A Sincere Thank You: Brian Keith McNeil

I recall the day that I was notified that I would be the recipient of the 2024 AUA Diversity, Equity, and Inclusion (DEI) Award. I was honored, grateful, smiled, and immediately thought of a conversation over dinner with my soon-to-be chair, Dr Jeffrey Weiss, while I was still a urologic oncology fellow at the Memorial Sloan Kettering Cancer Center. We spoke about life and what Brooklyn represented to us both. I shared stories of my youth in Philadelphia and how I lost my father to prostate cancer near the beginning of my senior year of high school. I decided to join him on his journey to shape the SUNY (State University of New York) Downstate urology residency into one that represented the community it served. For these and other reasons, he was the first person that I shared the news of the award with. While the AUA recognizes one individual, I believe that this award reflects the efforts of our entire department. I would like to extend a sincere thank you to all affiliated with our beloved organization for this honor.

My Journey as a Chair: Jeffrey P. Weiss

Upon being appointed chair of the Department of Urology at SUNY Downstate in 2010, it was evident that we needed to strengthen our faculty in terms of dedication to education and clinical practice. When a trusted chief resident returned from his rotation at Memorial Sloan Kettering Cancer Center and recommended we recruit their oncology fellow, Dr Brian McNeil, I followed his advice and learned that Dr McNeil and I shared a vision for Downstate Urology’s future. Dr McNeil was anxious to work in an academic milieu delivering care to a population of underserved citizens much as the one in which he spent his formative years. The result was a long-lasting career as a surgical educator for Dr McNeil and the kernel of a new program dedicated to patient care and recruitment of the best and brightest of a diverse group of learners.

Why Diversity Is Important to Me: Jeffrey P. Weiss

Despite being a native New Yorker, much of my practice in the first 2 decades following residency served a rather homogeneous community, which, while extremely needy, was distinctly nondiverse. That seemed unreasonable and unrealistic to me as a person reared in Brooklyn and having attended high school in Manhattan. My return to Brooklyn as a full professor was a relief in many ways, especially due to the daily exposure to patients from manifold backgrounds. However, the institution did not necessarily reflect the diversity of the community that we served. It was evident that if we were to recruit top candidates of divergent backgrounds into our residency program, it would be advantageous to have a diverse faculty to serve as mentors and role models, not to mention the incalculable benefit that results from patients interacting with their caregivers of similar backgrounds. And if we don’t promote diversity among our faculty and learners, who will? This philosophy has proven to be a formula for success in having established the most diverse residency program in the US, a superb program indeed.

Diversity’s Growing Pains: Brian Keith McNeil

How does one define diversity? This is a question I asked other leaders in health care, media, education, law, and business when I became an attending urologist on Clarkson Avenue in Brooklyn. Everyone had a different definition highlighting varying aspects of race, ethnicity, culture, religion, sexual orientation, socioeconomic background, and thought. This led to several difficult discussions among stakeholders of the department about our core mission and values. We found common ground in our desire to train residents who would be able to function well in any clinical setting. Because our community here in Brooklyn is so unique and varied, our definition of diversity needed to be encompassing and inclusive. One cannot have true diversity without inclusivity.

I have had several personal challenges over the course of my career thus far, which have shifted the way that I approach DEI. The AUA has provided several opportunities for me to spend time with our urology colleagues in various regions of the world. My approach to DEI has been shaped by my experiences in Brazil, Argentina, Colombia, Egypt, Oman, Ghana, Israel, Poland, South Africa, Italy, Jordan, the United Kingdom, and India. These adventures provided an opportunity for physicians in these nations and I to “get to know the best of one another.” This refined my approach to diversity and the delivery of care in medically underserved communities, a dilemma international in scope, which we must “think globally and act locally” to address. My selection as a Presidential Leadership Scholar in 2023 provided the opportunity for me to develop “Urology 2025,” a multitiered strategy to help urologists minimize health care disparities.

The Attack on DEI in 2024

George Floyd’s untimely death in 2020 and the ensuing protests led many to embrace DEI efforts in various sectors. However, there has been a backlash against DEI efforts propelled by the US Supreme Court’s June 2023 decision to eliminate the use of affirmative action in college admissions. In some states, many offices or initiatives in academia with DEI in the title were required to shut down and efforts to enrich variety and promote equity were eliminated. Some celebrated the Supreme Court decision, while others viewed it as yet another strike against the pursuit of true equity. DEI has become an evil word and will certainly be debated more as election day approaches. One misunderstanding that some have is that DEI aims to “lower the bar” for admission and promote unqualified women and underrepresented minorities to positions of prominence in medicine and other industries. We strongly disagree.

How Do We Move Forward?

Understanding that so many view the US as a land of opportunity, we remain grateful to be citizens of the third most populous country, with over 330 million people to care for. DEI remains as important today as ever and a wide global approach to inclusiveness is needed to achieve equity.