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African Americans Still Underrepresented in Urology

African Americans in urology are very slowly increasing in numbers and prominence, helped by networking and mentorship and through associations for African-American physicians, according to some senior African-American urologists.

The R. Frank Jones Urological Society, a group focused on African Americans in the profession, has a presence at every American Urological Association annual meeting. There is also a urology section within the predominantly African- American National Medical Association (NMA).

“We try to get African-American residents from around the country who are in urology programs to attend the NMA annual meeting,” said W. Bedford Waters, MD, the first African-American president of the American Board of Urology, and Professor and Chief, Division of Urology, University of Tennessee Medical Center, Knoxville. “That’s a very good mentorship opportunity.”

A recent report from the Association of American Medical Colleges on African Americans in medicine, Altering the Course: Black Males in Medicine, centers on African-American men because of their small and decreasing numbers among those graduating from medical school.

In 1978, 1410 African-American men applied to medical school compared with 1337 in 2014. The number of African-American men entering medical school is also sloping downward—542 in 1979 versus 515 in 2014. In 2014, the proportion of men applying for medical school was lowest (37.8%) among African Americans than among all the other races.

The report notes the importance of having African-American role models, and, conversely, the negative effect of a lack of African-American role models. “There are so many people who talk about their medical school experience as being so incredibly isolated—not seeing themselves reflected among faculty, not seeing other students around them who look like them,” said Anne C. Beal, MD, MPH, Chief Patient Officer at Sanofi.

“While I was in college I met some good role models who suggested I consider medicine, and an African-American pediatrician played a critical role in my getting into medical school. I also had a great mentor who was an Irish-American urologist and who told me everything I needed to do to match into the competitive field of urology,” said Tracy M. Downs, MD, Associate Professor of Urology and Assistant Dean of Diversity and Multicultural Affairs, University of Wisconsin School of Medicine and Public Health, Madison.

However, Dr Downs’s experience is still not the norm in urology practice. By examining the data, he found that:

  • African Americans applying to urology programs comprise only approximately 7.5% of the overall applicant pool
  • African Americans represent only 4%-5% of urology residents, and 1%-2% of urology faculty members.

Dr Downs is trying to increase those rates for African Americans, as well as for other minorities, including Native American, Latino, Vietnamese, and Lao Hmong members.

“But it takes time—it takes 11 years of education to become an assistant professor. So if you start increasing the minority base tomorrow, the next time you’ll see someone like me will be in 11 years,” Dr Downs pointed out.

“An analogy I like to use is master-planned communities, which start with deciding how many grocery stores and restaurants will be needed based on the demographics of the people they expect or hope will eventually live there when the communities are built. In urology, we need to be just as intentional in planning where we aim to be,” he said.