Education and training in hypospadias surgery: Current status, competency assessment, and the role of modern educational tools

Introduction Hypospadias is one of the most common congenital anomalies, yet surgical training remains variable worldwide. Despite advances in surgical techniques, outcomes continue to be challenged by high complication rates, uneven case distribution, and lack of standardized curricula. Objective To evaluate current hypospadias training, competency assessment, and the role of modern educational tools, using data from the Hypospadias International Society (HIS) 2024 Cairo meeting and a review of the literature. Study design This narrative review integrates published evidence with findings from a cross-sectional survey of 103 international HIS members and congress attendees. The survey explored surgical exposure, perceived training needs, and preferred educational modalities. Results Survey respondents reported a gap between the ideal number of hypospadias procedures required for competency and the actual exposure achieved during residency and fellowship. While most endorsed microsurgical training and stepwise progression, limited case volumes and inconsistent curricula were identified. Competency-based assessment tools such as the Objective Structured Assessment of Technical Skills (OSATS) and structured feedback provide more objective evaluation compared to traditional models. Advances in simulation—including animal models, 3D-printed and synthetic replicas, and emerging VR/AR platforms—offer reproducible environments for skill development. E-learning and tele-mentoring further expand access to training across regions. Discussion Hypospadias education benefits from combining traditional high-volume center experience with reproducible modern training tools. Structured curricula and competency-based assessments may reduce variability in surgical outcomes. Conclusion Training in hypospadias surgery should emphasize structured frameworks, objective assessment, and innovative modalities. Concentrating training in specialized centers, while integrating simulation and digital platforms, may better prepare future surgeons and improve patient outcomes.