In honor of the 20th anniversary of the medal, Dr. Skinner was honored for her distinguished career and advancements in the field of locally advanced bladder cancer and bladder reconstruction. Notable, this year marks the first time that the award is being given to a female and in addition to her clinical achievements, Dr. Skinner was recognized as a trailblazer, creating a path for women to follow. To that end, Dr. Skinner took advantage of this platform to discuss the history of women with the field of urologic oncology and urology as a whole.
She began her lecture by highlighting several key mentors along her path to the field of urologic oncology. Specifically, she focused on the impact of Drs. Donald Skinner and Derek Raghavan, noting how they welcomed her into the field and fueled her interest in urologic oncology. A particularly pivotal point for her, however, was being introduced to SWOG. At these meetings, for the first time in her career, she was able to see strong smart women, not just participating but leading. Female representation was rare at the time, particularly within urology.
Dr. Elisabeth Pickett was the first female urologic oncologist and member of the American Board of Urology in 1962. While she laid the groundwork for women in urology it took another 40 years and 129 male fellows for a second female urologic oncologist to graduate, Dr. Machele Donat. Dr. Skinner highlighted that in the 1990’s-early 2000’s there were very few women within the space and while that is changing (Figure 1) there is still much work to be done.
Figure 1: Women in Urologic Oncology in 1990-2005 compared to Today
Currently, only 10% of urologists are women, which is the lowest degree of representation across all medical specialties. And while there are increasing numbers of women in the pipeline, with 30% of current applicants being female, evidence has shown that there is a high degree of attrition with fewer women pursuing and achieving career advancements within academic settings. Currently, only 11% of academic urologists are women with the majority as assistant professors.
Dr. Skinner acknowledged key barriers for women entering academic urology in order to provide targets for improvement. These included the lack of role models and mentors and long educational time commitments with long hours and decreased flexibility. Additionally, she exposed the realities that many surgical departments still have a culture of an ‘old boys club’ that tolerates harassment and microaggressions and, at times, goes so far as to value toughness and confidence over brains, compassion and skill.
Furthermore, biology requires that women have children during their peak career-building years and typically, childcare is still considered optional and less valued than other non-work activities. COVID-19 has further unveiled real problems for professional women with young children. She shared the results of a recent JAMA surgery article that demonstrated a 10% decrease in female authorship in papers written in April/May 2020 versus the prior year. The full effect of these small changes are often not appreciated until years into the future and often have compounded effects for one's career trajectory.
She finished her talk with a prescription for the future (figure 2), noting that most of these interventions can be used to support not just women, but also other minority groups as well. Conclusion that re-shaping our field to attract the best and brightest is vital to the future success of urology and urologic oncology.
Presented by: Eila Curlee Skinner, MD, Urologic Oncologist, Stanford University, Stanford, California
Written by: Adrien Bernstein, MD, Society of Urologic Oncology Fellow, Fox Chase Cancer Center, Fox Chase Cancer Center, Philadelphia, PA, at the 21th Annual Meeting of the Society of Urologic Oncology (SUO), December 3-5, Virtual Conference