As Secretary of the AUA and Editor-in-Chief of AUANews, it is my privilege to introduce the second focus issue, “Celebrating Diversity with the AUA,” on which I collaborated closely with Tracy M. Downs, MD, who chaired the AUA’s Diversity & Inclusion (D&I) Task Force. We are thrilled to share with you this vitally important content, which we know will enrich the future of our urological community.

We are intentionally using our primary means of membership communication to connect our readership to the most important topics in diversity, equity and inclusion (DEI) in urology and beyond. It is our earnest hope that you will read this issue from cover to cover and have conversations and enact change within your own spheres of influence.

Looking Back on 2021

In 2021, Dr. Downs and I recognized the need for a forum to showcase issues related to DEI in urology. We hoped for a modest response to our inquiries for content, but we were gratified with the outpouring of passionate, heartfelt submissions we received. All 2021 content is available ahead of the paywall here: https://www.auanet.org/education/auauniversity/for-medical-students/medical-students-curriculum/aua-news-diversity-issue. Our pledge is to continue to publish this focus issue every year, mindfully adding to our library of “Celebrating Diversity” content while understanding the library will never be complete. We must continue to grow our understanding and knowledge, on a global level, of our community members, our patients, and how we can be increasingly more inclusive and accessible.

We encourage you to reflect on last year’s articles to absorb their impact. In 2021, Dr. Arthur L. Burnett, MD, MBA addressed inequities in research opportunities.¹ Porten et al wrote about promotion equity for women in urology.² Tomas L. Griebling, MD, MPH addressed ageism, sexual identity and his personal reflection on D&I.³ Vince et al shared their poignant perspectives in “Hidden Voices: Firsthand Stories from Black Trainees about Systemic Racism in Urology.”⁴ Linda L. McIntire, MD explored structural racism in urology and beyond.⁵ These articles, and so many more, resonated with our community. However, we realized there are still infinite stories left to tell. We need to extend this platform for honest discussion, and we need to continue to build on our library of freely accessible content related to DEI. We knew the focus issue could not be a one-time occurrence; it was imperative that it became an annual event. AUANews also highlights DEI news in all issues as we receive it. We encourage you, our members, to contribute your DEI news, innovations and strategies for consideration for publication.

The Second Annual “Celebrating Diversity with the AUA” Focus Issue

This year, we knew it was important to extend our platform globally. As we discussed topics to cover in this issue, it was clear to us that we needed to broaden our perspective on North American DEI improvement to include a global view of our colleagues across the world and how their individualities affect their daily lives as physicians.

It is our honor to showcase articles from female urologists in Bahrain, Brazil, Canada, Senegal, Central America and India. These urologists give honest transparency into what it looks like to be a practicing female urologist. In some cases, these women are among only a handful of females in their profession in their county. An excerpt from one of these articles by Reem Albareeq, MD, AFRSCI, CABU and Batool M. Turki, MD provides insight into the groundbreaking work they are doing as female urologists in the Middle East:

“Breaking the barriers to change a male-dominated department is difficult in Arab countries. There are several obstacles to overcome. I draw from my own experience, where I had several opposing peers and training faculty who continually tried to change my mind about my career choice. And still to this day, I tackle being undermined for the mere fact that I am female although I am a senior consultant in my respected field of Endourology & Urogynecology.

However, even with these obstacles women, such as myself, have overcome these issues and entered into this specialty. Although there may be unsupportive colleagues, there are those who encourage the expansion of female urologists, such as my mentor Professor Durazi, andrology consultant. With his guidance, I achieved my urology board qualification and became the first female urologist in Bahrain and the Arabian Gulf.”

The bravery and perseverance of urologists such as these are significant, but we cannot expect these trailblazers to succeed alone. We must support the efforts of these pioneering individuals with mentorship, leadership opportunities and anything they need to have long-lasting and rewarding careers. We celebrate these strong professionals but know we have so much further to go.

Other articles in this issue examine the gender gap in urology, health care disparities in DEI, social media as a platform for DEI, and transgender education and training. We are pleased with the breadth of content but again must say there are not enough pages in the world to print the voices that should be heard. We commit to providing this member newsletter as an ongoing outlet for DEI efforts.

The AUA’s Board of Directors and Our Commitment to DEI

This focus issue is only a small part of the efforts we at the AUA are making to advance DEI efforts in the long term. The AUA announced the formation of the D&I Task Force in December 2020. This group was charged with developing actionable recommendations for the Board by February 2022. The Task Force included Tracy M. Downs, MD, Chair; Simone Thavaseelan, MD, Vice-Chair; Arthur (Bud) Burnett, MD; Sam Chang, MD; Benjamin Davies, MD; Geolani Dy, MD; Efe (Chantal) Ghanney Simons, MD; Kirsten Greene, MD; Tomas L. Griebling, MD, MPH; Brian McNeil, MD; Linda McIntire, MD; Yahir Santiago-Lastra, MD; Vijay Vemulakonda, MD; and Hadley Wood, MD (see figure).

Figure. AUA D&I Task Force members.

The Task Force surveyed all AUA Sections and numerous stakeholder groups. Based on their feedback, the D&I Task Force presented recommendations to the Board in 5 focus areas: Just and Inclusive Environment; Diversity in the Workplace; Structural Competence; Advocacy; and Research.

A key outcome of the Task Force’s recommendations is the establishment, by AUA Bylaws, of a formal AUA DEI Committee. This Committee will advise the Board and AUA leadership on DEI issues and initiatives. The physician chair of the DEI Committee will hold the position of AUA Chief Diversity Officer.

Other outcomes of the Task Force’s recommendations include:

• Establishing a DEI award to recognize members’ achievements in this area;
• Enhancing the AUA’s collection of voluntary demographic information;
• Creating mentorship opportunities for underrepresented-in-medicine individuals;
• Establishing a DEI abstract category for the AUA Annual Meeting;
• Incorporating DEI and health disparities in AUA educational programming; and
• Increasing diversity among researchers at every stage of the career journey.

The AUA has adopted a new diversity statement, which reaffirms the commitment of the AUA and UCF to intentional actions aimed at being fully inclusive, deliberately diverse and equitable organizations that respect and value our membership, our staff and the communities we serve worldwide.⁶ The Board deferred action on the Task Force’s recommendation to establish the Chief Diversity Officer as a voting representative of the AUA Board, planning to address first the critical issue of Board diversity with the AUA Sections and others in the urological community.

The Conversation Must Continue

Our hard work around DEI cannot stop here. This focus issue and the D&I Task Force’s recommendations are important steps toward improving our community. It is imperative that we do not consider our work in this area ever truly complete. We must do better, and with our entire community committed to the vision of inclusivity, we can accomplish so much. We look forward to seeing what our new DEI Committee will do under the leadership of our new physician Chief Diversity Officer. With the support of our membership and the partnership of our Board, we will work together to advance DEI in tangible, measurable ways.

What Can You Do to Help?

The first step is to read this issue cover to cover. Learn from the thoughtful articles of your peers, covering many aspects of DEI. Reach out to these authors to continue the conversation.

Check out our DEI programming at AUA2022. We have content that will make you think more about your role in DEI and what you can do to support one another to improve DEI in urology.

Support your Board and the new DEI Committee. Better yet, get involved in these efforts. Explore opportunities in your Section. Learn more about the organizations sharing their advancements of DEI in this issue. We need as many of you as possible to spread the word across the world that we want to make urology more accessible to anyone who chooses this field as their specialty.

Read our publications and check out all of our content–not only AUANews. Our peer-reviewed journals, educational programming and the Urology Care Foundation all provide perspective on this important subject.

And lastly, tell us how we can be better. Do you have an idea for improvement? Do you have concerns? Questions? Share them with us. We are all in this together and will continue to be better together.