Perceived Barriers Among Underrepresented and Historically Marginalized Medical Students Pursuing a Career in Urology

Abstract

To assess perceived barriers to pursuing urology among medical students and to determine if marginalized groups identified greater challenges to entry. The Deans of all New York medical schools were asked to disseminate a survey to their students. The survey collected demographic information to identify underrepresented minorities (URM), students of low socioeconomic background, and lesbian, gay, bisexual, transgender, queer, intersex and asexual individuals (LGBTQIA+). Students were asked to rate various survey items on a five-point likert scale to determine which factors were perceived as barriers to applying to urology residency. Student t-tests and ANOVA were used to compare mean likert ratings between groups. A total of 256 students responded to the survey from 47% of medical institutions. URM students cited lack of evident diversity within the field as a more significant barrier than counterparts (3.2 vs 2.7, p=0.025). LGBTQIA+ students perceived the lack of evident diversity within urology (3.1 vs 2.65, p=0.01), exclusivity of the field (3.73 vs 3.29, p=0.04), and fear that residency programs would have negative perceptions of them as students (3.0 vs 2.1, p<0.0001) as substantial obstacles compared to peers. Students with childhood household incomes less than $40,000 cited socioeconomic concerns as a higher barrier compared to students with household incomes greater than $40,000 (3.2 vs 2.3, p=0.001). Underrepresented and historically marginalized students perceive more significant barriers to pursuing urology than their peers. Urology training programs must continue to foster an inclusive environment to recruit prospective students from already marginalized groups.