The Research on Calculus Kinetics (ROCK) Society is a specialty society focused on understanding the basic mechanisms of the etiology and management of urolithiasis. Members of the ROCK Society must demonstrate a substantial record of accomplishment in the area of urolithiasis research in order to be considered for membership. While the Society’s history includes an earlier period of exclusivity, in recent years, while remaining a Society requiring membership approval, we have embraced the inclusion of a broader diversity of members, including both clinicians and scientists. Unfortunately, the ROCK Society has suffered from the same lack of diversity and inclusion that is rampant across the rest of the urologic clinical and research communities. Thus, membership remains largely White and approximately 80% male. As we develop strategies to become more diverse and inclusive, an initial area of effort has been the conscious creation of a welcoming organizational culture. As a mechanism for assessing the ROCK Society’s diversity, equity, and inclusion efforts thus far, we welcome the comments of the ROCK Society immediate past-president, Jody Lulich, PhD, DVM.

My Year as President of the ROCK Society

Two years ago, when approached by the Society to accept a nomination for the office of president, I initially said no. The Society is comprised of 80% physicians and I am a veterinarian. When I became a member of the ROCK Society in 2008, I was the only Black member. Since that time, this has changed. Today there are 3 out of 120. These are the apprehensions that I carried on my sleeve. But what I carried in my pocket was also dear to me; I am a gay man with a husband. To some, these worries would appear inconsequential. However, I not only had to think about how I would be perceived by the Society’s members, but also how this society of colleagues would make me feel about myself. Would I be heard? Would I be included? Would I be relied upon? Would I matter?

Diversity (recognizing the visible and less visible ways in which people are different with curiosity and not judgment), equity (working toward fair access and opportunity to all by removing barriers), and inclusion (encouraging participation by supporting a culture where all, individuals and groups, are comfortable to be themselves to bring their ideas and differences to the table) is an iterative, 2-way street. We need to understand that the motivation for diversity and inclusion does not always result in the desired effect, even though the metrics (eg, more women and underrepresented populations) are met. We need to recognize that our best intentions may be misunderstood on both sides without clear supported goals. We need to understand that for many of us, diversity, equity, and inclusion can be personal. I had to overcome my own apprehensions that I had little to offer, or that what I had to offer was inconsequential. Thankfully, the members of the Society felt the opposite. First, they were genuinely welcoming. Before my nomination, the Society’s executive committee was heading out for a casual premeeting dinner. Nothing official, just a time and place to share food and conversation. They not only invited me, but also encouraged me to come. I came and listened. Second, at dinner, I gathered that becoming an officer was an opportunity for the Society to grow in many ways and not just representational diversity. This is a great testament to the inclusion that the Society and its leaders chose to extend.

During my year as president (Figure), there was more work than I had originally anticipated. Presentations at our annual meetings were gradually shifting toward less basic science and less focus on the mechanistic understanding of the etiology and medical management of stone disease, likely because of a change in membership makeup. We want a diverse and inclusive membership that includes both scientists and clinicians (urologists, nephrologists, and others who manage patients with stone disease). Thus, our challenge is to drive a diverse and inclusive membership of passionate contributors while maintaining a focused mission on basic mechanisms of the etiology and management of urolithiasis. We explored ways to uncouple membership requirements that are not necessary to our mission. In addition, I wanted to change the format of the annual meeting. Change is hard because it is often viewed with skepticism instead of possibility.

Let me tell you what came about. We did not always agree, but everyone always had a voice. And we deeply listened to one another. It was not a matter of race, gender, and specialty, but a recognition of race, gender, and specialty because our strength was and became our diversity. The decisions of all were considered and discussed with opportunity and less with judgment. With difficult decisions, we decided that we could not speak for the entire membership and that it was best to let members vote. On others, the committee trusted my abilities, and after discussion and debate said, “You are the president; we trust you to a make a good decision and we will support you to make it work.” Because of this trust, my self-imposed barriers in inequity were broken, and collectively we were able to clear the path for others who are marginalized. It was heartwarming to know how much everyone cared about the Society and everyone in it.

We All Hold a Piece of the Puzzle

Our Society recognizes the need to be diverse, equitable and inclusive on many levels, not just race, gender, and specialty, but also on ideas and access for all. Our Society understands that representation alone does not always equal mission, but that representation with trust and the curiosity to listen before judgment will better support a unified goal for success and progress. Our Society vows to continue incorporating a commitment to inclusion because it maintains our strength and opens the doors to greater possibilities. We all hold a piece of the puzzle, regardless of how small it may be or what it looks like. However, without that piece, the puzzle is not complete, and neither is our mission.