July 19, 2021 - At the organization responsible for certifying the training and skills of US urologists, achieving and maintaining diversity, equity and inclusion is more than just a "numbers game," according to a special article in Urology Practice®, an Official Journal of the American Urological Association (AUA). The journal is published in the Lippincott portfolio by Wolters Kluwer.
In the new article, the American Board of Urology (ABU) points out that the practice of diversity and inclusion has been a cornerstone of its values for years. However, the Board acknowledges that while progress has been made, more work remains to be done. The authors included ABU Trustees Douglas A. Husmann, MD, Martha K. Terris, MD, and Cheryl T. Lee, MD, and Executive Director J. Brantley Thrasher, MD.
Building and sustaining diversity and inclusion at ABU The report focuses on informing ABU diplomates about initiatives to evaluate and strengthen diversity and representation on three Committees central to the ABU's mission: The Board of Trustees and the Written and Oral Examinations Committees. For several years it has been the ABU's standard of practice to perform a yearly GAP analysis, comparing and contrasting the membership of their committees to the characteristics of their constituents: practicing urologists within the United States, as defined by the American Urology Association's 2019 annual National Census.
The selection of new Committee members is subsequently based on both the individual's merit and an attempt to match or exceed the diversity ratios defined within the Census regarding gender, race, ethnicity, geography of practice, and subspecialty area. This year's evaluation revealed the ABU committee structure consisted of 85% men and 15% women, compared to 90% and 10% in the 2019 National Census, respectively.
Regarding race and ethnicity, proportions of Committee members compared to the National Census of practicing urologists were non-Hispanic White, 74% versus 81%; Asian, 22% versus 12%; Black/African American, 3% versus 2%; and Hispanic, 1% versus 4%. Regarding region of practice, the ABU assesses the proportion of US urologists practicing within a given section, and attempts to achieve a Committee structure that is equivalent or within 1 to 4 percentage points.
While counting and comparing gender and racial/ethnic representation is a necessary first step, establishing ratios has not been found to change societal behavior or attitudes substantially - and indeed may have significant negative unintended consequences. Dr. Husmann and coauthors outline a series of "continuous and structural processes" to promote a lasting culture of diversity and inclusion. Specific aims include:
- Educating ABU diplomates and Committee members regarding the benefits of diversity
- Educating Committee members about the concept of unconscious bias
- Performing rigorous assessments of the ABU written and oral examinations to verify the absence of implicit bias
- Stressing the need to mentor today's diverse constituency of young urologists to participate and eventually take over leading roles in state, regional and national committees - giving them the experience they will need to succeed as ABU Committee members
- Anticipating the changing demographics of the next generation of urologists - for example, whereas only 10 percent of urologists currently in practice are women, they account for 30 percent of residents in training
- Above all else, encouraging frank and open discussions regarding diversity, equity, and inclusion
About Urology Practice
An Official Journal of the American Urological Association (AUA), Urology Practice focuses on clinical trends, challenges and practice applications in the four areas of Business, Health Policy, the Specialty and Patient Care. Information that can be used in everyday practice will be provided to the urology community via peer-reviewed clinical practice articles (including best practices, reviews, clinical guidelines, select clinical trials, editorials and white papers), "research letters" (brief original studies with an important clinical message), the business of the practice of urology, urology health policy issues, urology education and training, as well as content for urology care team members.
About the American Urological Association
Founded in 1902 and headquartered near Baltimore, Maryland, the American Urological Association is a leading advocate for the specialty of urology, and has more than 23,000 members throughout the world. The AUA is a premier urologic association, providing invaluable support to the urologic community as it pursues its mission of fostering the highest standards of urologic care through education, research and the formulation of health care policy. To learn more about the AUA visit: http://www.auanet.org.
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