r frank jones assessing the african american urology experience during training-aua 2013 san diego
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Dr. Tracy Downs' PresentationTRANSCRIPT
R. Frank Jones Urologic Society
AUA Meeting May 5, 2013 San Diego, CA
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 SurgeonsPioneers - 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 FACSAssociate 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 SpecialtiesRace/Ethnicity - Resident Workforce
Surgical and Medical SpecialtiesGender - Resident Workforce
Surgical and Medical SpecialtiesRace/Ethnicity - Faculty Workforce
Surgical and Medical SpecialtiesGender - 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
GUPEDS
RadOnc
Start Medical School
A R F
Radiation Oncology – Residents in Training Race/Ethnicity and Gender 2003 - 2011
GURadOnc
PEDS
Start Medical School
Urology Residency Applicants
ERAS 2011• Total applicants
431By Gender• Male
325• Female
106By Race• White
242• Black
31
ERAS 2012• Total applicants
507By Gender• Male
385• Female
122By 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 FACSAssociate 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
• Were you the first African-American to complete your residency?
45.5% Yes54.5% No
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 ProjectionsChanges 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
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 InstitutionsSupplying > 200 Applicants to
US Medical Schools, 2011
Undergraduate InstitutionsSupplying > 20 Black Applicants to
US Medical Schools, 2011
Undergraduate InstitutionsSupplying > 50 Asian Applicants to
US Medical Schools, 2011
Undergraduate InstitutionsSupplying > 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)
• Howard87
• Xavier68
• U. Florida64
• Spelman57
• U. Miami56
• U. Maryland48
• Hamptom Univ45
• U South Florida42
• 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
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
THE END
THANK YOU
