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R. Frank Jones Urologic Society
AUA Meeting May 5, 2013
San Diego, CA
RFJUS Members
Richard Francis Jones, MD
The First African-American Diplomate of the
American Board of Urology - 1936
Outline
• History Lane
– Milestones – African Americans in Medicine
– Howard Surgical Legacy
• A.A. Experience during urologic training
– Diversity in Medicine – Outside of Urology
– Diversity in the field of Urology
• Urologic “Pipeline” steps to insure African
Americans at the forefront of urologic
patient care
Milestones – Diversifying Medicine
• 1837 – James Smith- 1st African American to
receive the MD Degree
– University of Glasgow in Scotland
• 1847 – 40 medical schools in the U.S.A.
– David Jones Peck – 1st African American to
graduate from an American medical school
– Rush Medical School in Chicago
• 1864 – The 1st African American woman
physician graduated from New England Female
Medical College (now Boston University School
of Medicine)
HUCM - Surgical Legacy
• Howard University Surgery Residency
Program
• Early 1900s – achievement of board
certification, became one of the
program’s standards of excellence
• Five of the first African Americans to
receive board certification in a
surgical specialty were Howard
Faculty Members
African American Surgeons
Pioneers - Board Certification
• R Frank Jones MD Urology 1936
• J Richard Laurey MD
– Thoracic Surgery 1949
• Robert Gladden MD
– Orthopedic Surgery 1949
• Clarence S. Greene Sr.
– Neurological Surgery 1953
• Samuel Rosser MD
– Pediatric Surgery, 1975
Assessing the African
American Urology
Experience During Training
Tracy M. Downs MD FACS
Associate Professor
Introduction
• RFJUS – is the society of African American
Urologists in North America
• Members have diverse backgrounds of
urologic training
• Other surgical specialties have
documented the experience of
Race, Ethnicity and Gender
– Orthopaedic Surgery
– Vascular Surgery
– General Surgery
• No formal analysis for the field of Urology
Diversity – Urologic Surgery
• Primary Objective
– Evaluate the extent of diversity and perceived
barriers to multicultural training in American
urology programs
• Methods
– 25 question nonvalidated diversity
questionnaire was distributed to 112 American
Urology residency program directors
• Results
– 62 (55%) program directors responded
Vemulakonda, Sorensen and Joyner BD et al. J Urol 2008;180:668-672.
Diversity – Urologic Surgery
• Results
– 62 (55%) program directors responded
– Respondents: 92% Male, 90% > 40 y.o.
– As Faculty members
• 40% No female colleagues
• 49% No colleagues of color
• 75% No formal process to recruit faculty of
color
– Current resident training
• 36% 1 or fewer female residents
• 66% at least 1 black resident
• 42% at least 1 Hispanic resident
Vemulakonda, Sorensen and Joyner BD et al. J Urol 2008;180:668-672.
Diversity – Urologic Surgery
• Results
Vemulakonda, Sorensen and Joyner BD et al. J Urol 2008;180:668-672.
Diversity – Orthopaedic Surgery
• Primary Objective
– Diversity in the field of orthopaedics vs other
surgical and nonsurgical fields
• Variables - Race, Ethnicity and Gender
• Residents and Faculty Data
– 2007 JAMA Education Supplements
– 2007 AAMC Faculty Roster
• Residency applicants Data
– 2007 Electronic Residency Application Service
(ERAS)
Day CS et al. The Journal of Bone & Joint Surgery 2010;92(13):2328-2335
Diversity – Orthopaedic Surgery
• Primary Objective
– Diversity in the field of orthopaedics vs other
surgical and nonsurgical fields
• Variables - Race, Ethnicity and Gender
• Residents and Faculty Data
– 2007 JAMA Education Supplements
– 2007 AAMC Faculty Roster
• Residency applicants Data
– 2007 Electronic Residency Application Service
(ERAS)
Day CS et al. The Journal of Bone & Joint Surgery 2010;92(13):2328-2335
Orthopaedic Surgery
Residency Applicant Pool vs Resident Workforce
Surgical and Medical Specialties
Race/Ethnicity - Resident Workforce
Surgical and Medical Specialties
Gender - Resident Workforce
Surgical and Medical Specialties
Race/Ethnicity - Faculty Workforce
Surgical and Medical Specialties
Gender - Faculty Workforce
Diversity – Radiation Oncology
Physican Workforce
Diversity – Radiation Oncology
Physician Workforce
Radiation Oncology – Residents in Training
Race/Ethnicity and Gender 2003 - 2011
Radiation Oncology – Residents in Training
Race/Ethnicity and Gender 2003 - 2011
GU
PEDS
RadOnc
Start Medical
School
A R F
Radiation Oncology – Residents in Training
Race/Ethnicity and Gender 2003 - 2011
GU
RadOnc
PEDS
Start Medical
School
Urology Residency Applicants
ERAS 2011
• Total applicants 431
By Gender
• Male 325
• Female 106
By Race
• White 242
• Black 31
ERAS 2012
• Total applicants 507
By Gender
• Male 385
• Female 122
By Race
• White 291
• Black 39
`Number of Black Applicants by Year 2008 – 2012:
(Range : 31-39)
Assessing the African
American Urology
Experience During Training
Tracy M. Downs MD FACS
Associate Professor
African American Experience
Urologic Residency
• Electronic survey mailed to RFJUS
members
– November 2012
– Emailed to 61 RFJUS Members
– Response rate 36%
– 10 questions (Survey)
• Respondents (N = 22)
– 77% Male 23% Female
Medical Schools Attended – RFJUS
• U. Michigan (2)
• U. Pittsburgh
• Morehouse
• Temple
• UCSD (2)
• Yale
• Stanford
• Howard
• U Minnesota
• U. Kanasas
• U. Miami
• Cornell
• Albany Medical
College
• Meharry (2)
• Northwestern
• Johns Hopkins (3)
• Columbia
Urology Training Programs– RFJUS
• U. Michigan (4)
• Emory University
• Henry Ford
• UT Southwestern
• VCU (Virginia)
• SUNY Buffalo (2)
• Albert
Einstein/Montefiore
• Columbia (2)
• Harvard (BWH)
• U. Kanasas
• Medical College of
Wisconsin
• NYU
• Johns Hopkins
• UCSF
• United States Navy
• UT Houston
• Eastern Virginia
African American Experience
Urologic Residency
RESPONDENTS: 22 of 22RESPONDENTS: 22 of 22
Need to use the classic Analyze tool? Switch back
Analyze ResultsCollect ResponsesDesign Survey
Export AllExport All
0% 0
4.55% 1
22.73% 5
31.82% 7
40.91% 9
PAGE 1
Q1Q1
How many years have you been in practice
following residency or fellowship?
Answered: 22 Skipped: 0
2-5 years
5-10 years
10-20 years
> 20 years
0-2 years0-2 years
2-5 years2-5 years
5-10 years5-10 years
10-20 years10-20 years
> 20 years> 20 years
TotalTotal 2222
Q2Q2
What is your gender?
ExportChart TypeChart Type Display OptionsDisplay Options
Answer Choices Responses
ExportChart TypeChart Type Display OptionsDisplay Options
22.73% 5
77.27% 17
4.55% 1
81.82% 18
9.09% 2
0% 0
9.09% 2
FemaleFemale
MaleMale
TotalTotal 2222
Q3Q3
How would you describe your ethnic
background?
Answered: 22 Skipped: 0
0% 20% 40% 60% 80% 100%
African
African-Ameri
can
African-Carib
bean
African-Europ
ean
Other (please
specify)
AfricanAfrican
African-AmericanAfrican-American
African-CaribbeanAfrican-Caribbean
African-EuropeanAfrican-European
Other (please specify) Expand
Total Respondents:Total Respondents: 2222
Answer Choices Responses
ExportChart TypeChart Type Display OptionsDisplay Options
Answer Choices Responses
African American Experience
Urologic Residency
• Were you the first African-American to
complete your residency?
45.5% Yes
54.5% No
African American Experience
Urologic Residency
African American Experience
Urologic Residency
African American Experience
Urologic Residency
How to improve the “Urologic
Pipeline” for African
Americans
Urologic Pipeline for
African Americans
• Why?
• Who?
• Where?
• How?
Urologic Pipeline for
African Americans
• Why?
–US Demographics are changing
–Reduce Disparities in Health
Care
US Census Bureau Projections
Changes in the US Population Race/Ethnicity
2008 and 2050
Race/Ethnic Composition of Medical
School Graduates 2002 - 2012
Urologic Pipeline for
African Americans
• Who?
–Medical School Applicants
–Urologic Personality
Accepted U.S. Medical Student % by
Gender and Race
U.S. Medical Student Graduates by Gender
What Traits Make up a Good
Urologist?
Canadian Urologic Association Journal 2011;5(3):182-185
5 Dimensions of Personality were analyzed using the Validated personality inventory – NEO PI-R
Urologic “Pipeline” Considerations
• Gender Gap in undergraduate degree
students is Wider for African
Americans than Caucasian Americans
• Post baccaculaureate degrees “ Pool”
of eligible medical school applicants
– Whites Women > Men (12.8%)
– Blacks Women > Men (31.7%)
Urologic “Pipeline” Considerations
• Estimated by 2020
– 60% of Latino medical school applicants
(Females)
– 70% of African American medical school
applicants (Females)
• Recruitment strategies into Future
Urology Programs for African
Americans will need to account for
this Gender gap
Urologic Pipeline for
African Americans
• Where?
–Undergraduate Strategy
–Medical School Strategy
Undergraduate Institutions
Supplying > 200 Applicants to
US Medical Schools, 2011
Undergraduate Institutions
Supplying > 20 Black Applicants to
US Medical Schools, 2011
Undergraduate Institutions
Supplying > 50 Asian Applicants to
US Medical Schools, 2011
Undergraduate Institutions
Supplying > 140 White Applicants to
US Medical Schools, 2011
Undergraduate Institutions
> 8 Medical School Graduates
in 2011 (Black)
• Xavier Univ. 60
• Howard Univ. 32
• U. Florida 26
• Harvard 22
• Duke 20
• Stanford 20
• Spelman 18
• Univ Michigan 18
• Univ. North Carolina 18
• Yale 18
> 20 Medical School
Applicants in 2011 (Black)
• Howard 87
• Xavier 68
• U. Florida 64
• Spelman 57
• U. Miami 56
• U. Maryland 48
• Hamptom Univ 45
• U South Florida 42
• Florida State Univ. 41
• Cornell Univ. 40
Journal of Urology 2011;185(2):647-
Urologic Pipeline for
African Americans
• How?
–Identify model programs to
emmulate or create
partnerships
Urologic Pipeline for
African Americans
Current Programs to Improve
Diversity in GME
• UCSF Graduate Medical Education
Diversity Program
– Residency Diversity Committee
• MGH Multicultural Affairs Office
– Started in 1992
– Focus on residency recruitment and
pipeline development (i.e. Summer
research training program)
• Vanderbilt University SOM
– Associate Dean for Diversity
Current Programs to Improve
Diversity in Physician Workforce
• American Association of Orthopaedics
Surgeons
• American College of Surgeons
• NIH Diversity in Biomedical Research
(http://acd.od.nih.gov/dbr.htm)
• Robert Wood Johnson
• American Gastroenterological Association
– NIH R25 Grant to support minority
undergraduates and medical students
Current Programs to Improve
Diversity in Physician Workforce
• American Association of Orthopaedics
Surgeons
• American College of Surgeons
• NIH Diversity in Biomedical Research
(http://acd.od.nih.gov/dbr.htm)
• Robert Wood Johnson
• American Gastroenterological Association
– NIH R25 Grant to support minority
undergraduates and medical students
Diversity
Conclusion
• R. Frank Jones, MD and Howard
Department of Surgery have been pivotal
in the training of African American
Urologic Surgeons
• 46% of our members were the first
African American in their residency
training program
• 55% trained with other African-American
urology residents during their training
• 50% did experience racial challenges as a
resident or fellow.
R. Frank Jones Urologic Society
• Intentional undergraduate and medical
school strategies will need to be employed
to continue to attract African Americans
into the field of urology
• A Gender gap exists between no. male vs
female African American medical students
– Needs to be considered in the
recruitment of African American
Urologists
RFJUS Members
THE END
THANK YOU
R frank jones assessing the african american urology experience during training-aua 2013 san diego

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R frank jones assessing the african american urology experience during training-aua 2013 san diego

  • 1. R. Frank Jones Urologic Society AUA Meeting May 5, 2013 San Diego, CA
  • 3. Richard Francis Jones, MD The First African-American Diplomate of the American Board of Urology - 1936
  • 4. Outline • History Lane – Milestones – African Americans in Medicine – Howard Surgical Legacy • A.A. Experience during urologic training – Diversity in Medicine – Outside of Urology – Diversity in the field of Urology • Urologic “Pipeline” steps to insure African Americans at the forefront of urologic patient care
  • 5. Milestones – Diversifying Medicine • 1837 – James Smith- 1st African American to receive the MD Degree – University of Glasgow in Scotland • 1847 – 40 medical schools in the U.S.A. – David Jones Peck – 1st African American to graduate from an American medical school – Rush Medical School in Chicago • 1864 – The 1st African American woman physician graduated from New England Female Medical College (now Boston University School of Medicine)
  • 6. HUCM - Surgical Legacy • Howard University Surgery Residency Program • Early 1900s – achievement of board certification, became one of the program’s standards of excellence • Five of the first African Americans to receive board certification in a surgical specialty were Howard Faculty Members
  • 7. African American Surgeons Pioneers - Board Certification • R Frank Jones MD Urology 1936 • J Richard Laurey MD – Thoracic Surgery 1949 • Robert Gladden MD – Orthopedic Surgery 1949 • Clarence S. Greene Sr. – Neurological Surgery 1953 • Samuel Rosser MD – Pediatric Surgery, 1975
  • 8. Assessing the African American Urology Experience During Training Tracy M. Downs MD FACS Associate Professor
  • 9. Introduction • RFJUS – is the society of African American Urologists in North America • Members have diverse backgrounds of urologic training • Other surgical specialties have documented the experience of Race, Ethnicity and Gender – Orthopaedic Surgery – Vascular Surgery – General Surgery • No formal analysis for the field of Urology
  • 10. Diversity – Urologic Surgery • Primary Objective – Evaluate the extent of diversity and perceived barriers to multicultural training in American urology programs • Methods – 25 question nonvalidated diversity questionnaire was distributed to 112 American Urology residency program directors • Results – 62 (55%) program directors responded Vemulakonda, Sorensen and Joyner BD et al. J Urol 2008;180:668-672.
  • 11. Diversity – Urologic Surgery • Results – 62 (55%) program directors responded – Respondents: 92% Male, 90% > 40 y.o. – As Faculty members • 40% No female colleagues • 49% No colleagues of color • 75% No formal process to recruit faculty of color – Current resident training • 36% 1 or fewer female residents • 66% at least 1 black resident • 42% at least 1 Hispanic resident Vemulakonda, Sorensen and Joyner BD et al. J Urol 2008;180:668-672.
  • 12. Diversity – Urologic Surgery • Results Vemulakonda, Sorensen and Joyner BD et al. J Urol 2008;180:668-672.
  • 13. Diversity – Orthopaedic Surgery • Primary Objective – Diversity in the field of orthopaedics vs other surgical and nonsurgical fields • Variables - Race, Ethnicity and Gender • Residents and Faculty Data – 2007 JAMA Education Supplements – 2007 AAMC Faculty Roster • Residency applicants Data – 2007 Electronic Residency Application Service (ERAS) Day CS et al. The Journal of Bone & Joint Surgery 2010;92(13):2328-2335
  • 14. Diversity – Orthopaedic Surgery • Primary Objective – Diversity in the field of orthopaedics vs other surgical and nonsurgical fields • Variables - Race, Ethnicity and Gender • Residents and Faculty Data – 2007 JAMA Education Supplements – 2007 AAMC Faculty Roster • Residency applicants Data – 2007 Electronic Residency Application Service (ERAS) Day CS et al. The Journal of Bone & Joint Surgery 2010;92(13):2328-2335
  • 15. Orthopaedic Surgery Residency Applicant Pool vs Resident Workforce
  • 16. Surgical and Medical Specialties Race/Ethnicity - Resident Workforce
  • 17. Surgical and Medical Specialties Gender - Resident Workforce
  • 18. Surgical and Medical Specialties Race/Ethnicity - Faculty Workforce
  • 19. Surgical and Medical Specialties Gender - Faculty Workforce
  • 20. Diversity – Radiation Oncology Physican Workforce
  • 21. Diversity – Radiation Oncology Physician Workforce
  • 22. Radiation Oncology – Residents in Training Race/Ethnicity and Gender 2003 - 2011
  • 23. Radiation Oncology – Residents in Training Race/Ethnicity and Gender 2003 - 2011 GU PEDS RadOnc Start Medical School A R F
  • 24. Radiation Oncology – Residents in Training Race/Ethnicity and Gender 2003 - 2011 GU RadOnc PEDS Start Medical School
  • 25. Urology Residency Applicants ERAS 2011 • Total applicants 431 By Gender • Male 325 • Female 106 By Race • White 242 • Black 31 ERAS 2012 • Total applicants 507 By Gender • Male 385 • Female 122 By Race • White 291 • Black 39 `Number of Black Applicants by Year 2008 – 2012: (Range : 31-39)
  • 26. Assessing the African American Urology Experience During Training Tracy M. Downs MD FACS Associate Professor
  • 27. African American Experience Urologic Residency • Electronic survey mailed to RFJUS members – November 2012 – Emailed to 61 RFJUS Members – Response rate 36% – 10 questions (Survey) • Respondents (N = 22) – 77% Male 23% Female
  • 28. Medical Schools Attended – RFJUS • U. Michigan (2) • U. Pittsburgh • Morehouse • Temple • UCSD (2) • Yale • Stanford • Howard • U Minnesota • U. Kanasas • U. Miami • Cornell • Albany Medical College • Meharry (2) • Northwestern • Johns Hopkins (3) • Columbia
  • 29. Urology Training Programs– RFJUS • U. Michigan (4) • Emory University • Henry Ford • UT Southwestern • VCU (Virginia) • SUNY Buffalo (2) • Albert Einstein/Montefiore • Columbia (2) • Harvard (BWH) • U. Kanasas • Medical College of Wisconsin • NYU • Johns Hopkins • UCSF • United States Navy • UT Houston • Eastern Virginia
  • 30. African American Experience Urologic Residency RESPONDENTS: 22 of 22RESPONDENTS: 22 of 22 Need to use the classic Analyze tool? Switch back Analyze ResultsCollect ResponsesDesign Survey Export AllExport All 0% 0 4.55% 1 22.73% 5 31.82% 7 40.91% 9 PAGE 1 Q1Q1 How many years have you been in practice following residency or fellowship? Answered: 22 Skipped: 0 2-5 years 5-10 years 10-20 years > 20 years 0-2 years0-2 years 2-5 years2-5 years 5-10 years5-10 years 10-20 years10-20 years > 20 years> 20 years TotalTotal 2222 Q2Q2 What is your gender? ExportChart TypeChart Type Display OptionsDisplay Options Answer Choices Responses ExportChart TypeChart Type Display OptionsDisplay Options 22.73% 5 77.27% 17 4.55% 1 81.82% 18 9.09% 2 0% 0 9.09% 2 FemaleFemale MaleMale TotalTotal 2222 Q3Q3 How would you describe your ethnic background? Answered: 22 Skipped: 0 0% 20% 40% 60% 80% 100% African African-Ameri can African-Carib bean African-Europ ean Other (please specify) AfricanAfrican African-AmericanAfrican-American African-CaribbeanAfrican-Caribbean African-EuropeanAfrican-European Other (please specify) Expand Total Respondents:Total Respondents: 2222 Answer Choices Responses ExportChart TypeChart Type Display OptionsDisplay Options Answer Choices Responses
  • 31. African American Experience Urologic Residency • Were you the first African-American to complete your residency? 45.5% Yes 54.5% No
  • 35. How to improve the “Urologic Pipeline” for African Americans
  • 36. Urologic Pipeline for African Americans • Why? • Who? • Where? • How?
  • 37. Urologic Pipeline for African Americans • Why? –US Demographics are changing –Reduce Disparities in Health Care
  • 38. US Census Bureau Projections Changes in the US Population Race/Ethnicity 2008 and 2050
  • 39.
  • 40. Race/Ethnic Composition of Medical School Graduates 2002 - 2012
  • 41. Urologic Pipeline for African Americans • Who? –Medical School Applicants –Urologic Personality
  • 42. Accepted U.S. Medical Student % by Gender and Race
  • 43. U.S. Medical Student Graduates by Gender
  • 44. What Traits Make up a Good Urologist?
  • 45. Canadian Urologic Association Journal 2011;5(3):182-185 5 Dimensions of Personality were analyzed using the Validated personality inventory – NEO PI-R
  • 46. Urologic “Pipeline” Considerations • Gender Gap in undergraduate degree students is Wider for African Americans than Caucasian Americans • Post baccaculaureate degrees “ Pool” of eligible medical school applicants – Whites Women > Men (12.8%) – Blacks Women > Men (31.7%)
  • 47. Urologic “Pipeline” Considerations • Estimated by 2020 – 60% of Latino medical school applicants (Females) – 70% of African American medical school applicants (Females) • Recruitment strategies into Future Urology Programs for African Americans will need to account for this Gender gap
  • 48. Urologic Pipeline for African Americans • Where? –Undergraduate Strategy –Medical School Strategy
  • 49. Undergraduate Institutions Supplying > 200 Applicants to US Medical Schools, 2011
  • 50. Undergraduate Institutions Supplying > 20 Black Applicants to US Medical Schools, 2011
  • 51. Undergraduate Institutions Supplying > 50 Asian Applicants to US Medical Schools, 2011
  • 52. Undergraduate Institutions Supplying > 140 White Applicants to US Medical Schools, 2011
  • 53. Undergraduate Institutions > 8 Medical School Graduates in 2011 (Black) • Xavier Univ. 60 • Howard Univ. 32 • U. Florida 26 • Harvard 22 • Duke 20 • Stanford 20 • Spelman 18 • Univ Michigan 18 • Univ. North Carolina 18 • Yale 18 > 20 Medical School Applicants in 2011 (Black) • Howard 87 • Xavier 68 • U. Florida 64 • Spelman 57 • U. Miami 56 • U. Maryland 48 • Hamptom Univ 45 • U South Florida 42 • Florida State Univ. 41 • Cornell Univ. 40
  • 54. Journal of Urology 2011;185(2):647-
  • 55. Urologic Pipeline for African Americans • How? –Identify model programs to emmulate or create partnerships
  • 57. Current Programs to Improve Diversity in GME • UCSF Graduate Medical Education Diversity Program – Residency Diversity Committee • MGH Multicultural Affairs Office – Started in 1992 – Focus on residency recruitment and pipeline development (i.e. Summer research training program) • Vanderbilt University SOM – Associate Dean for Diversity
  • 58. Current Programs to Improve Diversity in Physician Workforce • American Association of Orthopaedics Surgeons • American College of Surgeons • NIH Diversity in Biomedical Research (http://acd.od.nih.gov/dbr.htm) • Robert Wood Johnson • American Gastroenterological Association – NIH R25 Grant to support minority undergraduates and medical students
  • 59. Current Programs to Improve Diversity in Physician Workforce • American Association of Orthopaedics Surgeons • American College of Surgeons • NIH Diversity in Biomedical Research (http://acd.od.nih.gov/dbr.htm) • Robert Wood Johnson • American Gastroenterological Association – NIH R25 Grant to support minority undergraduates and medical students
  • 61. Conclusion • R. Frank Jones, MD and Howard Department of Surgery have been pivotal in the training of African American Urologic Surgeons • 46% of our members were the first African American in their residency training program • 55% trained with other African-American urology residents during their training • 50% did experience racial challenges as a resident or fellow.
  • 62. R. Frank Jones Urologic Society • Intentional undergraduate and medical school strategies will need to be employed to continue to attract African Americans into the field of urology • A Gender gap exists between no. male vs female African American medical students – Needs to be considered in the recruitment of African American Urologists