Gender and racial disparities in early urology exposures during medical school

Abstract

PurposeWorkforce disparities in medicine have been well documented. Early medical school exposures have been shown to highly influence career choice. We hypothesize that gender and racial disparities exist in early medical school exposures to urology. MethodsWe surveyed urology residency applicants who interviewed at our institution from 2016-2017. Student demographics were collected in addition to forms of urology exposures (both clinical and research). Early urology exposure was defined as occurring before the 3rd year of medical school. Early exposures were compared by gender and underrepresented in medicine (UIM) racial/ethnic groups. ResultsDuring the study period, 72 interviewees were invited to participate, and 71 interviewees completed the survey (response rate=98.6%). The majority of participants were male (54, 76%). Thirteen participants (18%) met UIM criteria. Fewer female applicants discovered urology (41% v. 75%, p=0.01), first shadowed a urologist (35% v. 68%, p=0.02), first operated with a urologist (29% v. 60%, p=0.03), and began research (0% v. 49%, p<0.001) before the 3rd year of medical school compared to male applicants. Fewer UIM applicants had shadowed a urologist before 3rd year of medical school (31% v. 67%, p=0.02). We found no other statistical differences between UIM and non-UIM applicants in terms of other early urology exposures, medical school urology opportunities, or personal exposures. ConclusionsDisparities in early urology exposures, especially research exposure, exist by gender and less so among UIM applicants. Identifying these disparities may uncover systematic bias within career trajectories and provide targets for earlier interventions in medical school training.