Trends in the Racial and Ethnic Diversity in the US Urology Workforce

OBJECTIVE To examine the historical trends and factors underlying the current state of racial/ethnic represen-tation within the urology workforce at each stage of the educational pipeline. METHODS Using data from the US Census Bureau and the Association of American Medical Colleges, trends in racial/ethnic distribution for 2007-2008 to 2019-2020 were tracked in the educational pipe-line for academic urologists. This pipeline was defined as progressively diminishing cohorts, start -ing with the US population, leading to medical school application, acceptance, and graduation, through to urology residency application, matching, and graduation, and ending with urology fac-ulty appointment. A comparative cohort analysis was performed for academic year 2018-2019 for differences in racial/ethnic distribution across cohorts by binomial tests. RESULTS From 2007-2008 to 2019-2020, while the proportion of Latinx/Hispanic urology applicants increased by 0.38% per year (95% CI 0.24, 0.52), their proportion in the urology resident popula-tion remained unchanged (0.07% per year, 95% CI-0.20, 0.06) from 2011-2012 to 2019-2020. There was a decrease in the proportion of Black urology applicants (-0.13% per year, 95% CI-0.24,-0.02) and no change in the resident population (-0.03% per year, 95% CI-0.11, 0.05), despite an increase in total number of residents (n = 1043 ton = 1734) from 2009-2010 to 2019-2020. In 2018-2019, there were step-wise decreases in proportion of Black and Latinx/His-panic members represented at critical stages of the educational pipeline (P < 0.0001). CONCLUSION Attrition in URM urologists occur at key educational stages. This paper offers opportunities for the design of interventions to diversify the urology workforce. (C) 2021 Elsevier Inc.