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THE SOCIÉTÉ INTERNATIONALE D'UROLOGIE JOURNAL

A Global Pandemic Is Not Our  
Only Challenge in Urology
Peter Black, Editor-in-Chief  

Soc Int Urol J. 2021;2(1):5–6

Rarely has the transition from one year to the next 
been so eagerly anticipated as when we said goodbye 
(and good riddance!) to 2020 and ushered in 2021. We 
all would like a return to our “old” lives as they were in 
2019. The launch of global vaccination programs against 
the SARS-CoV-2 virus makes the light at the end of the 
tunnel clearly visible.

COVID-19, however, has not prevented us from 
addressing some important challenges in urology, 
including the issue of gender inequality, which is more 
prevalent in urology than in any other medical specialty. 
Less than 10% of urologists in the US are women, 
compared with 50% of pediatricians and obstetrician-
gynecologists[1–3]. This number has increased over time, 
and the fact that approximately one third of applicants 
to the US and Canadian urology residency matches are 
female indicates that these numbers are on the rise. The 
ultimate goal of gender equality is to develop a diverse 
urologic workforce that provides optimal patient care[4].

Since approximately one half of medical students 
are female[5], there is no question that the most 
imperative objective is to attract more talented female 
medical students into urology training programs. 
This goes beyond simply overcoming misconceptions 
about urologists dealing strictly with prostates and the 
male genitalia. Providing role models and mentorship 
for female medical students considering their career 
options is critical for enhancing female representation 
in urology. This is equally critical for inspiring young 
women in urology to seek academic and leadership 
positions.

There have been some notable achievements of 
women in urology in 2020, each of which is linked 
to an outstanding role model in the field. The most 
prestigious awards for early career urologists in the US 
(the American Urological Association Gold Cystoscope 
Award[6]) and in Europe (the European Association of 
Urology Crystal Matula Award) both went to remarkable 
women: Stacy Loeb and Derya Tilki, respectively. It 
is noteworthy that both have research and clinical 
expertise in prostate cancer, which emphasizes that 
women in urology should not be cornered into a focus 
on pediatric or female urology, as has often happened in 
the past. The gender gap in urologic oncology has been 

particularly stark, but this year two major awards of the 
Society of Urologic Oncology in the US were given to 
women who are real trailblazers in the field: the Huggins 
Medal to Eila Skinner[7], and the Young Investigator 
Award to Angela Smith[8]. These are just a handful of 
examples of women in urology being recognized for 
their outstanding achievements and contributions. 
They offer grounds for optimism that we are slowly 
overcoming some of the gender barriers.

These signs of progress in addressing the gender gap 
in urology are all from North America and to a lesser 
degree Europe. We know much less about the relative 
numbers of women in urology in the rest of the world, 
but it is likely the gender gap remains a much bigger 
issue, especially in low- and medium-income countries . 
For example, the organization Women in Surgery Africa 
reports that 7% of practicing surgeons in the College of 
Surgeons of East Central and Southern Africa region are 
women.

The SIU is a global organization with global 
representation well beyond North America and Europe. 
Racial and ethnic diversity are the very fabric of the 
organization, but addressing gender disparity remains 
a challenge. The Board of Directors of the SIU has 
recognized gender equality as a priority. Two members 
of the current Board are women, and the organization 
continues to work towards full representation.

As we build our new journal, the SIUJ, we also need 
to be particularly cognizant of female representation. A 
glance across the editorial boards of leading urological 
journals around the world would suggest that we all need 
to be much better in this regard. Are journal editorial 
boards the last bastion of the “old boys club” in urology? 
This question is posed not as a criticism of other journals, 
but as a call to action for us all to improve representation 
of women in the editorial process in urology. These are 
important leadership positions that shape our field. An 
effort to increase female representation now should lead 
to equality in the future.

The core editorial group at SIUJ has made it a priority 
to tackle the gender gap. We are not necessarily experts 
in this mission, so missteps are likely—but we intend to 
be flexible and responsive, and we welcome input from 
all stakeholders. We are faced with the added challenge 

mailto:pblack%40mail.ubc.ca%20?subject=SIUJ


6 SIUJ  •  Volume 2, Number 1  •  January 2021 SIUJ.ORG

EDITORIAL

of requiring global representation as a top priority for 
the SIUJ yet having few women in urology in many of 
the global urologic communities. This, however, can 
be viewed not as a limitation but as an opportunity. It 
allows the SIUJ to contribute to breaking down barriers. 

Ultimately, we all aim for a global urology community 
in which gender equality is a given and not something 
we need to think about and promote. For now, however, 
there is a lot of work to be done.

References
1. Medscape Physician Compensation Repor t 2015. Available at: 

ht tps:// w w w.medsc ape.com /slideshow/compensation -2 015 -
overview-6006679. Accessed December 18, 2020.

2. Ilin J, Langlois E, Jalal S, Khosa F. Gender disparity within academic 
Canadian urology. Can Urol Assoc J. 2020 Apr;14(4):106-110. doi: 
10.5489/cuaj.6117. Epub 2019 Oct 28.

3. American Urological Association. The state of urology workforce 
and practice in the United States 2017. 2018. Available at: https://
w w w.AUAnet.org/common/pdf/research/census/State-Urology-
Workforce-Practice-US.pdf. Accessed June 22, 2018.

4. Meara JG, Leather AJM, Hagander L, Alkire BC, Alonso N, Ameh 
EA, et al. Global Surgery 2030: evidence and solutions for achieving 
health, welfare, and economic development. Lancet. 2015 Aug 
8;38 6 (9 9 9 3):5 69 - 624. PMID: 259 24 8 3 4 DOI: 10.1016/S014 0 -
6736(15)60160-X. Epub 2015 Apr 26.

5. Association of American Medical Colleges. More women than 
men are enrolled in medical school. ht tps://w w w.aamc.org /
news-insights/more-women-men-are-enrolled-medical-school

6. The American Urological Association Gold Cystoscope Award. 2021 
Award Winners. Available at: https://www.auanet.org/about-us/
aua-governance/awards/award-winners. Accessed December 18, 
2020.

7. Society of Urologic Oncology Inc. The Huggins Medal. Available 
at: ht tps://suonet.org/awards/ huggins-medal.aspx. Accessed 
December 18, 2020.

8. Society of Urologic Oncology Inc. The Young Investigator Award. 
Available at: https://suonet.org/awards/young-investigator-award.
aspx. Accessed December 18, 2020.

9. Xepoleas MD, Munabi NCO, Auslander A, Magee WP, Yao CA. The 
experiences of female surgeons around the world: a scoping review. 
Review Hum Resour Health. 2020 Oct 28;18(1):80. doi: 10.1186/
s12960-020-00526-3. PMID: 33115509 PMCID: PMC7594298 DOI: 
10.1186/s12960-020-00526-3




