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DIVERSITY Mentorship and Progress

By: Lorie Fleck, MD, FACS, University of South Alabama, Mobile | Posted on: 17 Jul 2024

It is a tremendous honor to have been elected as the first female president of the Southeastern Section of the AUA (SESAUA). I am filled with both a sense of gratitude and of responsibility. You may wonder, how did I get here? And is this presidency only the culmination of a journey, or can it be a beginning for continued progress?

I started medical school in 1985, and as of that year, there were only 22 female urologists in the United States and only 50 in the world.1 This was the face of urology when I began my journey.

Mentoring plays a vital role in empowering women in traditionally male-dominated fields. Having access to female mentors who have faced similar challenges can offer invaluable insights, wisdom, and practical advice. In the past, female mentors have not always been available due to the small numbers of women in medicine, especially surgical fields. Women can face unique challenges in the medical field, such as work-life balance and gender disparities. A recent JAMA article titled “Good Enough” highlights individual struggles with balance. “Being a woman in medicine will continue to be challenging until we shift our expectations of ourselves and each other. . . . We cannot be everyone’s everything all the time.”2

Research has shown that women choose surgery when they have both female and male role models.3 I have had the privilege to work with great mentors who, to me, are giants in the fields of general surgery and urology. I have learned that a mentor does not have to be the same gender or have the same background as I do to be exactly the right kind of mentor at that time in my career. In the face of negativity and discouraging comments by some, my mentors have encouraged me to believe in myself and my abilities.

When I became interested in general surgery, there were no female general surgery attendings at the Medical College of Georgia to serve as mentors. However, when the male general surgery attendings noted my interest in surgery, they encouraged me to pursue surgery as a career despite the small number of female surgeons. In 1980, women made up only 2% of all female surgical residents in the United States, including obstetrics and gynecology residents. When my interest in surgery narrowed to the field of urology, Dr Roy Witherington, chair of urology, took an interest in my career (Figure 1). There had never been a female urology resident at the Medical College of Georgia since its urology department was founded in 1943. The paucity of women urologists nationwide meant there were very few female mentors. During my residency, I was treated the same as the other residents. The friendship and camaraderie that grew throughout residency was nourished by equality of treatment.

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Figure 1. Dr Roy Witherington.

Upon completion of residency, I was encouraged by the late Dr William Cooner at Emory to interview with the group he had founded in Mobile, Alabama (Figure 2). Dr Cooner and I met on several occasions to talk about my career, and I knew that he believed I could be a good urologist. That encouragement and faith gave me the confidence to pursue a position in this private practice group. The late Dr William J. Terry, a partner in this group, was also a powerful mentor and sparked my interest in advocacy (Figure 3). As I watched his participation in organized medicine and health policy, I decided to become more involved in the SESAUA. I began on the Health Policy Committee and then was elected to the Executive Committee as the member at large. Following 3 years in that position, I became treasurer for 3 years. This time on the Executive Committee allowed me to become familiar with the nuances of guiding and managing an AUA section.

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Figure 2. Dr William Hollis Cooner.

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Figure 3. Dr William Jefferson Terry. Reprinted with permission of the Alabama Healthcare Hall of Fame (healthcarehof.org).

I have witnessed the increase in diversity of urologists over the last 35 years. This diversity has expanded opportunities for mentorship with urologists with varying personalities and backgrounds. My earliest mentors were all strong men who encouraged and supported women in surgery and urology. More recently, I have had an inspiring group of women urology mentors. The formation and growth of the Society of Women in Urology has helped improve access to female urology mentors. I am proud to be a member of this group founded in 1980, that now has about 900 members.

In my current position as program director for the urology residency at the University of South Alabama, I can now mentor students and residents and pass along wisdom that was given to me by all the supportive and inspiring mentors I have had. Throughout all of this, the support and encouragement of my family was essential. I have not been successful at everything, and I still struggle to manage work and home life balance. We are inherently overachievers, and we want to take care of those around us, but we cannot forget to take care of ourselves. Well-being is essential to a joy-filled life, and this requires that we strive for the balance we need for our own selves and our families.

During my tenure as President of SESAUA, I want to continue the SESAUA mission of increasing the participation of residents and young urologists in our section so they can learn the inner workings of a large urology organization and contribute their innovative ideas. I want to make sure that we involve a diverse population so we can provide inclusive and compassionate representation. As the diversity in urology grows, the opportunity for improved mentorship increases exponentially. I hope that throughout this year I will be able to inspire others to reach out and serve as a positive force for growth and mentorship.

  1. Gillespie L, Cosgrove M, Fourcroy J, Calmes S. Women in urology: a splash in the pan. Urology. 1985;25(1):93-97. doi:10.1016/0090-4295(85)90580-1
  2. Rissman L. Good enough. JAMA. 2024;331(17):1447. doi:10.1001/jama.2024.2937
  3. Wirtzfeld DA. The history of women in surgery. Can J Surg. 2009;52(4):317-320.

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