Continuing Urologic Certification (CUC) Pilot

The American Board of Urology is piloting a transition of its Lifelong Learning (LLL) program to a continuous, formative process called Continuing Urologic Certification (CUC).  The ABU has developed this CUC pilot program to fulfill ABMS requirements for more consistent assessment of skills needed to deliver proper urologic care.   The CUC pilot also responds to Diplomate feedback regarding practice disruption, expense, and scheduling difficulty caused by the current 10-year Knowledge Assessment exam at a secure testing center.   Participating Diplomates would remain certified while participating in CUC.  

Participation in the CUC pilot is offered to Diplomates in year 7 and 8 of their certification or recertification (LLL Level 2).  This is an elective opportunity and not required.  Participation will result in a waiver from the required 10-year Knowledge Assessment Exam that is currently administered in a secure testing center and a one-time, 20-hour reduction in CME requirements.  Those participating in the CUC pilot are required to complete all other portfolio activities currently required in Level 2 of Lifelong Learning (practice log and complication/mortality narratives, peer review and modules). 

The longitudinal learning activity of the CUC pilot is based on three components that are completed over 5 years: Knowledge Reinforcement, Knowledge Exposure, and Knowledge Assessment.   Knowledge Reinforcement is focused on basic information that the Urologist should know.  Knowledge Exposure pertains to new information important for the practice of Urology gained from contemporary journal articles and AUA Guidelines. The final component, Knowledge Assessment, identifies relevant gaps in knowledge.  NOTE: Diplomates achieving a score of > 60% correct during the Knowledge Reinforcement (years 1 and 3), and ≥ 80% correct during the Knowledge Exposure (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 area 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 pilot will continue for 2-3 years.  The formal CUC program is based on a 5-year cycle.  If the pilot is performed well, and found beneficial by Diplomates, the ABU will submit the CUC program to the ABMS for formal approval.  If approved, Diplomates participating in the pilot will continue on course with the 5-year cycle.  If the pilot is discontinued, Diplomates will return to the current program.

The CUC program is based on a longitudinal learning cycle that repeats every 5 years.  In addition to the 3 components (Knowledge Reinforcement, Knowledge Exposure and Knowledge Assessment), all other activities currently undertaken in Lifelong Learning have been included in the CUC program.  The specific year assignments of activities are intended to provide guidance to the Diplomate and decrease burdens.  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 are only required every 10 years by all Diplomates (B).  However, 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).  The cycles (A and B) with required activity make up the CUC Portfolio.  

CUC 5 Year Cycle 

 CUC Portfolio  LLL Activity
5 Year Cycle


Year 1 Knowledge Reinforcement: Using own computer and self-paced, Diplomates will have 6 weeks to answer 40 online questions.  (See sample question and co-related knowledge reinforcement below).  The 6-week period commences when the Diplomate elects to undertake the first question from a 4-month window beginning April 15, with all questions completed by August 15, 2022.  The knowledge reinforcement must be initiated no later than July 4, 2022.  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 practice.  Diplomates may not discuss any question or obtain assistance from others.  Responses 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 > 60% correct)

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

 Question Screen


 Knowledge Reinforcement

Year 2 Knowledge Exposure: Diplomates will review 8 contemporary journal articles housed in an activity within the AUAUniversity over 8 months.  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.  CME credit will be awarded by the AUA and incur a fee. (threshold goal ≥ 80% correct) 

Year 3 Knowledge Reinforcement: 40 questions as in year 1.  (threshold goal > 60% correct) 

Year 4 Knowledge Exposure: 8 journal articles as in year 2.  (threshold goal ≥ 80% correct)

Year 5 Knowledge Assessment:  Using 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 individualized CME activities based on deficiency content areas.

NOTE:   Diplomates achieving a score of > 60% correct during the Knowledge Reinforcement (Years 1 and 3), and ≥ 80% correct during the Knowledge Exposure (Years 2 and 4) will not be required to take the Year 5 Knowledge Assessment, but may participate if desired.  If the Knowledge Assessment is not taken, learning would be self-directed in Year 5. 


This 5-year cycle then resets.


There is no charge to participate in the pilot and there is no planned increase in annual certification fee if the CUC is approved.   There will be a fee established by the AUA for receipt of CME credit.  In appreciation to those Diplomates who participate in the CUC pilot, there will be excusal from the 10-year Knowledge Assessment exam undertaken at a secure testing center.  For the 2023 CUC Pilot Year 1 process, the ABU will extend a one-time reduction of urology focused CME credits to 40 overall, at least 10 of which must be Category 1.

Pilot Incentive

  • 10 Year Knowledge Assessment waved
  • CME Credit for completing Knowledge Exposure Articles
  • One-time reduction in CME requirements in 2023 from 90 urology focused credits to 40 overall (At least 10 of which must be Category 1)
  • One-time credit for PAP Part A & B in 2023

Continuing Certification Supporting References

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