Alicia Morgans: Hi, I'm so excited to be at AUA 2022, where I have the opportunity to talk to Dr. Svetlana Avulova as well as Dr. Kristen Scarpato, both talking with me about women in urologic oncology, women in science in general. Thank you so much for being here today.

Svetlana Auvlova: Thank you for having us.

Kristen Scarpato: Thank you for having us.

Alicia Morgans: Wonderful. I want to highlight before we get started, or as we get started, that the two of you have a really special relationship too, that, Kristen, you were one of the mentors I would assume of Svetlana, and you mentioned this as we were getting started. Just any comments on that just as we start?

Kristen Scarpato: Well, I first met Svetlana actually when I was a resident and I remember it well, we sat next to each other, eating pizza, and she was a medical student, very interested in urology and Svetlana is a force to be reckoned with. And I distinctly remember meeting her and unfortunately, where I did my residency, we didn't match her, but fortunately, she ended up at Vanderbilt where I did my fellowship and stayed on faculty. And so I had the opportunity to work with her quite extensively as a resident and she continued to be a force to be reckoned with. And I was so happy to see that she chose urologic oncology.

Alicia Morgans: Absolutely.

Svetlana Auvlova: And one of the main reasons I chose it is I was lucky enough to see Kristen Scarpato as one of the first female urologic oncologists that was hired on staff at Vanderbilt, by Dr. David Penson. So I think having you as a role model was inspirational and it made me feel like, yeah, I can do it too.

Alicia Morgans: Yeah. And I think that's so important to have role models. And to that point, there have not been a large number of female urologic oncologists. There actually are relatively low number of female urologists. But when we look specifically in urologic oncology, the numbers are pretty low. And it's something that I think is important to change as we really diversify the group of people, caring for patients with urologic cancers.

Kristen Scarpato: Yeah, it's true. One of the things that has been highlighted at a couple of sessions this meeting, is that about 11% of practicing urologists are females, so it's a pretty low number and somewhere 3 or 4% of urologists who identify as urologic oncologists, are female. And so the numbers have been really quite low, unfortunately.

Svetlana Auvlova: And I think to that point, a lot of the women that are in the 3 to 4%, are actually probably within 10 years of practice, or even within five years. We have the greats of Isla Skinner and Char Lee, but really, if you can name a few more in their...

Kristen Scarpato: Elizabeth Picket was the first and she's always-

Svetlana Auvlova: Thank you.

Kristen Scarpato: She's always highlighted. And I think so much now of sort of, I don't know if you can call them mid-career, but Angie Smith, Sima Porten.

Svetlana Auvlova: Kristen Green.

Kristen Scarpato: Yep. Kirsten Green, Ann Schuffman. These are pioneer women in urologic oncology who I think-

Svetlana Auvlova: Stacy Loeb.

Kristen Scarpato: Stacy Loeb, inspire all of us.

Alicia Morgans: And you too now, too, as well. Svetlana, how do we change this? How do we support women to go into this field? I think having a diversity of perspectives is always important and there is an emphasis in the field of medicine in general, I think, on making sure that we have a diverse population, not just of our patients, but that we really make sure our workforce is also diversified. So how do we change this?

Svetlana Auvlova: Well, I think we're doing it right now, we're talking about it. And so I think awareness of it, and then I think also supporting each other, and we've been able to do that through the Society of Women in Urology, as well as through the WUO that's Women in Urologic Oncology, that's been sponsored by SUO and led by Sara Sudka and Sima Porten. So getting women together who are in this field and networking and supporting each other.

Kristen Scarpato: Yeah, absolutely. I think sponsorship and mentorship are key. And I think, you don't need to have a female mentor to succeed in urologic oncology. I think it helps to have someone who looks like you and shares sort of a common experience to go to and rely on for information about the specialty and to sort of motivate you, but a good mentor, a good sponsor, is really important, whether it's a male or a female.

Alicia Morgans: I certainly agree with that. I think some of the conversation around the lack of diversity here, has also been, in terms of gender, has also focused a little bit on manels. And I wonder if either of you have comments on that, I know that the AUA has made some effort to highlight women in urology. Sometimes those efforts are exactly what we need. Sometimes we still need to take a few more steps to continue that progress, but would love to hear your thoughts.

Kristen Scarpato: Yeah. I think we need to get away from manels. I think there are many qualified women and it takes an organization being deliberate, but it also takes the men on the manels speaking up about the lack of gender diversity. And I can think of three examples in the past month of men declining to participate in a program or on a panel or saying that a female needs to be added because they feel uncomfortable with the lack of representation, and that's huge. I feel like that's what we need.

Alicia Morgans: I would agree. We need those advocates from both genders.

Svetlana Auvlova: Yeah. And this reminds me of one of my favorite books by Elizabeth Lesser called, Cassandra Speaks, where at the end, kind of the message that she gives is its important for us women to support each other. But what is going to change the needle and change the culture are the men that are going to be supporting the female, so the heforshe in our Twitter hashtag world.

Alicia Morgans: I agree with that and thanks for bringing Twitter into it because of course, there's a lot of conversation on there and there has been over time and some of it gets a little bit intense. So I think, how do we elevate the dialogue around this? How do we keep it all on the up and up instead of devolving, where we sometimes could? How do we support that conversation, heforshe?

Kristen Scarpato: I think it's hard sometimes, and you want to offer sort of a knee-jerk reaction and reply. But I think personally, my own hesitation is that whatever you put out there, lives forever. And so you want to be mature and responsible and not engage in some of the dialogue that maybe is not productive.

Alicia Morgans: Agreed. Other thoughts? Who have heroes of yours been, Svetlana?

Svetlana Auvlova: Yeah. And this is something that we've discussed earlier, but Madeleine Albright has definitely been a hero of mine, and it's coincidental that she just passed this past month in April. And she always said that women who don't support other women have a special place in hell, so that's sort of been the mantra that I've always stood by. And one of my goals as a young urologic attending at Albany Medical Center is to support our female residents and to have them dream big, because if you don't dream big, then you don't know what you can accomplish.

Alicia Morgans: I would agree with that. What do you think, Kristen?

Kristen Scarpato: I think that was an awesome answer and a tough act to follow. And so what I will say is that one of my current day heroes actually is Svetlana. As I said, forced to be reckoned with, great surgeon, brilliant mind, excellent presenter if anyone's looking for a panel participant, but someone who really goes after what she wants and doesn't stop with no. And I think you are inspiring other women to go into your urologic oncology.

Svetlana Auvlova: Thank you.

Alicia Morgans: I agree with that. And I also feel inspired just generally by both of you. I think the energy, the passion, and the commitment to supporting the women around you. It's not always easy to keep all of that up. And sometimes, especially in academic medicine, there are forces that push you in directions where you wouldn't necessarily naturally be generous and naturally pull up others, but you both do it and you do it every day. And I encourage you to continue to do it, and I encourage other women to follow your lead. So thank you both for your expertise, your time and your dedication.

Svetlana Auvlova: Thank you.

Kristen Scarpato: Thank you.