Strategies for Attracting Women and Underrepresented Minorities in Urology
Purpose of Review
This article summarizes the current state of underrepresented minorities (URM) and women within urology. Specific strategies to promote the recruitment and retention of URM and women within urology are discussed.
Minorities and women remain underrepresented within urology, a disparity that has roots as early as medical school and persists throughout residency and practice. This is likely due to implicit and explicit bias, lack of role models, and persistent disparities in compensation and promotion. Strategies to improve recruitment and retention of these individuals should focus on increasing early exposure to urology, opportunities for mentorship, and support in professional development. Creation of a supportive institutional culture, consideration of alternative career advancement paths, and intentional diversity-focused recruitment efforts are also critical.
Successful recruitment and retention of URM and women in urology requires specific, directed efforts to increase opportunities for exposure, mentorship, and career promotion at a programmatic, institutional, and national level.
KeywordsResidency training Urology Recruitment Underrepresented minorities Women Diversity
American Urological Association
Society of Women in Urology
Compliance with Ethical Standards
Conflict of Interest
Jessica C. Dai, Nnenaya Agochukwu-Mmonu, and Adam B. Hittelman each declare no potential conflicts of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 1.“Underrepresented in Medicine Definition”. Association of American Medical Colleges. 2019. Available from: https://www.aamc.org/initiatives/urm/. Accessed 1 Jun 2019.
- 2.Alsan M, Garrick O, Graziani G. Does diversity matter for health? Experimental evidence from Oakland. 2018. Report No.: 24787. Available from: http://www.nber.org/papers/w24787. Accessed 1 Jun 2019.
- 6.Association of American Medical Colleges. Medical School Graduation Questionnaire 2018 All Schools Summary Report. 2018 [cited 2019 Mar 15]. Available from: https://www.aamc.org/download/490454/data/2018gqallschoolssummaryreport.pdf
- 8.Smedley BD, Stith Butler A, et al. Committee on institutional and policy-level strategies for increasing the diversity of the U.S. Health Care Workforce Board on Health Sciences Policy Brian D. Smedley. National Academies Press (US); 2004.Google Scholar
- 10.Bureau USC. Quick Facts, United States. 2019. Available from: https://www.census.gov/quickfacts/fact/table/US/PST045218. Accessed 1 Jun 2019.
- 11.The State of Urology Workforce and Practice in the United States 2018. Linthicum, Maryland, U.S.A.; 2019.Google Scholar
- 12.• Shantharam G, Tran TY, McGee H, et al. Examining Trends in Underrepresented Minorities in Urology Residency. Urology. 2019;127:36–41 This reference highlights current disparities in the representation of URM in Urology, as compared to other specialties, and provides thoughtful discussion of some of the factors contributing to this. CrossRefGoogle Scholar
- 13.Association of American Medical Colleges. 2018 Matriculating Student Questionnaire [Internet]. 2018 [cited 2019 Mar 15]. Available from: https://www.aamc.org/download/494044/data/msq2018report.pdf.
- 15.Association of American Medical Colleges. 2018 [cited 2019 Jun 1]. Available from: https://www.aamc.org/download/359238/data/urology.pdf.
- 16.Data Resource Book, Academic Year 2017–2018. Accreditation Council for Graduate Medical Education. Chicago, IL; 2018 [cited 2019 Jun 1]. Available from: https://www.acgme.org/Portals/0/PFAssets/PublicationsBooks/2017-2018_ACGME_DATABOOK_DOCUMENT.pdf.
- 20.American Urological Association. The State of Urology Workforce and Practice in the United States. Linthicum, Maryland, U.S.A.; 2017.Google Scholar
- 21.• Gaither TW, Awad MA, Breyer BN, et al. Gender and racial disparities in early urology exposures during medical school. Urol Pract. 2019;6(2):129–34 This reference examines early factors during medical school that may contribute to gender and racial disparities among urology trainees. CrossRefGoogle Scholar
- 35.Rotker K, Iosifescu S, Baird G, et al. What’s gender got to do with it: difference in the proportion of traditionally female cases performed by general urologists of each gender. Urology [Internet]. 2018 Jun [cited 2019 Mar 15];116:35–40. Available from: http://www.ncbi.nlm.nih.gov/pubmed/29550347.
- 37.Rangel EL, Smink DS, Castillo-Angeles M, et al. Pregnancy and motherhood during surgical training. JAMA Surg. 2018.Google Scholar
- 39.Kutikov A, Bonslaver J, Casey JT, et al. The gatekeeper disparity--why do some medical schools send more medical students into urology? J Urol. 2011;185(2):647–52 Available from: http://www.ncbi.nlm.nih.gov/pubmed/21168862. Accessed 1 Jun 2019.
- 42.•• Butler PD, Aarons CB, Ahn J, et al. Leading from the front: an approach to increasing racial and ethnic diversity in surgical training programs. Ann Surg. 2019;269(6):1012–5 This references provides evidence for the role institutional-level programmatic efforts to increase diversity during recruitment of surgical residents and offers a framework that may be adopted by other training programs. CrossRefGoogle Scholar
- 47.Moody J. Faculty diversity: problems and solutions: Routledge; 2004.Google Scholar
- 48.•• Carnes M, Devine PG, Baier Manwell LB, et al. The Effect of an Intervention to Break the Gender Bias Habit for Faculty at One Institution. Acad Med. 2015;90(2):221–30 This references highlights the long-term impact of a brief intervention to reduce bias within STEM departments on departmental hiring practices and provides evidence for the benefit of such programs. It also provides an example of a structured intervention that could be carried out at other institutions. CrossRefGoogle Scholar
- 52.Stein SL. The changing face of surgery today: it is not a women’s issue, It’s a Work Force Issue. Ann Surg. 2017.Google Scholar