When AUA Publications invited me to submit an article on my reflections of being selected for the Leadership Class my first thought was I would probably have something more insightful to share after the experience. However, the invitation forced me to reflect on my path to get here and perhaps there are worthy lessons learned for young urologists in a similar position. In my 13th year of practice, I’ve increasingly spent more time and effort in professional development surrounding leadership. My younger self would have said that I was in the right place at the right time to fall into early opportunities to engage in academic urological leadership roles. I became the section chief of urology at a small Veterans Administration hospital in year 2 of practice, associate residency program director by year 3, and program director by year 5, board member of my practice by year 4, and had roles on the Board of Directors for the Society of Women in Urology and the Society of Academic Urology thereafter. My older self would say that it wasn’t just timing. I had some of the basic skills necessary to lead. I had ideas and sometimes strong opinions on equity and fairness, was very good at communication, being organized, detail oriented, and just plain old execution. And the more I executed, the more projects, assignments, committees, task forces, and appointments came my way. But at many of the tables of surgical leadership that I would sit at, I was typically the #firstonlydifferent woman of color and while this engendered pride, the responsibility to advocate for those who I knew did not get that same seat felt heavy and isolating. And the struggle of leadership was real. There was conflict management, negotiation, motivation to get people to do things they might not want to do, a constant need to manage and communicate both above and below the hierarchy, and it didn’t take too many years before I felt wrung out, tested, occasionally defeated, and overworked. Being a woman in surgical leadership felt less like Brene Brown’s Dare to Lead and more like Game of Thrones. This occurred while my clinical skills had matured and I no longer felt like a “pre(at)tending,” and yet it was obvious I had to develop new leadership skills. How could I be more effective at gaining consensus, influencing, and leading change? How could I increase my emotional intelligence to finesse crucial conversations and deliver difficult feedback, balance competing interests with the residency educational environment where major tensions between education and service and complex health care systems limit any one person’s ability to change? How could I convince and negotiate with administrators for resources that required a financial justification over which I had no authority? Probably most importantly, how could I manage myself and my own mindset? What I did know was if I couldn’t trade in the currency of hard money, I could trade in the currency of soft influence. I’ve spent the back half of my career focusing my efforts on professional development towards developing these leadership skills to present my ideas effectively, build relationships, manage politics and strategy, and influence culture.

For the younger urologists, I applied to the Leadership Program via my section 3 separate times before being accepted. So if you have interest, keep trying—you never know when it will work out. Second, for me burnout is a passenger in the journey of my career. It ebbs and flows, and while the satisfaction of solving surgical problems still motivates me clinically, some of the most meaningful work I have done has been with professional societies where you can impact urology in more global ways. I’m honestly not sure where the path of my career in urology takes me next. While I’ve tried to sketch that out by setting goals and thinking about my mission and vision, my view is still foggy on what “might come next.”

So instead, I’ll share my goals with the Leadership Program: (1) Connect meaningfully with other urologists. I got 6 interviews when I applied to urology. It’s a miracle I’m even here and it turns out that urology is a small world that I was lucky to find myself invited into. Now that I’m here, meeting urologists from across the country and the globe reminds me constantly of the similarity of our struggles and the privilege to have meaningful work. (2) Reconnect to some passion and joy within our work. The opportunity to work with other urologists and commit to a project, see it through, learn from one another and bond is itself a way to combat burnout. (3) Increase my circle of influence. I believe the AUA should and can be an organization that changes to reflect the growing diversity of its members. I believe strongly in the possibility of professional medical societies being a bastion of opportunity for urologists to have influence and legacy on national and global levels within our uniquely small subspeciality. So ultimately, I hope to use the Leadership Program to find where I might impact the AUA most in the coming years with this opportunity.