5. Ash AS, Carr PL, Goldstein R et al: Compensation and advancement of women in academic medicine: is there equity? Ann Intern Med 2004; 141: 205. 6. Espaillat A, Panna DK, Goede DL et al: An exploratory study on microaggressions in medical school: what are they and why should we care? Perspect Med Educ 2019; 8: 143. 7. Nunez-Smith M, Pilgrim N, Wynia M et al. Health care workplace discrimination and physician turnover. J Natl Med Assoc 2009; 101: 1274. 8. Clark R, Anderson NB, Clark VR et al: Racism as a stressor for African Americans: a biopsychosocial model. Am Psychol 1999; 54: 805. 9. Sue DW, Alsaidi S, Awad MN et al: Disarming racial microaggressions: microintervention strategies for targets, white allies, and bystanders. Am Psychol 2019; 74: 128.
10. WOMEN IN UROLOGY: UNIQUE CHALLENGES TO WOMEN IN THEIR EARLY CAREERS This section was authored by Julie Riley, MD, Assistant Professor and the Director of Endourology, and Director of Urologic Research at the University of New Mexico. While gender equality is steadily improving in the U.S., it is important to remember that women in urology are still relatively new, with the first becoming board certified in 1962. Currently, 10.3% (1,375) of practicing urologists are women – but with women accounting for a quarter of urology residents (and 21.3% of female practicing urologists under the age of 451), the number is steadily increasing. Furthermore, in the 2021 Urology Match, there was a record high match rate for women at 85%.2 And, as of 2019, women now represent a majority of medical school students.3
10.1 Practice Patterns When entering a practice, women can oftentimes be pigeon-holed into seeing the female patients – even if this isn’t necessarily the desire of the physician. While this may be a much-needed role to fill within the practice, it is important to consider that these cases can often result in non-operative conditions that could potentially lead to decreased earnings. Suggestions to help with practice patterns: • Prior to joining a practice, discuss your targeted patient population with partners and consider adding clauses to contracts to note this. • Market to your target population. • If your target population is female patients, ensure your compensation reflects the work you do given that the RVUs and operative case potential may not compare to other subspecialties. • Ensure that those who schedule for you AUAnet.org
understand your desired patient population. The front staff can have significant influence on the patients scheduled into clinic. Some schedulers, for example, may ask patients if they mind seeing a woman. While non-malicious in intent, this question can be a very subtle way in which your practice can be dramatically affected. You may need to be involved in scripting the language used by schedulers, front staff and even Advanced Practice Providers within your practice who may refer patients.
10.2 Work/Life Balance The term “Work-Life balance” is a bit of a misnomer. There is no magical, harmonious balance between work and life. There are moments when life outside your profession will become priority and others when work will. Feeling guilt for prioritizing one over the other can distract from both productivity and satisfaction. Be present in what is happening in the moment and realize it is a give and take: no one is perfect; stop feeling guilty about it. Evaluate and prioritize your time and stick to it. Suggestions include the following: • Keep a unified calendar for your work and personal life. • Determine which events are important well in advance like family commitments or work events and put them on the calendar. Calendared events could include school schedules, spouse/partner/ family schedules, celebrations/milestones such as birthdays, anniversaries, etc. • Set time limits on activities and do not do anything else (such as check email, take phone calls, etc.). When the time is up, move on to the next activity. • Ask for help when you need it. If you don’t have the support staff you need, ask for it (particularly if your male counterparts have this help). • Streamline or simplify household duties like using a house cleaning and/or laundry service if it will help. • Schedule 20 minutes periodically for yourself (really, schedule it). A happier doctor is a more productive doctor. Remember, you would never miss a day in the operating room because there “just wasn’t enough time in the day.” Another issue more prevalent for women can be the inability to say no and/or the strong desire to please those around them. It is important when you say yes to something that it is meaningful and you do what you say you will do. It is important to say yes to
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