Michael P, Tran VT, Hopkins M, et al. - Four academic medical centers were chosen for this study in order to investigate urologic transfers and the rate of tertiary center interventions from four geographically distinct academic medical centers. Overall, 984 urologic transfers were involved. About 69% of individuals were transferred to the two rural centers, and 30.7% to the two metropolitan centers. The most prevalent reason for the transfer was nephrolithiasis at 26%. For all urologic transfers in this study, the overall surgical intervention rate was 44.4%. During the study period, rural center transfers had a lower rate of surgical intervention compared with metropolitan centers and a significantly greater number of total transfers. In summary, provided that a majority of individuals did not need surgical intervention, methods for avoiding needless urologic transfers are assured.