Voices from the Pipeline: Experiences of Black Medical Students Destined for Urology

Historically, physicians underrepresented in medicine (URM) perform a disproportionate amount of service related to diversity and inclusion (D&I). Without appropriate recognition, this service may hamper academic progression and promotion, and contribute to career dissatisfaction. ^, Currently, we do not fully understand how D&I service expectations and activism affect the overall bandwidth of URM students, particularly those interested in competitive fields such as urology. Racial representation among urology residents lags behind other specialties, with a significantly lower proportion of URM, as defined as the aggregate of Asian or Pacific Islander, Hispanic, Black, Native American/Alaskan and Other, trainees (Urology: 17.7%-30.8%) when compared to other fields (42.3%). It is therefore critical to understand unique competing interests experienced by URM medical students and their related impact on students’ academic trajectory. The racial justice movements of 2020 presented a significant acceleration and growth in D&I efforts at medical institutions hoping to address concerns of racism as a public health crisis and racial bias within the medical field. Many students participated in new D&I initiatives. The expanding focus on D&I activities could inadvertently negatively influence student wellness, non-D&I pursuits, and focus on academic success, potentially limiting student competitiveness as residency applicants. We sought to measure how much time Black medical students interested in urology spent on institutional service following the recent racial justice movements, and we further explore the perceived academic impact of this service.