Dr. Mehta on strategies for recruitment and retention of women in urology

In this interview, Akanksha Mehta, MD, MS, discusses strategies for recruitment and retention for female urologists, which were outlined in her recent publication, “The past, present and future of women in the Unites States urological workforce”. Mehta is an assistant professor of urology and the director of male reproductive health at Emory University School of Medicine in Atlanta, Georgia.

Video Transcript:

Recruitment into urology is a challenge. The way the current medical school curriculum exists across medical schools in the United States, many schools actually do not have a formalized introduction to the field of urology for their medical students. Students will complete 4 years of medical school, sometimes with just 1 or 2 hours dedicated to urologic education. Many students will never actually complete a clinical rotation in urology. So, it's not unusual for students to go through medical training having very little knowledge of what the field of urology encompasses. That's the first thing to change. And I think the AUA as an organization can take an instrumental role in that.

Of the folks that do find out about urology and are fortunate to be able to rotate in our departments, for them to choose urology as a career depends heavily on how they see their faculty practicing, how much they see their faculty and the trainees enjoying their field [and] their patients, and deriving satisfaction from the practices that they have. To the extent that we can offer flexibility in the breadth of urology and the type of practice patterns that as a field we support, I think that can be very helpful.

For many of our women trainees, they are going through training at a time that's also the peak years for their reproductive planning, and I think that's always a concern. We know that women surgeons are at increased risk for a diagnosis of infertility and for fertility-associated complications, even if they do not struggle with infertility. That can be daunting. It is a big ask of a trainee to have them sign up for a field that is demanding in terms of training, but also demanding in terms of non-professional commitments that they would otherwise make to their family life and their personal life. It's important for us as a field to be able to recognize that and to support our trainees, whether it's through the introduction of parental leave policies that many schools are doing [and] that the ACGME has also mandated and now that the EBU is trying to mirror, that's one thing. But to also think outside of the box, to be able to support lactation for those female trainees who may have young children at home that they're trying to breastfeed to be able to support participation at academic meetings. And AUA, again, has made great strides in this in being able to offer babysitting and child support services at the meeting. That has been a tremendous help for some of our trainees. Sometimes the the need for a flexible work schedule, or a shortened work week, or unconventional work week that allows for work on campus, as well as remote work is helpful. COVID has forced us to think about that, to some extent, so many institutions and practices have been able to implement that. That needs to be on the forefront for us as well.

And then lastly, I would say that in addition to the clinical roles that many women urologists play, many of them are also tasked with administrative roles that have little recognition associated with them. They can be a time commitment and a time sink without any benefit, either related to academic promotion or pay increases. That's something we need to be very mindful of to make sure that those administrative tasks are being assigned equally to all urologists in the practice or the department, not disproportionately to the women. On that topic, I'll also say that pay equity in terms of gender equity has been an important problem for all of medicine, and urology is no exception to that. Transparent reimbursement policies, making sure that we are informing our physicians of how they are making money compared to their peers fosters that collegial work environment where women feel that they have pay transparency and the opportunity to have pay equity. That's really important.

This transcription has been edited for clarity.