“Diversity is the engine of invention. It generates creativity that enriches the world.” –Justin Trudeau

As part of introducing the Strategic Plan of the AUA’s Office of Research, I will take the opportunity to do deeper dives on each of our goals. In my last AUANews column, I reviewed our plan to maximize sustainment and optimization of research support. Our overall focus is to increase impact via a wider and more strategic constituency. In this article, I will describe our efforts at increasing capacity for diversity, equity and inclusion.

Despite this recognition of the importance of diversity, the urology community, as many or most of us know, has historically struggled, and even now continues to struggle, with including full representation of the breadth of backgrounds that will enable us to equitably meet the needs of all urology patients. There are many different reasons for this–some fairly obvious, such as a lack of early exposure to urology in medical school, but some more difficult to identify, such as implicit and even explicit biases that impact opportunities and must be addressed. In response, the AUA has wholeheartedly been examining every aspect of its programming and governance to increase diversity and inclusion, and address equity to the best of its ability. These efforts, as shown in this example list, span the spectrum of the AUA mission of education, research and the formulation of public policy, as well as communications, data collection, humanitarian efforts and also, importantly, our governance.

It is inarguable that health care disparities exist. In addition, there is a disproportionate lack of underrepresented minorities (URM) in grant submissions, grant reviews and research governance. There are a myriad of reasons why this has happened in the past, but there is a concerted effort to change this arc. We have a laser focus on funding research for urological diseases that disproportionately impact diverse persons and interventions that reduce health care disparities. More specifically, the Office of Research increased its efforts to improve diversity starting in 2018 and with the previous AUA Research Chair, Dr. Aria Olumi, who started with casting a critical eye on its scientific symposia, research workshops, research awards and various advisory groups. Some of the changes that resulted include the following:

• In early 2020 and in partnership with the Society of Urologic Oncology, the very first research endowment for the AUA and Urology Care Foundation focused on increasing diversity in urologic oncology research, including women, was established.
• When I became Research Chair-elect in June of last year and in partnership with Aria, we began to establish a new 5-year strategic plan, with improving diversity, equity and inclusion as 1 of our 5 key goals.
• As we built momentum with our strategic plan, we identified new partners who shared our goals, and we were able to establish another new endowment with Urovant Sciences, the LEAD (Leadership in Education, Achievement and Diversity) program, that will target increasing diversity in residency research.
• On the heels of that achievement, and with the leadership of the New York Section, we jointly established the AUA’s first medical student research award targeting diversity and inclusion, and other Sections have since followed suit.
• And finally, we are continuing on truly a daily basis to identify additional ways in which we can achieve our diversity, equity and inclusion-related goals.

One of the first things that we fully recognized as we developed this plan was that having the right expertise to inform our goals was critical, and so we established a workgroup, led by AUA Research Council member Dr. Margarett Shnorhavorian, which has been meeting monthly over the past 6 months to closely examine every one of the Office of Research programs to make recommendations for diversity, equity and inclusion-related improvements. I think it’s appropriate to say that many of the improvements to the AUA’s and Urology Care Foundation’s research programs that you’re going to see over the next few years are going to stem from the recommendations of this dedicated and expert group of advisors.

While these goals are important, have we begun to “walk the talk”? We have made substantive progress! In 2021 we have already achieved within our research grant programs alone:

• Summer Medical Student Fellowship
  • Achieved equal awards by gender in 2021
  • 4 AUA Section-sponsored URM targeted awards (all disease areas) in 2022
• Residency Research Award
  • 5 URM targeted awards (urologic oncology, bladder health, men’s health) in 2022
• Research Scholar Award
  • Achieved equal awards by gender in 2021
  • 2 URM and disparities targeted awards (urologic oncology) in 2022

There is great enthusiasm from many of our partners in enhancing and achieving these goals. We were able to work together with Urovant, who generously endowed $2M to create the LEAD program, which will fund 3 residents per year to conduct mentored research training, engage in AUA research education opportunities and be championed through networking events as they develop successful research careers.

While we have made progress, there is so much left to do. It is our mission to have a diverse research and discovery village so that we can truly bring premier urological care to all our patients. I hope to engage all of those interested in this mission. Please feel free to contact me with ideas, suggestions or thoughts. Together, let us create a better future! @MaleHealthDoc