The early retirement of experienced doctors in the UK poses a significant challenge to healthcare provision, particularly in urology, where workforce shortages are exacerbated by high attrition rates among both trainees and consultants. While career dynamics in high-income countries have been widely studied, the specific factors influencing UK doctors’ retirement decisions remain underexplored. This review synthesises key findings on the drivers of early retirement among urologists, emphasising the interplay between systemic pressures and individual stressors. Financial disincentives, such as punitive taxation policies, alongside dissatisfaction with clinical autonomy, work-life imbalance, and deteriorating working conditions, contribute to early exits from the profession. A specialty-specific survey of UK urologists revealed that, despite high job satisfaction, workplace-related stressors (particularly on-call demands, strained relationships with non-clinical management, and suboptimal working environments) were primary motivators for early retirement. Notably, on-call stress emerged as a critical, yet under-researched factor, distinct from other medical specialties. The Covid-19 pandemic further intensified these pressures, accelerating workforce attrition. To mitigate early retirements, a dual approach, combining systemic reforms and individual strategies, is essential. Institutional changes, including improved job planning, enhanced managerial support, and flexible work policies, could alleviate workplace dissatisfaction. At a national level, addressing taxation policies and medicolegal pressures may reduce financial disincentives. Individually, consultants can adopt better workload management and teamwork practices to sustain longer careers. Proactive succession planning and career adjustments may also improve retention. Without targeted interventions, the NHS risks losing a growing number of experienced urologists, threatening the sustainability of urological services. Policymakers and healthcare leaders must prioritise workforce wellbeing to ensure long-term stability in this critical specialty.
