In December 2020, the AUA Board of Directors charged a diversity and inclusion (D&I) task force to identify and prioritize potential strategies the AUA could realistically implement for enhancing diversity, equity and inclusion (DEI) within the AUA and within urological practices/institutions and to make recommendations for education, research, and/or advocacy initiatives that AUA could pursue, in collaboration with others, to help enhance DEI within these settings. Widespread, systemic change is required to challenge structures and norms that perpetuate such disparities for our patients and individuals who are underrepresented in the urological workforce.¹ As a leading professional organization in urology, the AUA has a duty to recognize the scope of these issues related to justice, diversity, equity, and inclusion, and to guide the change that is needed to advance our field.

Under the leadership of Dr Tracy Downs as chair and Dr Simone Thavaseelan as vice chair, as well as then Executive Vice President of Public Policy Kathy Shanley, PhD, the task force carried out its charge through structural competency development and training via an experiential, interactive, and transformative curriculum to establish common understanding and foundations around DEI work, didactics and small group discussion, readings, and reflection for members to further develop DEI expertise.

The task force delivered 14 recommendations to the AUA Board, all of which were accepted with the exception of voting rights for the chief diversity officer.² The establishment of a new and standing DEI committee as approved by the AUA Board of Directors was to address the lack of an existing, centralized structure, beyond the Board’s D&I Task Force, directly charged with making recommendations for and executing ongoing D&I initiatives. Previously, the AUA took a decentralized approach to DEI with departments or program areas sponsoring various DEI activities and initiatives without centralized oversight or communications effort within the organization or with affiliated societies. With regards to voting rights for the chief diversity officer, the Board elected to address the urgent need of diversification of the AUA governance structures though efforts at the Section level to promote representational diversity and create leadership reflective of both changing workforce and population demographics.

With the appointment of Dr Larissa Bresler as chief diversity officer and creation of the DEI Committee, the AUA has begun to operationalize these recommendations in short order. Dr Bresler has met with multiple stakeholders across the DEI space in urology already, and has further engagement planned. Members of this newly formed committee represent broad diversity within urology and across social identifiers of race, gender, ethnicities, sexual orientation, religion, language, and age, as well as AUA Section and subspeciality and clinical or academic focus (see Figure). The committee has chairpersons, program directors, society presidents, and specialty society DEI chairs; more than half of the committee is bilingual, several are double-boarded in either urological subspecialty or another medical discipline, and several are funded researchers. This intentional decision to include intersectional identities across the urology workforce is demonstrative of the practice of inclusive excellence.

In addition, the executive vice president and chief human resources officer serves as the AUA liaison for the committee. Four workgroups have been established in the DEI Committee: Education and Research, Unity and Collaboration, Media and Publication, and Pipeline, each with the following goals:

The Education and Research Workgroup:

• Collaborate with Education and Research council chairs including Dr. Jay Raman and relevant committee chairs to increase the scope of DEI and health care disparities education within the AUA.
• Connect with Dr. Cheryl Lee from American Board of Urology to create educational content/videos on health care disparities to be included in the recertification process and lifelong learning process.

The Media and Publication Workgroup:

• Assigned initial tasks to collaborate with the AUA media team to work on publications, podcasts, and editorial opportunities.
• Plan and execute future podcasts, 100 posts, and publications such as AUANews, journals, podcasts, etc.
• Collaborate with key AUA directors Caitlin Lukacs and Jennifer Regala (AUA Communications and Publications departments, respectively).

Unity and Collaboration Workgroup:

• Coordinate efforts with AUA sections and specialty societies to avoid duplicate efforts, reinventing the wheel, and provide best practices to guide organizations in their internal DEI efforts.

The Pipeline Workgroup:

• Assigned initial tasks to advance pipeline programs for underrepresented in medicine and underrepresented in urology groups by building strong national programs for first- and second-year medical students.
• Develop the “Prospect” Pipeline mentoring program as a long-term program designed for underrepresented in medicine students to learn of urology and develop intentional mentoring, sponsorship, and networking to successfully pursue a match and career in urology.
• Execute a career-day mentoring program at the annual meeting location to encourage students of nearby medical schools to attend the meeting with a urologist mentor.

Urology and its organized leadership are not diverse and this will not change passively. Amid the COVID-19 pandemic and recognition in particular of racial inequity, many organizations have found they are poorly equipped to institute change and that their governance structures are no longer designed to fully support their strategic visions. There is an urgent need to modernize these cultures and the structure, policy, practice, norms, and values associated with them. The evolution of organizational with the transition from the AUA D&I Task Force to the standing AUA DEI Committee has been swift, consistent with the AUA’s commitment to advancing DEI goals as part of its strategic mission. Professional medical societies are uniquely poised to evolve themselves to remove barriers to advancement and accelerate health equity by creating a more just and inclusive urological community for the betterment of our patients.