We are in the midst of a paradigm shift in the surgical management of benign prostatic hyperplasia (BPH). After decades of decline, there is a recent surge in the rate of BPH surgeries - largely represented by laser prostatectomy and office-based thermotherapies. In the United States, the number of transurethral resections of the prostate (TURP) continues to decline, now representing a minority of all procedures performed. We reflect on how such changes may affect resident training. We review education models that strive to maintain TURP proficiency amongst urology residents, despite fewer opportunities for training on live patients. Furthermore, we review how proposed changes in the structure of urology education might impact training in office-based procedures, such as prostate thermotherapy.