Reflections of an AUA President

By: Raju Thomas, MD, FACS, FRCS | Posted on: 01 Jun 2022

It has been a privilege to serve as the AUA President, although my presidency is one of the shortest in AUA history. My tenure began with the virtual AUA Annual Meeting in Las Vegas in September 2021 and lasted through the New Orleans meeting in May 2022, a total of 8 months. Short and sweet is how I would label this time. At this milestone in my career, I have taken a moment to reflect back and feel nothing but gratitude and thankfulness. For me, 3 important entities brought me to where I am today; for them, I am forever grateful.

Family

First of all the entities is my family. Growing up in a devout Christian family in India, I was taught at an early age about the important value of education, which was embedded in my psyche by my wonderful parents and 2 brothers. The finest education through high school, college and medical school led me to where I am today.

What Brought Me to Tulane?

The second most important entity of my career is Tulane. In 1960, President Lyndon B. Johnson signed the Great Society Act and introduced the United States to Medicare, Medicaid and Social Security. Simultaneously, there was a raging war in Vietnam and we had to send significant numbers of U.S. doctors to military bases within the U.S. and overseas to Vietnam, Laos and Cambodia, thereby creating a shortage of physicians. Citizens were paying Medicare taxes, but in many areas there was inadequate medical care because of this shortage and poor planning—or no planning at all. As a result, the U.S. aggressively recruited qualified physicians from overseas, including India. I was surprised when, after my 1975 interview at the U.S. Consulate, my green card to immigrate to the U.S. was hand-delivered within 6 weeks to my home in Bombay. This efficiency eased any decision-making process that could have delayed, or nixed, my arrival in the U.S. And so my journey began. I quickly found myself in the Department of Urology at Tulane University School of Medicine. I’ve spent almost 40 years on the Tulane University Urology Faculty and 26 years as Departmental Chair.

I appreciate the opportunities that Tulane Urology gave me for research, for the AUA–National Kidney Foundation Fellowship and for mentors such as Dr. James Robertson, Dr. Ron Lewis and many others. My fellow faculty at Tulane were motivating and embracing. This support quickly guided my active participation in the Southeastern Section (SES) of the AUA, the Endourological Society and the American Association of Genitourinary Surgeons. My involvement with these organizations led to me becoming Secretary, then President, of the SES and President of the World Congress of Endourology Meeting in New Orleans in 2013. Finally, I was elected by the SES to become President of the AUA.

Back to Family

New Orleans is where I met my bride-to-be, Ginny, whose patience and understanding are tough to duplicate. Over the past 42 years we’ve made New Orleans our home, and with our 2 wonderful daughters, Laura and Christina, the fabric of Tulane and New Orleans is embroidered in our lives.

The AUA, the Third Entity

Image. Raju Thomas, AUA President, September 2021–May 2022.

The AUA, the premier global urological organization over the past 120 years, is the third pillar in my life. How Would I Describe the AUA? The AUA is an awesome organization, akin to a well-staffed battleship. Why a battleship? Because it is enhancing its members by fighting for them on 3 fronts: for education, for the best in clinical practice, and for advocacy on behalf of our patients and the urological community. This battleship has been sailing in a focused manner for the past 120 years, picking up steam along the way. The AUA has deftly navigated these urological waters by constantly updating practice guidelines and changing focus amid decreasing reimbursements as technology, medications and procedures improve the lives of patients, and as competing organizations fight for the ocean of Urology. Our AUA battleship continues its smooth sailing because of stellar leadership over the years. Although my presidency lasted a mere 8 months, the ship continues to sail smoothly despite turbulent waters and stormy headwinds at times.

What Has Been Accomplished during my Presidency?

Diversity, Equity and Inclusion (DEI) initiatives

The 14-member AUA Diversity and Inclusion (D&I) Task Force, supported by the AUA’s former President, Dr. Scott Swanson, and led by Dr. Tracy Downs and Dr. Simone Thavaseelan, was formed in December 2020. This group was charged with developing actionable recommendations for the Board of Directors by February 2022. During my tenure as President, the Board approved the following recommendations by the D&I Task Force, which are being implemented:

  • Establishing a formal, standing AUA D&I Committee to advise the Board and other AUA leadership on D&I initiatives, and help implement other Board-approved recommendations. The chair of the committee will hold the position of AUA Chief Diversity Officer and will consult regularly with the AUA Board;
  • Enhancing the AUA’s collection of voluntary demographic information;
  • Establishing a DEI award to recognize member achievements in this area;
  • Creating mentorship opportunities for underrepresented-in-medicine individuals;
  • Establishing a DEI abstract category for the AUA Annual Meeting;
  • Incorporating DEI and health disparities in AUA educational programming; and
  • Increasing diversity among researchers at every stage of the career journey.

On behalf of the entire AUA membership, I thank the D&I Task Force for their hard work and leadership. Although we have seen small victories in some areas, we still have a long way to go. For instance, we have succeeded in improving matching for female residents, thereby growing our female membership. Now we need to do the same with other underrepresented-in-medicine groups. We must improve and increase the pipeline of minority students who go to college, and motivate and mentor them to pursue the field of medicine. Once these students are in medical school, it is important that they are given ample opportunity to pursue Urology as a career.

Advancement of our publications portfolio

We selected the next Editor of The Journal of Urology®, Dr. D. Robert Siemens, who has already started several novel initiatives, including open peer review and the inclusion of Early Career Editors on the Editorial Board. The Board also approved the launch of a new Gold Open Access journal, JU Open Plus. Dr. John Davis has been appointed as the Editor of this online-only journal, which will make critical urological research open and accessible immediately after acceptance.

Notable leadership changes

Dr. Matthew Nielsen was selected as the next Chair of the AUA Science and Quality Council. After an extensive selection process, Dr. Jorge Gutierrez-Aceves was identified as the next Assistant Secretary to the AUA for the Americas, including Mexico, Central and South America, and beyond. We also chose the successor to the highly successful Dr. John Denstedt. Dr. David Penson will be our next Secretary of the AUA.

Additional key accomplishments

We are proud that despite the turbulence of the pandemic, our prudent financial management has kept us in the black.

The AUA Innovation Nexus was established to support researchers, inventors, entrepreneurs and industry enterprises in moving their early stage concepts into tangible products, as proposed by Dr. Steven Kaplan.

The AUA Institute for Leadership & Business was established. This formal institute solidifies leadership and business as areas of priority and focus for the AUA.

The Office of Education and its Chair, Dr. Jay Raman, have made tremendous strides in the urological education arena, including their work with the American Board of Urology in establishing the Continuing Urologic Certification program for our members.

The Urology Care Foundation (UCF), under the leadership of Dr. Harris Nagler, succeeded in promoting urological research, patient education and humanitarian programs. In 2021, the AUA and UCF provided more than $1.4 million in research funding. The focus of the UCF has been on DEI and the importance of research and identifying emerging young physicians/scientists. The UCF also prioritizes patient education and care by disseminating significant urological material to both patients and practicing urologists. Many patient-related materials are now available in several languages and are freely accessible to anybody worldwide at www.urologyhealth.org. Also, the SES-PRUA (Puerto Rico Urological Association)-AUA Humanitarian Endowment will launch in January 2023.

The AUA meets many needs for our membership. Patient advocacy ensures that our patients’ needs are of the utmost importance. We held the in-person AUA Summit in March 2022 in Washington, D.C., where we had representation from 37 states and 215 encounters with congressmen and senators. The issues we addressed with policymakers at the Summit were

  1. Improving diversity in clinical trials;
  2. Creating a reasonable and permanent fix for the ever-decreasing Medicare fee schedule for physicians;
  3. Addressing the shortage of specialty physicians in rural areas;
  4. Expanding telehealth services permanently for our patients; and
  5. Handling the impending serious workforce shortage.

The Urology Residency Match, a unique AUA service, had a record number of applicants in 2022, matching a record number of females. The overall acceptance at the 143 residency programs was 66%. Thus, the field of Urology continues to attract top-caliber, gifted residents.

Our stellar AUA Staff has continued to be resilient, brilliant and dedicated. They were able to switch in a matter of days from an in-person AUA2021 meeting format to a virtual one, thanks to the nimble coordination of the staff and the foresight of our Secretary, Dr. John Denstedt.

Urology continues to change quickly. Through it all, the AUA battleship continues to cruise at a breakneck pace, with our CEO Mike Sheppard at the helm, fighting for its members and for our patients by advocating for all of us. We need to keep our ship on a steady course of success.

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