The Societies for Pediatric Urology (SPU) is an umbrella organization with nearly 850 members, representing the full range of the subspeciality of pediatric urology, with its own organizational structure but also working closely with the Section on Urology of the American Academy of Pediatrics, American Association of Pediatric Urologists, American Board of Urology, AUA, International Children’s Continence Society, Pediatric Urology Nurse Specialists, and the Society for Fetal Urology. As such, we seek to advocate across the spectrum of pediatric urological practice, and this includes strong advocacy for diversity, equity, and inclusion (DEI) in our professional ranks, as well as in patient care. Data show that clinical outcomes may be improved when clinicians and patients share common racial and ethnic backgrounds,^1-4 so a professional workforce that fully reflects the full diversity of our patients and families is important.

Gender representation has made great strides in urology in recent decades, and pediatric urology has led the way. Historically, and notoriously, urology was recognized as a nearly all-male specialty. This has changed dramatically. In 2022 to 2023, according to Association of American Medical Colleges, 31.7% of urology residents were female, while 53.1% of pediatric urology fellows were female.⁵ Thus, in our younger ranks at least, the subspecialty of pediatric urology has already achieved gender parity. Our future goals must include ensuring that this cohort of young female pediatric urologists has the same opportunities for career advancement, academic productivity, and leadership within the specialty as their male peers.

The SPU has recently launched an initiative to promote DEI efforts within the specialty. In 2023 the SPU established a new task force focused on DEI to promote racial, ethnic, gender, and sexual diversity within our field. It will be appropriate for this task force to focus on groups that have been historically marginalized or underrepresented in medicine. The SPU’s DEI Task Force will prioritize the following 3 objectives:

• Creation of a clear and implementable action plan for the SPU to promote a more diverse and inclusive pediatric urologic workforce
• Collaboration with other member committees and task forces to encourage focus on research and educational curriculum that focuses on health equity topics
• Engagement of other urologic DEI committees and task forces with a goal of delineation of synergistic and complementary initiatives

We are also developing a new approach to the SPU’s nominating process for positions within the organization. The goal is to create a more transparent system to facilitate access and encourage participation by engaging pediatric urologists representing a variety of backgrounds and perspectives.

Of course, the professional doorways to pediatric urology sit at the end of a very long “pipeline” of education and training, starting with high school students seeking to attend college to lay the groundwork for a future medical education, and running all the way through to the application, interview, and match process for pediatric urology fellowships, and finally to hiring of fully trained pediatric urologists to work in practices both private and academic. The SPU can focus most immediately on our internal systems to optimize the capacity of our match and training systems to proactively and effectively identify, recruit, and support candidates who will increase the diversity of the specialty. System changes such as the shift away from in-person fellowship interviews expand the potential pool of candidates by reducing the financial impact of the match process. Efforts further “upstream” in the pipeline will require collaboration with both the broader urologic and medical communities, where initiatives might have greater impact on the pool of potential future pediatric urologists, as well as all of those members of groups historically underrepresented in medicine who seek this professional path.

The SPU and its leadership remain committed to supporting a diverse and representative pediatric urology workforce that upholds the standards of academic excellence, delivers compassionate care, and advocates for pediatric patients with urological conditions.