Mentor

Nine years ago, my University of Florida/Gainesville urology resident, Mohit Gupta, and I attended the combined AUA and AACU (American Association of Clinical Urologists) Joint Advocacy Conference (JAC) as a team. I am reminded of this because Mohit, who is now faculty at Georgetown University School of Medicine as a urologic oncologist, produced a photo taken of the two of us at the front of the United States Capitol in 2014 (Figure 1) that exactly mirrors the photo taken of us this year (Figure 2). By exact, I mean that I do not look a day older. In truth, some things have changed, including a little bit of aging. Nine years ago, the JAC was advertised as the only national advocacy conference devoted to protecting and promoting the interests of urologists and their patients. Urologists have learned over the last decade that group advocacy integrally and effectively supports the rights and health care needs of our patients. Advocacy is a pillar of the tripartite mission of the AUA.

Figure 1. Drs Mohit Gupta and Thomas Stringer at the Joint Advocacy Conference in 2014.

Figure 2. Drs Mohit Gupta and Thomas Stringer at the Annual Urology Advocacy Summit in 2023.

The 2014 Summit was the 9th annual urology JAC. Although it was open to all members of the AUA and AACU including residents, fellows and medical students, younger member attendance and participation was the exception. Mohit was one of a handful of residents to attend in 2014. Ironically, despite my experience, Mohit knew the back halls of the congressional office buildings better than I did. He had served as a legislative intern to Senator Bill Nelson (D-Florida) years before. Mohit was so engaged in the political process that he applied for the Holtgrewe fellowship the next year. So, in the end, we both learned from each other in 2014. The process continues in 2023.

The AUA transitioned to the Annual Urology Advocacy Summit (AUA Summit) in 2018. On a similar note, the AUA Political Action Committee was launched at the second AUA Summit in March 2019. The agenda for the AUA Summit was nearly entirely stakeholder driven, including all 8 AUA sections and key urology specialty organizations as well as patient advocacy organizations. Additionally, a concerted focus was on the involvement of young and future urologists in advocacy. As a result, typically one-third of AUA Summit attendees are now medical students, residents, fellows, and young urologists. They are subsidized by the AUA and the AUA Sections. At University of Florida/Gainesville, resident attendance was additionally funded for several years through a scholarship established by a local private-practice urologist, Kevin Lee.

The organization, content, focus, and effectiveness of the AUA Summit have grown and expanded since its inception. So has the face of the Summit. Individual tables, which represented each state, were filled in 2023 with bright and enthusiastic young residents and students who were diverse and engaged. On Capitol Hill, my 2 residents from University of Florida/Gainesville expertly discussed the 4 Summit asks, which pertained to patient access, student loan forgiveness, cancer prevention, and physician fee schedule reform. I am certain that their message to their coresidents across all sections of the AUA will be to engage in the advocacy process. I marveled at the interaction between my current and past residents spanning over a decade of training. They shared common passion, insight, and vision as well as burgeoning comradeship in the advocacy effort.

Mentee

During my residency at University of Florida/Gainesville, I was fortunate to be trained under a group of faculty who helped build a solid foundation of surgical skills, clinical knowledge, and compassion in preparation for a career in urology. One of my mentors, Dr Thomas Stringer, also identified my passion for public policy and helped cultivate an interest in advocacy. He took me to my first AUA Summit in 2014 and showed me how I could combine my background in political science with my career in urology. I learned how essential it was for urologists to participate in the legislative process, and why it was necessary to advocate on behalf of our patients and profession. Walking the halls of Congress with other AUA members, I began to understand that as physicians, we are in the trenches of patient care and can inform policy makers based on firsthand experience of the challenges patients face and changes needed to deliver quality, effective health care. Dr Stringer had opened my eyes to an important facet of the AUA and solidified my interest in participating in advocacy throughout my career.

Nine years later, as part of the 2023 AUA Summit, I had the opportunity to bring my own current residents to the Capitol and to help grow their interest in the democratic process of representation. As we discussed important legislative asks with members of Congress and their staff, I saw their awareness and resolve for advocacy grow, just as Dr Stringer saw in me in 2014.

It is essential that the AUA continue to engage residents and young urologists in the legislative process: early involvement will pave the way for a career of advocacy. Many of our legislative priorities in 2023—support for permanent expansion of telemedicine, passage of the HIM (High-risk Insured Men) Act, support of equitable reforms to the Medicare physician fee schedule, and sponsorship of the SPARC (Specialty Physicians Advancing Rural Care) Act—are legislative battles that will continue for years to come, and we need urologists eager to take on the mantle on behalf of our patients and profession. I hope that my current residents will teach the next generation of urologists about the importance of advocacy, just like Dr Stringer did for me years ago.