Study assesses projections for URiM representation in urology

In this video, Ashley Appleton discusses the background and key findings from the study, “The Future State of Race/Ethnicity in Urology: Urology Workforce Projection From 2021-2061,” for which she served as the lead author. Appleton is a third-year medical student at the University of California, Los Angeles.

Video Transcript:

Could you describe the background for this work?

The United States is on the brink of a demographic shift. About 44% of the population will identify with a race considered underrepresented in medicine. These races include Black/African American, LatinX/Hispanic, Native American/Alaskan Native, and Native Hawaiian/Pacific Islander. Now, with the increase of URiM identifying patients on the horizon, it will behoove us to align the urology work force with this demographic. It becomes not just a matter of representation, but also a practical necessity. There's extensive literature detailing the many benefits of diversity across various professional fields. In medicine, diversity has been linked with lower health care costs, increased patient satisfaction, and better health care outcomes. Similarly, patient and physician racial concordance has also been documented to reduce health disparities. But over the years, unfortunately, we've experienced a stagnant growth in the representation of URiM urologists. When you combine this with an impending work force shortage–there is an impending physician work force shortage across many specialties, including urology–we're at risk of widening that gap between minority providers and patients. This can translate into less access and worsening care for these populations. So, we thought it was necessary to project the growth of URiM urologists and offer some recommendations so that we can increase diversity in the field.

What were the key findings?

For our study, we looked at 2 scenarios. One, if historical trends were to continue in the rate of increase in URiM urology residents as is, or 2, if they were to be interventions implemented to deliberately increase diversity within the URiM residency population. Currently, there is an increase of URiM urology residents by 0.145% per year. If this were to continue, URiM urologists will likely make up 16% of the urology residency graduates, and 13% of practicing urologists in 2061. These percentages would constitute a continued underrepresentation of residents and urologists identifying as URiM in 2060. Then we explored a second scenario that assumes an increase in the proportion of URiM urology graduates. This is if we were to make deliberate efforts in increasing the number of URiM urology graduates per year. We found that in order to reach racial and ethnic parity in the urology residency graduates, there needs to be an increase of these graduates by 0.845% per year. This would equate to 44% of the urology residents being URiM, and 26% of URiM practicing urologists. Though this does not achieve equitable representation among the practicing urologists, it is a steppingstone in the pathway of reaching racial equity and representation in the residency cohort.

This transcription has been edited for clarity.