The AUA Diversity, Equity & Inclusion (DEI) Committee has the support and engagement of the AUA Board of Directors to take action for the AUA to advocate for and foster a diverse and inclusive environment within the Association as well as the global urology community. As such, in the framework of inclusive excellence, the AUA Unity & Collaboration Workgroup of the AUA DEI Committee extended outreach to the AUA Sections and subspeciality societies/organizations as significant stakeholders to seek input and feedback in order to ensure this work is representative of the thoughts, concerns, successes, and challenges they face as an organization with DEI as well as those they desire the AUA to collaborate to address. Current data were obtained from the AUA to summarize gender, racial, and ethnic diversity of the AUA Sections themselves (Table). This represented the second formal reach out following the initial AUA DEI Task Force of 2020 that similarly surveyed affiliated organizations. A list of organizations is included in the Appendix.

Table. Gender, Racial, and Ethnic Diversity by AUA Section

Appendix. List of Section and Subspecialty Organizations

Process

On January 9, 2023, the AUA Unity & Collaboration Workgroup released the stakeholder engagement survey to the Sections and subspecialty societies to raise awareness and create opportunities for synergy and collaboration across the Sections. Response was requested by March 1, 2023, with reminders provided and subsequent additional personal member reach out thereafter. Valuable input was requested by completing a short survey.

The following DEI status items were queried:

1. Do you have a DEI committee or task force?
2. Please describe specific, ongoing DEI initiatives such as committees, programs, bylaws or policy changes, governance, etc, in your Section or subspecialty organization.
3. What is the composition of your leadership board in terms of gender and racial diversity?
4. Who is coordinating education on health care disparities and DEI in your annual meeting and how are they doing so?
5. What assistance from the AUA DEI Committee would you desire?

Outcomes

There was a 100% survey response rate (8/8) from the AUA Sections and a 41% survey response rate (12/29) from affiliated subspeciality societies. Within the AUA Sections, 37.5% (3/8) have a DEI committee or task force, 12.5% (1/8) do not have a committee or task force but have plans to develop one, 37.5% (3/8) do not have plans to develop one, and 12.5% (1/8) response was not clear. Within the affiliated subspecialty societies, 11/29 responded to the survey. Of the 11 that responded to the survey, 54.5% (6/11) have a DEI committee or task force, 18.2% (2/11) do not have a committee or task force but have plans to develop one, and 27.3% (3/11) do not have a committee or task force and have no plans to develop one. Each of the 3 societies that stated they had no plans to develop a DEI committee or task force specifically noted that they are a very small society, with 1 noting they don’t have the volunteer bandwidth for such a committee, and 1 noting that the leadership has taken on the DEI tasks.

There are numerous ongoing DEI initiatives across the Sections. Among the Sections, funding opportunities exist for both residents and medical students. One Section provides funding opportunities for both residents and medical students to present at meetings. More than 1 Section supports grants for underrepresented medical students to do subinternships within the Section, with 1 Section calling it a premedicine enrichment program. Another Section invests funding support for a summer medical student fellowship that provides specific priority to minorities and underrepresented researchers with a stipend to engage in basic, translational, clinical, or health services urologic research in an academic laboratory of medical facility, administered in collaboration with the Urology Care Foundation™. In addition, there are young urologist committee outreach scholarship programs to diversify and enhance the urologist pipeline in medically underserved areas. At annual meetings there are events or forums for women in urology and for young urologists. Some Sections deliberately make an effort to include underrepresented minorities in event planning and meeting participation, including on DEI content. Others make explicit efforts to ensure diversity in speaker panels and educational programs. DEI-specific abstracts may also be preferentially selected for presentation. Some Sections try to choose AUA DEI Committee members for their Section DEI committees. Lastly, Sections are updating bylaws to have inclusive language.

Among the subspecialty organizations, there are also many ongoing DEI initiatives. Some of these deidentified initiatives are shared here. One global theme is within the organizational structure, such as changing bylaws to both include a DEI policy and to increase transparency of board member and executive committee selection while also adjusting term lengths to provide more opportunity. One society wants to create an organizational policy for reporting member issues. Another society plans to work with the Legislative Affairs Committee to advocate for diverse agenda items to take to the AUA National Agenda. Another global theme is on education with specific efforts including DEI representation for meeting planning to diversify the programs, having a speaker database, tracking speaker diversity, creating DEI educational modules for their members, and organizing DEI quarterly webinars. Another global theme is on increasing the pipeline with outreach and mentorship programs that include direct support such as application review and mock interviews. Several societies are also promoting DEI and disparities research and providing research mentorship as well.

In terms of composition on leadership boards within the Sections, there is a range of gender and racial diversity, but women and underrepresented minorities are within the minority. Women hold 18% to 36% of positions among the Section boards. Underrepresented minorities hold 6% to 20% of positions on Section boards. It is important to note that 1 Section did not provide the information requested and 1 Section provided incomplete information. It is also important to note these data represent a single snapshot in time in what is a dynamic assessment of diversity of leadership boards that change over time.

In terms of composition on leadership boards within subspecialty societies, gender and racial diversity is highly variant. Some societies have 50% gender composition (7 and 7) with racial diversity described as 10% African American and 30% Asian American. Affinity-based societies have gender and racial diversity according to the mission of the society. For example, there are societies that have all underrepresented minorities as their leadership.

There are a variety of ways the Sections and subspecialty societies coordinate education on health care disparities and DEI in their annual meetings. More than half (52.6%) incorporate education on health care disparities and DEI through their program chairs and scientific committees. The majority accomplish this by selecting speakers and presentations that demonstrate the diversity of the organization and/or on the topic of health care disparities and do so without the involvement of a DEI committee, DEI task force, or other representative, while 15.8% have a DEI task force or committee providing input on DEI topics for sessions, including the plenary. A small percentage (15.8%) coordinate programming through their director of operations, their entire team, or through their Section secretary. Fifteen and eight tenths percent have no formal programming. This cumulative information comes from 12 total responses from 7 Sections and 12 total responses from 11 subspecialty societies (1 subspecialty society had the survey filled out twice by 2 different members). Lastly, there were numerous responses from both the AUA Sections and subspecialty societies to the query regarding the AUA DEI Committee assistance desired. While 1 Section stated “none,” most Sections and societies did have suggestions. Funding was central to many suggestions, specifically for outreach and mentoring programs in addition to support of speakers for meetings. Guidance on education was another principal theme requested by those surveyed. Ideas ranged from the AUA having a topic-specific speaker portal to having a list of educational topics for annual meetings. One subspecialty society requested suggestions for internal board member DEI training. Some wanted guidelines, policies, and events at the AUA Annual Meeting. Many Sections and 60% of subspecialty societies responding to the survey also wanted guidance and insight on opportunities and best approaches to enhance DEI efforts at the Section and subspecialty level, including both how to initiate and nationalize a pipeline program. Some simply wanted guidance on forming a DEI committee. A subspecialty society suggested a published repository of ideas for committees to execute. One Section wanted assistance to increase transparency in the election of awards, honors, committee membership, and officers. Several suggestions centered around communication. One Section desired a news blast on what the AUA and Sections can do, while several other Sections specifically requested better communication of AUA DEI activities, initiatives, and plans. Lastly, 10% of subspecialty societies wanted the AUA to pave the way for more ease of access of affinity groups to the AUA Board.

Organizational Awareness Scorecards

Various organizations working on DEI have used organizational scorecards to develop metrics against which to benchmark progress towards their goals. Inclusive leadership must make a commitment to mission-specific DEI goals, but the logistics of how to execute this remains an evolving science. For Sections and subspeciality societies that are along the continuum of this journey, we share the following resource to share with your leadership to assist you in making society-specific action items and develop strategy to measure and manage your progress: https://seniorexecutive.com/diversity-scorecards-dei-reports/

Innovation Alert

PROSPECT is a collaboration spearheaded by 2 long-standing North Central Section (NCS) members. The PROSPECT initiative is an 8- to 10-week research fellowship for underrepresented in medicine (URiM) students following their MS1 year. The goal is to provide early exposure to urological research for URiM students in order to capture students who otherwise may not get exposure to urology until they are too far along in medical school to be competitive for training programs. There are 5 current URiM students in the inaugural class. NCS is sponsoring their travel to the upcoming NCS Annual Meeting in Scottsdale, Arizona. There will be a poster/session mixer where PROSPECT students will present a poster on the research that they did during their summer fellowship.

Stay Tuned: FUTURE at the Sections

The inaugural AUA Future Urology Talent from Under-Represented Entities (FUTURE) Mentorship Day was a resounding success, unveiled during the 2023 AUA Annual Meeting. It provided 40 URiM medical students with the unique opportunity to delve deep into the urology field, offering them access to roundtable discussions, educational courses, and hands-on experience with live device demonstrations.

Beyond this education immersion, these students also had abundant networking opportunities, crucial for emerging urology professionals. The effectiveness of this initiative was evident in the subsequent survey data, with over 80% of survey respondents indicating they would like to pursue urology, and more than 90% of medical student participants would recommend the program to other URiMs. One of the inaugural 2023 FUTURE Mentorship Day participants, Hamed Heydari, a first-generation Iranian American and the first in his family to pursue a career in medicine, echoes the impact of the AUA FUTURE Mentorship Day by saying, “The AUA conference can be overwhelming for a medical student, but thanks to the FUTURE program, it turned into an informative and enjoyable experience for me. The connections I made with mentors and colleagues throughout the weekend not only deepened my passion for urology, but also reassured me that a urology residency, despite being highly competitive, is within my reach. After attending the AUA Annual Meeting and participating in the FUTURE program, my ambition to pursue a career in urology has only grown, and I feel supported by the AUA community.”

The AUA is taking strides forward with its innovative FUTURE programming for AUA Sections, aiming to offer FUTURE resources to its Sections. The primary goal is to empower Sections with the necessary tools and provide them with structured programming templates for the smooth integration of FUTURE activities into Section annual meetings and other related events.

As part of its initiative, the FUTURE Mentorship Toolkit will be designed for AUA Sections to bolster their mentorship activities. AUA Sections will benefit from a range of support, including a comprehensive mentor day template and assistance with marketing the event. With these resources, the AUA Sections will provide detailed reports based on pre- and postevent surveys, including details of participants and tracked progress of their continued engagement in the wider ambit of FUTURE programs.