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VOICES Building Health Equity and Diversity in Urology: A Personal Journey

By: Jameshisa Alexander, MSc, Morehouse School of Medicine, Atlanta, Georgia; Mentor: Quoc-Dien Trinh, MD, MBA, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts | Posted on: 06 Jul 2023

Growing up in Southside Jamaica, Queens, an underserved neighborhood in New York City, I experienced firsthand the challenges of limited access to health care; underperforming schools and pervasive violence were daily realities. Being an immigrant from Guyana, I faced similar challenges of limited resources and information as young people often do not know what they do not know. These experiences have shaped my commitment to fostering health equity and diversity, particularly in the field of urology.

From a young age, I recognized the need for adequate support, resources, and high-value educational opportunities in communities like mine. My goal as a physician is to be a familiar face in underserved neighborhoods like mine, an agent of change providing medical services, mentorship, and opportunities to those in need. Mentorship is vital; however, I once read an article that stated, “Sometimes young people need more than a mentor; sometimes they need a fan!” Thus, both through mentorship and professional adult fans, who guided, motivated, suggested, supported, and cheered me on, I discovered the power of excellence, knowledge, service, and community. My goal is to extend this same guidance and support to the upcoming generation and my patients, with an emphasis on patient care, access to medical resources, preventive health knowledge, and promoting diversity in the field of medicine—I will both be able to pay it back and pay it forward.

My passion for urology stems from a desire to help individuals with some of the most painful, uncomfortable, and intimate health issues that significantly impact their daily lives. Previous research experience in obstetrics has indicated that there are both physical, psychological, and emotional impacts of such conditions as prolapse or incontinence on women’s health and well-being. As a future urologist, I aim to continue researching innovative ways to combat harmful outcomes and apply my findings in clinical practice. By focusing on patient-centered research (care and caring), I intend to contribute to improving the quality of life for individuals suffering from urological conditions.

Participating in the FUTURE (Future Urology Talent from Underrepresented Entities) Program as a first-year medical student was a transformative experience that both ignited and solidified my passion for urology. Under the mentorship of Dr Quoc-Dien Trinh (Figure 1), whose work revolves around health services and health equity, I received valuable guidance based on his experience and pathway to the field. Attending the Diversity, Equity & Inclusion: Health Equity & Outcomes poster session exposed me to the pioneering work being done to advance health equity in urology (Figure 2). Interacting with Dr Trinh’s numerous residents, fellows, and colleagues created a uniquely immersive and welcoming experience in this field.

Figure 1. Quoc-Dien Trinh and Jameshisa Alexander at AUA2023.

Figure 2. Jameshisa Alexander attending AUA2023.

As an underrepresented minority student pursuing urology, I am motivated to contribute not just to the diversification of the field, but also to innovations and discoveries in the field. That Black urologists constitute only about 2% of total physicians in the specialty is alarming, especially in light of the literature that states over and over again that outcomes of Black patients improve when they see Black physicians.1,2

Thus, it is quite evident that more effort is needed to address this disparity and increase representation in the field.3 Moreover, building trust within Black communities, given the historical mistrust of the medical field, is crucial to ensuring equitable health care access and outcomes.4 I am committed to engaging in conversations and initiatives that promote diversity and representation among practicing physicians, helping to bridge the gap between patients and health care providers as a medical student and physician specializing in urology.

Looking ahead, I hope to see the FUTURE Program continue and expand its reach, enlightening more students about the intriguing field of urology. To foster diversity and collaboration, I advocate for the establishment of AUA travel scholarships, multiday mentoring programs, and sustained partnerships with organizations such as Urology Unbound and the R. Frank Jones Society. By collectively addressing the underrepresentation of minority groups in urology, we can create a more inclusive and equitable medical field that truly reflects and understands its patient base.5,6

My personal journey, shaped by my upbringing in an underserved neighborhood and my experiences as an immigrant and a first-generation college student, has fueled my passion for urology and the pursuit of health equity. Through research, mentorship, and a commitment to diversity, I aim to make a lasting impact in underserved communities. By creating a more representative and inclusive field of urology, we can provide better care for all patients, regardless of their background. Together, we can build a future where health care is accessible, equitable, and compassionate.

  1. American Urological Association. The State of the Urology Workforce and Practice in the United States. 2022. Accessed May 20 2023.
  2. Snyder JE, Upton RD, Hassett TC, Lee H, Nouri Z, Dill M. Black representation in the primary care physician workforce and its association with population life expectancy and mortality rates in the US. JAMA Network Open. 2023;6(4):e236687.
  3. Powell CR, Cameron AP, Goh M, Neal C, Memo R, Richards KA. Gender and racial diversity among U.S. urology residency programs and efforts to improve it: you can’t be what you can’t see. Urol Pract. 2022;9(5):466-473.
  4. Wells L, Gowda A. A Legacy of Mistrust: African Americans and the US Healthcare System. 2020. Accessed May 20 2023.
  5. Wallace NO, Pittman AB, Wilson SN. The R Frank Jones Urology Interest Group: an intentional and strategic pipeline program to increase diversity in urology. Urology. 2022;162:27-32.
  6. McIntire LL. R. Frank Jones Urological Society updates on diversity, equity, and inclusion efforts. AUANews. 2023;28(4):9-11.

To hear more from Jameshisa and Dr. Trinh, listen to their Voices podcast episode: FUTURE in Urology Recap #1.