Alicia Morgans: Hi, I'm so excited to be at AUA 2022, where I have the opportunity to speak with Dr. Sam Chang. Thank you for being here.

Sam Chang: Alicia, it is really my honor and pleasure.

Alicia Morgans: Well, it is my honor and pleasure, and I'm really excited also to talk to you about allyship and supporting women in urologic oncology and in urology in general, and I'd love to hear how you and different allies at the AUA and The Society of Women in Urology have been working to really elevate this topic.

Sam Chang: Alicia, this is a topic that for individuals who know about it, they're the ones who really don't need to know about it. It's for the huge majority of individuals, many of them men, who really don't understand the current situation, the situation in the past, and the situation in the future. So, actually thanks to the AUA and Dr. Raman and The Society of Women in Urology, the AUA helped support a course and a course was put on specifically for allyship in terms of the gender disparities in the issues that we've had. And, part of that was an evaluation of kind of what is the issues, what are the problems, and then action steps. And so, understanding that this starts early on in terms of individuals in medical school, not having mentors, not having any idea of what is going on in urology, then understanding that once women are in urology residency, still less than 10% of urology residents are women.

And if you look at the practicing workforce, it's even a lower percentage, and so the numbers are improving, but unfortunately, as women finish their residencies and they look at positions, they're paid on average almost $100,000 less per year. It takes them on average almost one and a half years longer to get promoted from assistant to associate professor. When they come to publications, they're in fact less likely to be cited, less likely to be cited as having actually noble and innovative work just because they're not getting the support, and the mechanisms aren't in place. And so, a part of this course was education regarding just that there's just a few of the examples of disparities, and then action items in terms of what individuals, like men in the workforce, who have already started these kinds of networks and connections that women have always been excluded for. So, I think it was very important to start off with the recognition, start off with their action items that can be done,, and then hopefully we can start making inroads.

Alicia Morgans: I think that's a great approach, and really, as you said, raising awareness first, and then to think about the publications, we echo the people around us. We echo our teammates, we echo our colleagues, and if women aren't in the room, are not the colleagues that we're around on a regular basis, we're not going to be echoing them as much, or citing them as much. So, what did the AUA say? How can we help with that particular problem?

Sam Chang: So, repeatedly the understanding of starting that process of recognition, so how? Well, you have the understanding of, and the AUA has made active inroads in, we're going to have more women in panels, we're going to have more women as moderators, we're going to have more women invited to speak. And then within the editorial process of The Journal of Urology, there's been a big emphasis on the assistant and the associate editors and the lead editors to actually model and mentor other women, so they can become more involved. And so, I think understanding the problem, then starting those processes, and also understanding within the SWIU, that actually at different levels mentorship can occur. And so, they actually have a group of young women urologists actually starting to mentor residents within the program, and young female urology residents are looking at medical students as well. So, they're starting processes to begin the education, but more than anything, it's actually starting to put those women in positions to succeed.

Alicia Morgans: Well, and you are in a position, and have been for years at your institution where you do elevate and support those around you. Do you have advice for others about how to put women in those positions?

Sam Chang: Well, I think men... It's a two-way street obviously. The men need to understand, men being people that are my age and multiple times as this panel has been put together, I've been deemed the senior, seasoned person on this panel, and part of it is understanding that it's been an old boys network in reality, and that's starting to change, but what we need to do as men is recognize there's an issue and problem, like I said, but then make an active stance of, okay, if we have this individual, we need another individual that is a woman.

Oh, we don't have this, we need... And, just by recognizing that and putting women in those positions, we make a difference, but a point that we really try to emphasize is that that's not enough. We need to make sure that those women have all the resources then to succeed, and I think too often early on women been put out as [inaudible], okay, we've put them in this position, but we've not given them resources to succeed, and they've been on an island. That's starting to change, and so it's a combination of recognizing, supporting, and then making sure they succeed.

Alicia Morgans: Well, I am so pleased that you are working on this topic. You are a good friend and colleague, and I know you're a such a [inaudible]-

Sam Chang: We've tried.

Alicia Morgans: We have always tried, and you have tried in particular and you're such a supporter of women in any stage of their career, and of course, you have daughters, which also means you're supporting young women even from the ground up.

Sam Chang: Absolutely, and I've been fortunate because I've learned from my mentors who've always made that, and so it's not been as big a step for me. For others, it's really a big step, and so I applaud those who are really starting to make those efforts and I think a groundswell has started, so hopefully, that'll continue.

Alicia Morgans: I hope so too, and I applaud you for your efforts and I appreciate your ongoing support with AUA and SWIU.

Sam Chang: Thanks very much, Alicia. I appreciate it.

Alicia Morgans: Thank you.

Sam Chang: Thanks.