Continuing Urologic Certification (CUC)

Continuing Urologic Certification (CUC) is a continuous formative process developed to fulfill ABMS requirements for more consistent assessment of skills needed to deliver contemporary urologic care.  The CUC program also responds to Diplomate feedback regarding practice disruption, expense, and scheduling difficulty encountered by the 10-year Knowledge Assessment exam at a secure testing center.

The longitudinal learning activity of CUC is based on three educational components that are completed over 5 years: Knowledge Exposure, Knowledge Reinforcement, and Knowledge Assessment.   These learning activities were developed to prevent fatigue of a repetitive process while enhancing everyday knowledge, exposing advancements in care, and identifying individualized knowledge gaps that benefit from additional learning.

Knowledge Exposure pertains to new information important for the practice of Urology gained from contemporary journal articles and AUA Guidelines.  Knowledge Reinforcement is focused on basic information that the Urologist should know.   The final component, Knowledge Assessment, identifies relevant gaps in knowledge.  NOTE: Diplomates achieving an average score of ≥ 80% correct during the Knowledge Exposure (years 1 and 3), and an average > 65% correct during the Knowledge Reinforcement (years 2 and 4) are not required to take the year 5 Knowledge Assessment but may participate if desired.  If the Knowledge Assessment is not taken, learning in year 5 would be self-directed.  

The learning components are based on Core Urology, important to all urologists, and selection of a module that best characterizes the Diplomate’s practice.   The ABU acknowledges that no module will duplicate an individual’s practice.   Module selection helps the ABU individually target learning and Knowledge Assessment material to best represent a Diplomate’s daily activity.  Module selection also helps place a Diplomate’s practice log into perspective.  The modules and major content areas covered are indicated below.

Knowledge Reinforcement and Knowledge Assessment

Modules and Content Areas


            Office based urology
            Imaging/Radiation safety

Oncology, Urinary Diversion, and Adrenal

            Upper tract
            Lower tract

Calculus, Lap-Robotics, Upper tract obstruction

            Upper tract obs
            Renal calculi

Impotence, Infertility, Infection, Andrology

            Androgen deficiency

General Office-based Urology

            Erectile dysfunction

The CUC program is based on a longitudinal learning cycle that repeats every 5 years.  In addition to the 3 learning components (Knowledge Exposure, Knowledge Reinforcement, and Knowledge Assessment), all other activities currently undertaken in Lifelong Learning are included in the CUC program.  Assigning activities to a specific year is intended to provide guidance to the Diplomate and decrease the burden of completing all activities at the end of a 5 year cycle.  The 5 year cycles (A and B), while similar, do not duplicate all activities.  For example, the need to complete complication/mortality narratives and a practice log is required every 10 years by all Diplomates (B).   Diplomates who are found to have several knowledge gaps based on performance on the Knowledge Assessment may be required to provide complication/mortality narratives, a practice log, and enhanced peer review (A) in order to determine their level of knowledge judgment and skill.  The cycles (A and B) with required activity make up the CUC Portfolio.

CUC Portfolio 
5 Year Cycle

Year 1 Knowledge Exposure: Diplomates will review 8 contemporary journal articles over 8 months housed in an activity within the AUAUniversity.  The articles within this activity will be grouped into sections:  Core Urology, Guidelines, and 4 sections corresponding to the specific content modules.  Four articles must be selected from the core/guideline sections, and 4 articles from any of the other sections.  Articles relative to the chosen practice module may be selected or any article deemed beneficial.  Each article will be linked to 5 questions.  Optional CME credit will be awarded by the AUA at a nominal fee. (threshold goal ≥ 80% correct) 

Year 2 Knowledge Reinforcement: Using your own computer and self-paced, Diplomates will have four months to answer 40 online questions.  (See sample question and co-related knowledge reinforcement below).  The format is “open resource” and not time limited.  The questions will consist of 20 core urology and 20 from a specific content module self-selected to best align with your practice.  Diplomates may not discuss any question or obtain assistance from others.  The first response to each question will be recorded and Diplomates will be directed to the correct answer, a brief learning review, and reference option(s) to further reinforce knowledge.  (threshold goal > 65%)                                   

Please note ~ 30% of all questions for the General Urology CUC Knowledge Assessment questions will come from the last 5 years SASP & pertinent AUA guidelines for the section of the exam chosen.

Year 3 Knowledge Exposure: 8 journal articles as in year 2 (threshold goal ≥ 80% correct).

Year 4 Knowledge Reinforcement: 40 questions as in year 1 (threshold goal >65%)

Year 5 Knowledge Assessment:  Using your own computer, untimed, Diplomates will answer 90 online questions (45 core knowledge and 45 related to chosen module), within a 24-hour period.  The format is “open resource.”  Diplomates may not discuss any question or obtain assistance from others.  The Knowledge Assessment is not pass/fail.  Diplomates identified to have knowledge gaps will be directed to complete 1-3 individualized CME activities based on their weakest content areas performance.

NOTE:   Diplomates achieving an average score of ≥ 80% correct during the Knowledge Exposure (Years 1 and 3), and an average score 65% correct during the Knowledge Reinforcement (Years 2 and 4) will not be required to take the Year 5 Knowledge Assessment but may participate if desired. The Knowledge Reinforcement threshold is calculated yearly and based on exam difficulty. The threshold varies by a few percentage points in order to provide an equal and fair comparison of Diplomate performance year-to-year.  Past experience shows that a correct score above 65% correct typically surpasses the threshold.  Diplomates are notified at the end of year 4 if they can opt-out of the Knowledge Assessment.  Learning is self-directed in Year 5 if the Knowledge Assessment is not taken.

The 5-year cycle then resets.

With CUC, there will no longer be an expiration date on ABU certificates.  Diplomates who remain active in all aspects of CUC will be continuously certified.  

Diplomate Responsibility

Diplomates should periodically visit the ABU portal.  Important information and Board initiatives will be posted along with an individualized overview of current status and pending requirements. 

Maintaining Certification

Certification can be withdrawn for lack of participation, or when performance falls below the standard in knowledge, judgement, skill, and professionalism.


  • One-year deferral considered case-by-case upon written request by the Diplomate due to a life event: Diplomate status - CERTIFIED.   All activities must be completed within the following year.
  • Noncompliance with requirements up to 2 years without notification: Diplomate status - NOT CERTIFIED.  All incomplete activities must be completed within the following year, along with a late fee.  The Knowledge Assessment will be completed regardless of past performance on the Knowledge Exposure and Knowledge Reinforcement.  Once all activities are completed satisfactorily, Diplomate status will be changed to Certified. 
  • Noncompliance with requirements > 2 years without notification: Diplomate status - NOT CERTIFIED.   Re-entry plan considered and developed on a case-by-case basis upon written request by the Diplomate. 


  • Falling below the standard in knowledge, judgement, skill, and professionalism results in a summative assessment.
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