“Do I Fit in Here?” is a question that often enters the minds of medical trainees as they seek out their chosen future profession. For many women, racial and sexual/gender minorities, the answer may not be reflected within the urology workforce and organized urological societies such as the AUA.

According to the latest AUA Census, urologists are 90% male, 3.8% Hispanic and 2.1% Black.¹ This is even though, according to the U.S. Census 2020, our population is 51% women, 15% Hispanic and 13% Black.² The lack of proportionate representation has several negative effects as it contributes to implicit bias, microaggressions, stereotype threats, tokenism and imposter syndrome.³ This lack of representation also contributes to a lack of connection (homophily) and is an opportunity that the AUA cannot afford to miss.

As members of the AUA’s Young Urologists (YU, defined as those within 10 years of completing training) Committee (YUC), we are keenly aware of this discrepancy and are working towards the necessity of diversity, equity and inclusion. The YUC, being comprised of representatives from each of the AUA sections as well as the Doctor of Osteopathy Section, and the Society of Government Services Urologic Society and Consultants from the American College of Surgeons, American Medical Association, Advanced Practice Provider Membership Committee, and the Residents and Fellows Committee, is uniquely positioned to bring together wide-ranging members and represent the breadth of the larger urology community. Yet, we too recognize the need for our YUC to reflect not just the YU membership of the AUA but also the diversity of society at large and to foster a pathway for future generations to see themselves in that reflection. To that end, the YUC is very proud of our AUA YU membership at large, who are often at the forefront of these efforts.

Urology Unbound, LatinX in Urology and Urologists for Equity, among others, have recently been established to engage with underrepresented racial and sexual and gender minority (URM) medical students and residents in Urology. The first annual URM residency bootcamp was held in May 2021 by Dr. Shenelle Wilson/Urology Unbound to help URM residents acclimate to and thrive in residency, along with other ongoing events throughout the year for URM medical students looking to match into urology. These important efforts are essential to underscoring the belief that underrepresented medical students and residents are welcomed into Urology and are beacons of hope in strides towards increasing diversity, equity and inclusion (DEI) within our field.

YU membership also contributed to the AUA Office of Education’s Medical Student Education Committee-hosted webinar on March 22, 2021, titled “Diversity in Urology: Initiatives and Opportunities.” The webinar included a panel discussion with Dr. Shenelle Wilson, Dr. Jessica Delgado, Dr. Sam Washington and Dr. Jessica Bienstock, hosted by Drs. Marissa Clifton and Adam Weiner. This was an excellent discussion regarding the impressive medical student initiatives that have developed in the recent past, with efforts directed towards increasing diversity in the applicants to our specialty. The archived webinar can be viewed online at the AUAUniversity YouTube channel (https://www.youtube.com/watch?v=RMUMpA82SCY).

On a regional level, several YU members of the New York Section of AUA spearheaded an effort to sponsor new AUA Office of Research medical student summer research fellowships geared towards URM students. The New York along with the Northeastern, South Central and Southeastern sections are now sponsoring 4 medical student summer research fellowships specifically for URM students for 2022. This is in addition to several lectures on DEI given at sectional meetings coordinated by YU representatives. It is also important to note that YU-sponsored panels are encouraged to embrace a diverse panel of speakers. Further, the AUA Office of Research and Urology Care Foundation have DEI initiatives promoting a pipeline of URM researchers at all stages to address disparities in urological research.

Still, there is much progress to be made and it needs to start earlier. Efforts to attract students in college and even earlier to Urology will be part of the ongoing work needed to bridge the equity gap. To this end, the Mid-Atlantic Section has created and funded a pre-medicine enrichment program for URM undergraduate students. In the summer after their sophomore year, URM students will participate in a comprehensive mentorship and academic program aimed at fostering and attracting pre-medical students to Urology specifically. This program was spearheaded by Dr. Kurt McCammon (of the Mid-Atlantic AUA Section Board) and advanced as well by Dr. Jay Raman (Past President of the Mid-Atlantic section and current AUA Office of Education Committee Chair), along with support by Mid-Atlantic YU members. This program can be a model for other grassroots efforts to create pathways for younger generations, which will hopefully lead to our field one day truly reflecting society at large.

Membership in the YUC has the potential to be the first formal volunteer role for a young urologist within the AUA. Such membership could lead to further exposure within the AUA governance structure and may often lead to further volunteer opportunities within the AUA. The YUC is striving to minimize the barriers to appropriate representation and support. “You DO fit in here!”