Background

Dell Medical School at the University of Texas at Austin has fostered a culture of inclusivity, as evidenced by the high proportion of female urology residency applicants. Since Dell Medical School first opened its doors in 2016, 81% of urology applicants (9 out of 11) have been women (Figure). This significantly outpaces national statistics, which indicate only 40.6% of urology applicants in 2024 and 11.6% of practicing urologists in 2022 are women.^1,2 A recent analysis linked increased recruitment to urology to having a residency program at a student’s home institution, as well as multiple residents and faculty members on site, and urology interest groups.³ Furthermore, female recruitment within surgical subspecialties such as urology was found to increase following even a brief clinical rotation experience⁴ and the presence of strong mentors.⁵ Dell Medical School lacks some of these key elements as there is currently no urology residency program and a lack of female faculty. Despite this discordance, unique elements within Dell’s systems help empower and proactively draw women toward urology, a traditionally male-dominated domain.

All current and former female urology applicants trained under Dell urology faculty were contacted to participate in a focus group to learn more about how the school supported their interest in urology. Eight out of 9 students were able to participate in a 1-hour focus group interview conducted by a current Dell Medical student. Common themes were identified across participants and recorded (Table). Throughout the interview, we uncovered Dell’s exemplary mentorship and sponsorship, training environment, and culture of paying it forward as indispensable drivers of female engagement with urology.

Table. Common Themes and Key Takeaways That Encouraged Dell Medical Trained Students to Pursue Urology

Mentorship and Sponsorship

Dell Medical School’s Urology Department, led by a team of dedicated faculty, places substantial emphasis on providing comprehensive support in the form of both mentorship and sponsorship to guide female trainees along their journey from student to resident urologist. As a mentor, experienced faculty provide invaluable 1-on-1 support, guiding mentees through career endeavors, aiding in skill development and goal setting.⁶ While mentorship aids in developing the applicant’s self-
direction, sponsorship leverages faculty influence to propel mentees’ goals forward. Sponsors facilitate introductions, help overcome obstacles, and advocate for their mentees, especially crucial for women’s success in traditionally male-dominated fields like urology and academic medicine.⁷ Furthermore, faculty members serve as advocates for students throughout the application process, ensuring that their potential is recognized in the competitive landscape of urology residency programs.

A student described how their mentor embodied both mentorship and sponsorship: “By listening to my career desires and clinical interest we discovered I have a strong interest in exploring urology through urogynecology and reconstructive pelvic surgery (URPS). Understanding Dell Medical School’s program currently lacks a fellowship-trained URPS urologist, he facilitated a connection with a female URPS urologist at another institution.” Through these efforts, Dell Med’s Urology Department creates a nurturing environment where aspiring female urologists from diverse backgrounds feel empowered and supported in pursuing their career aspirations.

Training Environment

A philosophy of empowering students to reach their maximum potential is woven into the fabric of the department’s educational approach, where trainees are immersed in hands-on learning experiences and trained to “act and think like residents.” This sentiment resonated with an alumnus, who shared, “The level of autonomy and skills you gain in the operating room (OR) at Dell are levels ahead of what is given to medical students at our current institution. Although Dell does not have a residency program, it does offer more opportunities to be involved in the OR.”

Medical students at Dell rotate in the OR as second-year medical students, providing them with both early exposure to urology as well as increased opportunity for further exploration of urology during their third year, where students are trained to think and practice like interns. Students are encouraged to take initiative and observe cases, learn from resident-level educational materials, and utilize robotic simulators whenever they can. This allows our students to be well prepared and thrive in subinternship rotations. The preparation also helps students from underrepresented backgrounds, such as women, obtain an equal footing and combat feelings of imposter syndrome in environments that are traditionally male dominated.

Paying It Forward

Through the robust ethos of “paying it forward,” the support received permeates Dell’s urology community. Attendings devote substantial effort toward counseling students, shaping students’ desire to similarly devote time to guiding peers navigating urology’s early phases. This support particularly resonates among our female students, as one stated, “Seeing other women in Dell’s Urology Interest Group and female alumni across the United States makes me feel uplifted and supported in pursuing my dream of becoming a urologist.”

Support from upperclassmen and alumni involves providing advice within the specialty and residency application process, reviewing application materials, and sharing resources that helped
students succeed in urology rotations. Furthermore, residents have been able to help connect interested students with residents and attendings at other institutions who share common research interests. This channel strengthens yearly as students transform into resident mentors, fellows, and attendings—expanding Dell’s network. No longer are the urology attendings the only mentors, but rather they are joined by the Dell urologists in training. Students thereby access personalized guidance from an ever-growing spectrum of urology role models at varying career stages. An applicant responded, “The support we have at Dell is truly unmatched, and the network of growing alumni has been paramount to helping me feel integrated within the greater urological community.” The peer support culture at Dell empowers women to pursue urology and fosters a legacy of inclusive excellence for future generations.

Dell Medical School’s model for supporting women applicants has manifested in a 100% urology residency match rate, with Dell graduates securing competitive positions across multiple states to date. The outlook remains promising for women to spearhead urology’s future transformation. Dell has created an ecosystem that nurtures talent regardless of gender—one that continually regenerates itself through members who actively lift up the next wave.

Acknowledgments: We thank the Dell Medical School faculty—Dr J. Stuart Wolf Jr, Dr Aaron A. Laviana, Dr E. Charles Osterberg III, and Dr Harras Zaid—for their invaluable mentorship and unwavering commitment to training and furthering the next generation of urologists. We are tremendously grateful for the time and wisdom these mentors have generously shared to foster our growth, and it has been an honor to learn from their exceptional insight and leadership in urology.