SUO 2022: The Joseph A. Smith Jr. Mentorship Award Lecture

( The 2022 Society of Urologic Oncology annual meeting included the Joseph A. Smith, Jr. Mentorship Award Lecture, including a presentation by recipient Dr. Mark Litwin. Dr. Litwin started his presentation by highlighting that he is originally from South Carolina, with his family living in Charleston for 6 generations. Moving forward, he noted that while at Duke University in 1978 doing his undergraduate work, he met several influential people that helped shape his career. The first was John Feinstein, a renowned sports author, who was in several classes with Dr. Litwin and was a constant encouragement to pursue writing and journalism. The second was his close friend and urologic oncology colleague, Dr. Tom Jarrett. While at Duke, Dr. Litwin eventually became an assistant statistician for the basketball team, sitting in the Crow’s Nest of Cameron Indoor Stadium, fostering an early love for statistics that would eventually become the core of his health-services research career. Legendary Duke basketball coach Mike Krzyzewski had several common mantras and sayings, several of which Dr. Litwin included in the presentation that resonates with him:

  • People want to be on a team
  • They want to be part of something bigger than themselves
  • They want to be in a situation where they feel that they are doing something for the greater good
  • Leaders show respect for people by giving them their time

Fast forwarding 10 years to his training at The Brigham, Dr. Litwin highlighted several important individuals that influenced his career throughout residency and fellowship:

  1. Dr. M. Judah Folkman, with whom he worked in his lab for 2 years
  2. Dr. William Hsiao
  3. Dr. W. Hardy Hendren
  4. Dr. William C. DeWolf
  5. Dr. Robert H. Brook

Mentorship Award Lecture-0.jpg

During his time with Dr. Folkman, Dr. Litwin noted that he did primarily bench research, publishing a paper in Nature Medicine in 1988-1989 looking at reverse-phase chromatography. However, he realized that his love was not in the lab setting, and based on several lunches in the School of Public Health building at Harvard, he eventually joined with these colleagues in the early workings of the relative value scale (RVS) project. Thus, his first publication in the urologic literature and what would form the basis of the next several decades was “The Resource Based Relative Value Scale: Methods, Results, and Impacts on Urology”.1

One of the books that has been influential in his life was given to him by Dr. DeWolf entitled “The Courage to Fail” by Art Mortell. By that token, Dr. Litwin made the full time jump to health-services research, what he calls “quantification of qualitative phenomena”, and moved to California to work with Dr. Brook as a Robert Wood Johnson Foundation clinical scholar at UCLA. Some of his seminal work included recognizing the widespread adoption of PSA, subsequently leading to an increase in radical prostatectomy utilization, and the task of developing, validating, and deploying a patient-centered measure of health-related quality of life to assess outcomes after surgery or radiation. This was the start of the UCLA Prostate Cancer Index, which now has ~20 validated translations, has been included in more than 400 studies, trials, and cohorts (including CaPSURE), and lead to the Expanded Prostate Cancer Index Composite (EPIC). However, Dr. Litwin notes that perhaps his greatest joy as a mentor and colleague has been the numerous “related projects” that he has overseen with the following individuals, to name a few:

Mentorship Award Lecture-1.jpg

As a mentor, there are several qualities we should all strive for as highlighted by Dr. Litwin:

  • Be giving of your time
  • Guide mentees in seeking their truth and their passion
  • Care about them as a whole person
  • Teach them little lessons in addition to the big lessons
  • Let them see you sweat
  • Provide rigor, humor, and honor
  • The relationship with them never ends

Dr. Litwin also provide some additional insights that he has made into a plaque in his office:

  1. Do the right thing
  2. One week turn around for manuscript revisions
  3. Small decisions make with your head, big decisions make with your heart
  4. Better lucky than good
  5. Don’t take yourself too seriously
  6. During a Q and A session, listen to the entire question before answering
  7. A blank slate – be open to new ideas

To summarize Dr. Litwin’s three pillars of his career (clinical work, scholarship, and mentorship), he had a local artist produce the following piece, for which he has summarized as follows: “On passing glance, it appears foreign, like a collection of characters in an Asian alphabet, its components sparingly echoed in the surrounding chaos. But, if we stop and stare long enough, the word slowly emerges in a grand thematic crescendo. And at the moment of epiphany, when truth finally articulates itself, the reflective material with which the artist chose to build the letters reminds us that our journey within has just begun.”

Mentorship Award Lecture-2.jpg

Dr. Litwin concluded his presentation with two final quotes:

  • On mentorship, by Winston Churchill “We make a living by what we get, but we make a life by what we give”
  • Psychologist and Holocaust survivor, Viktor E. Frankl “Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and freedom” 

Presented by: Mark S. Litwin, MD, UCLA, Los Angeles, CA

Written by: Zachary Klaassen, MD, MSc – Urologic Oncologist, Assistant Professor of Urology, Georgia Cancer Center, Augusta University/Medical College of Georgia, @zklaassen_md on Twitter during the 23rd Annual Meeting of the Society of Urologic Oncology (SUO), Nov 30 – Dec 2, 2022. San Diego, CA


  1. Litwin MS, Sacher SJ, Cohen WS. The Resource Based Relative Value Scale: Methods, Results, and Impacts on Urology. J Urol. 1993 Sep;150(3):981-987.
email news signup