gender imbalances" (2025), https://www.ama-assn.org/medical-students/preparing-residency/these-physician-specialties-have-biggest-gender-imbalances. ↩

  17. Direct FPMRS women% and URiM% — Winkelman et al., "Sex and Racial/Ethnic Diversity in Accredited Obstetrics and Gynecology Specialty and Subspecialty Training in the United States," Obstet Gynecol (2022), https://pubmed.ncbi.nlm.nih.gov/35033485/ (full text is not openly accessible, ⟳ verify); Urology-track diversity, Nix et al., Urology (2022), https://www.sciencedirect.com/science/article/abs/pii/S0090429521006415. ↩ ↩2

  18. ACGME, Data Resource Book, Academic Year 2024-2025, Table C.21 (Number of Active Residents by Specialty and Subspecialty and Sex) — under obstetrics and gynecology, "Urogynecology and reconstructive pelvic surgery: 59 programs, 175 fellows, 146 women (83.4%), 29 men (16.6%), 0 not reported"; under urology, the same subspecialty at 16 programs, 40 fellows, 30 women (75.0%), 9 men (22.5%), 1 not reported. https://www.acgme.org/globalassets/pfassets/publicationsbooks/2024-2025_acgme_databook_document.pdf Corrected 2026-08-17. This page put OB/GYN's parent-residency figure in the dashboard's % women row and sent the reader to a paywalled 2022 paper for the subspecialty figure, closing with "Read it there." The subspecialty's own figure is free, current, and in the book that dozens of other profiles here already cite, and it publishes two rows, one per training track, which the paper's single figure would not have given. Both are now stated. The Winkelman citation is kept as an independent peer-reviewed reading rather than as the only place the number exists, and the instruction to the reader is gone. ↩

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