Current state of inclusion and diversity in pediatric urology fellowship programs

Abstract

Increased racial/ethnic diversity of the physician workforce can improve health outcomes for marginalized populations. Currently, the pediatric urology workforce is less racially/ethnically diverse than the pediatric population it serves. We aimed to assess current recruitment efforts and barriers to recruitment of underrepresented in medicine (URM) fellows in pediatric urology fellowship programs. A 20-question REDCap survey was created and distributed to 27 pediatric urology fellowship program directors (PDs). The survey consisted of 4 sections of questions focused on PD demographics, program characteristics, recruitment efforts, and perceptions of barriers to recruitment. A total of 20 PDs responded to the survey (74%), including 3 incomplete responses. A majority of participants identified as Caucasian/white (79%), male (68%), over 40 years of age (89%), and had served as PD for 5 years or more (68%). Most PDs (70%) identified their program having 5-10 full-time pediatric urologists. Many PDs (75%, 15/20) identified their program as less diverse than the patient population served, and 53% (9/17) reported having no methods in place for diversity recruitment. Of those who reported a recruitment method, mentorship was the most common (35%, 6/17). When asked about recruitment barriers, 59% (10/17) reported that no barriers existed, while those who identified a barrier most commonly cited an overall limited applicant pool (18%, 3/17). Pediatric urology fellowship programs are less diverse than the patient populations served; while PDs value program diversity, most PDs report that there are no mechanisms in place to recruit racially/ethnically diverse trainees. To address this, we recommend active and intentional efforts to increase URM recruitment in pediatric urology. By taking an active role in existing recruitment efforts, pediatric urologists can increase their visibility, broadcast their commitment to diversity, form relationships with trainees earlier in training and increase opportunities for mentorship and early exposure to the field. Intentional recruitment efforts are needed to recruit URM trainees to pediatric urology fellowship programs and ensure the diversity of the pediatric urology workforce can better reflect patients served.