Urology, along with many other medical specialties, suffers from a lack of diversity in the provider workforce. Since 2020, the University of Michigan department of urology has hosted the Michigan Urological Academy (MUA) annually. MUA is a 2-day coaching program, now offered both in-person and virtually, with the goal of increasing exposure to urology among medical students who are underrepresented in medicine or those without a home urology residency training program. MUA relies on our faculty and trainee partners from multiple backgrounds who share their time, stories, and advice with our attendees. As the 4-year anniversary of MUA approaches, we looked back at our outcomes in increasing representation within urology and offer a blueprint for other programs.

During the first 3 years, MUA hosted 208 students from 104 medical schools. One-third of the participants lacked a urology program at their home institution. Launched during the pandemic, our program was originally entirely virtual and provided sessions on the “hidden curriculum” of the urology match, including application logistics, away rotations, interviews, and constructing a rank list. Students often feel there is a lack of transparency around the competitive urology match, and our sessions aim to demystify the process of how program directors approach application cycles. Sessions were also provided on responding to microaggressions and often featured faculty members from diverse backgrounds. Many participants have remarked on the importance of vulnerability and story sharing from faculty who are from underrepresented backgrounds, and students often use these experiences as a catalyst for inspiration and motivation to move forward with their urology journey. After ample feedback from our participants, we identified that while virtual options promote inclusivity by removing barriers to participation, such as time off and cost, they limit the development of meaningful relationships that are needed to foster mentor-mentee partnerships. One of the goals of MUA is to introduce participants to partner pathway programs that can provide longitudinal support such as UReTER (UnderRepresented Trainees Entering Residency), Urology Unbound, and LatinXUrology. In addition, we identified a clear need within the current national landscape of diversity, equity, and inclusion programs for tailored support for students without a home urology training program. As part of our continued commitment to support underrepresented in medicine students on their journey into urology, our department served as a host site for the inaugural PROSPECT Clinical Research Program.

In 2023, we launched the first in-person component of MUA. Twelve third-year medical students without a home program (Figure 1) attended an all-expenses-paid in-person MUA curriculum at the University of Michigan in Ann Arbor, Michigan. These students had the opportunity to participate in a laparoscopic skills workshop (Figure 2) and receive coaching at the peer, resident, and faculty levels to support them in their application to urology. More recently, our 2024 MUA participant class had an overall match rate of 77%, which is the same as the AUA reported match rate; however, those who do not have a home urology program continue to match at a lower percentage (73%).

Figure 1. Michigan Urological Academy, June 2023: first in-person cohort with faculty.

Figure 2. Michigan Urological Academy, June 2023: working on laparoscopic skills.

As we look ahead to 2024 and beyond, our hope is to continue to elicit feedback from our participants and provide the content they deem necessary to support them through the residency application, interview, and match process. In 2024, our goals are to refine the in-person experience for students without a home urology program and to continue to support our virtual students as the landscape of the application process changes with the introduction of signaling. MUA presents an opportunity for urology programs nationwide to implement similar coaching/enrichment strategies at their own institutions or partner with similar programs. MUA has shown that students benefit from meeting faculty from underrepresented backgrounds, receiving both in-person and virtual mentorship, and experiencing a supportive and inclusive community.