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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. 1. R. Frank Jones Urologic Society AUA Meeting May 5, 2013 San Diego, CA
  2. 2. RFJUS Members
  3. 3. Richard Francis Jones, MD The First African-American Diplomate of the American Board of Urology - 1936
  4. 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. 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. 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. 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. 8. Assessing the African American Urology Experience During Training Tracy M. Downs MD FACS Associate Professor
  9. 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. 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. 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. 12. Diversity – Urologic Surgery • Results Vemulakonda, Sorensen and Joyner BD et al. J Urol 2008;180:668-672.
  13. 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. 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. 15. Orthopaedic Surgery Residency Applicant Pool vs Resident Workforce
  16. 16. Surgical and Medical Specialties Race/Ethnicity - Resident Workforce
  17. 17. Surgical and Medical Specialties Gender - Resident Workforce
  18. 18. Surgical and Medical Specialties Race/Ethnicity - Faculty Workforce
  19. 19. Surgical and Medical Specialties Gender - Faculty Workforce
  20. 20. Diversity – Radiation Oncology Physican Workforce
  21. 21. Diversity – Radiation Oncology Physician Workforce
  22. 22. Radiation Oncology – Residents in Training Race/Ethnicity and Gender 2003 - 2011
  23. 23. Radiation Oncology – Residents in Training Race/Ethnicity and Gender 2003 - 2011 GU PEDS RadOnc Start Medical School A R F
  24. 24. Radiation Oncology – Residents in Training Race/Ethnicity and Gender 2003 - 2011 GU RadOnc PEDS Start Medical School
  25. 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. 26. Assessing the African American Urology Experience During Training Tracy M. Downs MD FACS Associate Professor
  27. 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. 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. 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. 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. 31. African American Experience Urologic Residency • Were you the first African-American to complete your residency? 45.5% Yes 54.5% No
  32. 32. African American Experience Urologic Residency
  33. 33. African American Experience Urologic Residency
  34. 34. African American Experience Urologic Residency
  35. 35. How to improve the “Urologic Pipeline” for African Americans
  36. 36. Urologic Pipeline for African Americans • Why? • Who? • Where? • How?
  37. 37. Urologic Pipeline for African Americans • Why? –US Demographics are changing –Reduce Disparities in Health Care
  38. 38. US Census Bureau Projections Changes in the US Population Race/Ethnicity 2008 and 2050
  39. 39. Race/Ethnic Composition of Medical School Graduates 2002 - 2012
  40. 40. Urologic Pipeline for African Americans • Who? –Medical School Applicants –Urologic Personality
  41. 41. Accepted U.S. Medical Student % by Gender and Race
  42. 42. U.S. Medical Student Graduates by Gender
  43. 43. What Traits Make up a Good Urologist?
  44. 44. Canadian Urologic Association Journal 2011;5(3):182-185 5 Dimensions of Personality were analyzed using the Validated personality inventory – NEO PI-R
  45. 45. 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%)
  46. 46. 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
  47. 47. Urologic Pipeline for African Americans • Where? –Undergraduate Strategy –Medical School Strategy
  48. 48. Undergraduate Institutions Supplying > 200 Applicants to US Medical Schools, 2011
  49. 49. Undergraduate Institutions Supplying > 20 Black Applicants to US Medical Schools, 2011
  50. 50. Undergraduate Institutions Supplying > 50 Asian Applicants to US Medical Schools, 2011
  51. 51. Undergraduate Institutions Supplying > 140 White Applicants to US Medical Schools, 2011
  52. 52. 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
  53. 53. Journal of Urology 2011;185(2):647-
  54. 54. Urologic Pipeline for African Americans • How? –Identify model programs to emmulate or create partnerships
  55. 55. Urologic Pipeline for African Americans
  56. 56. 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
  57. 57. 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
  58. 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. 59. Diversity
  60. 60. 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.
  61. 61. 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
  62. 62. RFJUS Members
  63. 63. THE END THANK YOU

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