The year 1883 will always remain special to all Indian female doctors as this was when Dr. Anandibai Joshi became the first Indian woman to be fully trained in the science of Western medicine. India has come a long way since then, and today almost 50% of medical admissions are secured by girls. However, female surgeons still remain rare and female urologists even rarer.

Urology was officially established as a surgical subspecialty in India in 1961, culminating later in the formation of the Urological Society of India (USI).¹ Dr. Lakshmi Sankaran was the first woman to be fully trained as a urologist in the late 1960s at Madras Medical College. Today, USI is a strong body with 3,077 fully trained urologist members, but out of these only 1.1% are women, a number much smaller compared to that in the rest of the world.

There are 2 degree courses in India for urology: MCh (Magister Chirurgiae or Master of Surgery) and DNBE (Diplomate of National Board of Examinations), and presently there are close to 100 centers recognized separately for each of these across the nation.¹ Sadly, the number of female candidates enrolling for and qualifying as urologists is low and unpredictable. I qualified from the Department of Urology at KEM Hospital in Mumbai in 1991, and so far 5 women have qualified from this department since its inception in 1980. Interestingly, heads of 3 urology departments in the city of Mumbai when I qualified were women (Dr. Shobha Lal, Dr. Sulabha Punekar and Dr. Vatsala Trivedi). The current head of the KEM Urology Department is also a woman (Dr. Sujata Patwardhan). All of these women have been truly inspirational. However, for a country of 1.4 billion people, the number of female urologists remains abysmally low.

The reasons behind this could be multifactorial, from the widely prevalent belief that surgical specialties tend to be harsher physically with very little family time, to urology being a line mainly dealing with male genitalia. A recent webinar-based survey (for which I was one of the contributors) revealed that most female urologists felt guilty at not being able to give enough time to their family.² I was privileged to be the editor of the quarterly newsletter of the West Zone chapter of USI in March 2021, dedicated to female urologists, in which all of these issues were discussed from an Indian perspective.³ All authors expressed the opinion that the path may be challenging but their male patients never felt awkward at being treated by a female urologist, which is indeed interesting considering India’s social dynamics. Though many older female urologists had accepted a career in “Female and Functional Urology” by default (as they attracted more female patients), the younger lot clearly showed a preference toward advanced endourology as well as laparoscopic-robotic work.

The world is waking up to “manels” (all-male panels) and India is no exception. I recently talked about this issue at a hybrid annual national conference (USI 2022), and recommendations unique to India were made to circumvent and eventually eradicate urology manels. The main recommendation was, of course, to educate girls and encourage them to take up higher studies in scientific subjects.

I was born into a medical family with Dr. Sharad Bapat (renowned urologist and past-president of the USI) as my father, a role model and a mentor. I have had very supportive colleagues, junior and senior, and at no stage have I received differential treatment from them because of my gender. Of course, I had my share of the occasional male patient viewing me with skepticism and calling me a sister (meaning a nurse) rather than a doctor. My outpatient departments during my training invariably had this never-ending line of female patients hoping I would wield this magic wand and cure them of all ills…from headache to acidity to ingrown toenails and, of course, urinary tract infections and the works.

I believe it is the responsibility of the male urologist community to become the ideal colleagues, teachers and mentors, and to create a gender-neutral and equal space. The best time to encourage more women to take up urology is at the start of their surgical training, where faculty from urology departments can address them. Urology is indeed a unique specialty–offering great variety from open to laparoscopic-robotic surgery, to endourology, with several subspecialty options–and I believe it is ideally suited for women. Almost all emergencies can be dealt with by inserting a tube by the appropriate route in the urinary tract, and one is unlikely to be disturbed in the middle of the night to explore a patient (the most attractive part of this specialty). I sincerely hope more women take up urology in India and across the world. I congratulate the AUA for coming out with this newsletter dedicated to Diversity and Inclusion in Urology.

I wish to thank Dr. Ravindra Sabnis (USI President), Dr. Keshavamurthy Ramaiah (USI Secretary) and Dr. Prashant Mulawkar (West Zone USI Secretary) for their invaluable help in putting together facts and figures for this article.