Inclusivity pendulum mirroring membership diversity: Analysis of British Association of Urological Surgeons Annual Scientific Meeting (2022–2025)

Introduction

Scientific meetings are the cornerstones for sharing latest scientific information, collaborating, and developing networks to innovate and progress. They play a critical role in shaping academic careers by providing opportunities for professional recognition, networking, and leadership development. Historically women, ethnic minorities, and international medical graduates (IMGs) have remained disproportionately underrepresented in leadership positions, academic visibility, and conference participation. Lack of female representation has been reported across various specialties and globally.^1–4 Literature on Black and minority ethnic (BAME) representation in this field is also sparse. Ensuring diverse representation among Chairs and Speakers (C&S) is essential for fostering an inclusive professional culture that allows overall development of the historically underrepresented groups.

British Association of Urological Surgeons (BAUS) is the subspecialty organization for urologists in the United Kingdom. It has taken proactive steps to embed equity, diversity, and inclusivity (EDI) principles within its governance and scientific program planning. In recent years, structured efforts have been implemented to ensure that annual scientific meeting (ASM) panels better reflect the diversity of the UK urology workforce. By comparing this data against its membership demographics, we aim, through this study looking at the C&S at the BAUS ASM from 2022 to 2025, to evaluate progress made toward addressing the differential representation and reflecting the workforce mix.

Methods

This retrospective observational study analyzed publicly available BAUS ASM final programs from 2022 to 2025. All listed C&S were identified, and demographic variables were extracted, including gender, ethnicity, and primary region of medical qualification. Gender and ethnicity data was inferred from publicly available professional profiles, institutional websites, and regulatory registers. The primary region of qualification was determined from medical registration data. Two authors independently reviewed all entries. Discrepancies were resolved by a third reviewer. General Medical Council (GMC) workforce statistics for UK-registered urologists were used as comparator data, including gender distribution and IMG status.

Descriptive statistics were used to summarize demographic representation. Trends across years were assessed using appropriate statistical tests, with significance thresholds defined prior to the analysis. Statistical analyses were conducted using a standard statistical software program.

Results

A total of 682 C&S were identified across the study period. This comprised of 187 Chairs and 495 Speakers (Table 1). Annual representation increased from 99 in 2022 to 228 in 2025, with a maximum of 232 panelists in 2024 due to comparatively increased number of sessions. This was compared against the known denominator from BAUS workforce (Figure 1(a) to (c))

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Table 1.

Four-year panelists’ demography.

Category		Male	Female	Total
Ethnicity	Caucasian	411	169	580
	Minority	616	108	724
	Total (known ethnicity)	1027	277	1304
Primary medical qualification (PMQ)	United Kingdom	802	315	1117
	Non-United Kingdom	600	85	685
	Total (known PMQ)	1402	400	1802

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Figure 1.

Representation compared with membership profile, (a) gender, (b) ethnicity and (c) primary medical qualification country.

Gender representation

Across all ASMs (N = 682), 469 (68.8%) C&S were male, and 213 (31.2%, 95% CI 27.7–34.9%) were female (Table 2). Compared with membership (81.0% male, 19.0% female), women were significantly overrepresented (χ² = 66.72, p < 0.0001, V = 0.31). No significant linear trend in female representation was observed across years.

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Table 2.

Female and male panelists’ representation 2022–2025.

Year	Male (n)	Female (n)	Total	Female %	95% CI
2022	63	36	99	36.40%	27.1–46.7%
2023	90	33	123	26.80%	19.2–35.8%
2024	156	76	232	32.80%	26.8–39.5%
2025	160	68	228	29.80%	23.9–36.5%
Total	469	213	682	31.20%	27.7–34.9%

Ethnicity

Among C&S with identifiable ethnicity (N = 682), 401 (58.8%), 281 were minority ethnicity, making up 41.2% of the overall sample (95% CI 37.5–45.0%) (Table 3). Compared with membership (44.5% Caucasian, 55.5% minority), Caucasian speakers were significantly overrepresented (χ² = 56.52, p < 0.0001, V = 0.29). Minority representation increased significantly from 34.3% (95% CI 25.4–44.4%) in 2022 to 48.7% (95% CI 42.1–55.4%) in 2025 (trend test p < 0.01).

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Table 3.

Caucasian vs ethnic minority panelists’ representation 2022–2025.

Year	Caucasian (n)	Minority (n)	Total	Minority %	95% CI
2022	65	34	99	34.30%	25.4–44.4%
2023	77	46	123	37.40%	28.9–46.8%
2024	142	90	232	38.80%	32.5–45.5%
2025	117	111	228	48.70%	42.1–55.4%
Total	401	281	682	41.20%	37.5–45.0%

IMG status

Among C&S with an identifiable qualification status (n = 594), 445 (74.9%) were UK-trained (Table 4). IMG’s accounted for 149, making up only 25.1% (95% CI 21.7–28.8%). Compared with membership (61.9% UK-trained, 38.1% IMG), IMGs were significantly underrepresented (χ² = 42.14, p < 0.0001, V = 0.27). A modest upward trend in IMG representation was observed but did not reach statistical significance (Cochrane-Armitage trend test p = 0.058).

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Table 4.

PMQ UK and PMQ non-UK panelists’ representation 2022–2025.

Year	PMQnon-UK (n)	PMQUK (n)	Total	IMG %	95% CI
2022	19	58	77	24.70%	16.3–35.0%
2023	19	87	106	17.90%	11.7–26.3%
2024	52	153	205	25.40%	19.9–31.7%
2025	59	147	206	28.70%	22.8–35.5%
Total	149	445	594	25.10%	21.7–28.8%

Discussion

This multi-year analysis provides the first formal evaluation of demographic representation among C&S at BAUS ASMs against known membership demographics. This is also the first reported ethnicity representation review in conference scientific activity, particularly in urology. The findings demonstrate some improvement in representation over time. However, significant disparities remain when benchmarked against BAUS membership data.

Gender representation showed a substantial increase in the absolute number of female C&S across the study period. ⁶ However, proportional representation fluctuated year on year, without a consistent upward trend. When aggregated across all years, women were significantly overrepresented, relative to the proportion among the BAUS membership. This reflects deliberate efforts by BAUS to increase visibility of women in academic and leadership roles. Bias in academia extends beyond conference leadership ⁷ and needs to be actively overcome for meaningful progress.

Ethnicity balance demonstrated most notable improvement. Minority representation increased steadily from 34.3% in 2022 to 48.7% in 2025, with a statistically significant positive trend. Despite this progress, Caucasian speakers remained significantly overrepresented relative to the membership denominator. This discrepancy may reflect seniority gradients within the specialty, differential academic engagement opportunities, and historical underrepresentation of minority clinicians in leadership and academic roles. ⁸ The upward trajectory, however, suggests that BAUS’s EDI strategy is beginning to shift representation toward greater equity.

IMG representation also increased in absolute terms, with a modest upward trend that approached statistical significance. However, IMGs remained significantly underrepresented relative to their proportion in the BAUS membership. This finding aligns with broader literature indicating that IMGs often face structural barriers to academic visibility, including reduced access to mentorship, fewer research opportunities, and slower progression into senior roles.^9–11 The increasing IMG participation observed in later years may reflect growing awareness of these disparities and targeted efforts to address them.

The strengths of this study include its multi-year design, independent dual-reviewer methodology, and use of membership data as a denominator for any inferential analysis. However, several limitations must be acknowledged. Demographic data for ethnicity and qualification were incomplete within the membership dataset (membership demographic data at 58% completion), necessitating the use of reduced denominators. Demographic characteristics of ASM participants were inferred from publicly available sources rather than those self-reported, introducing potential misclassification bias. Analysis in this study does not account for seniority, academic ranking/expertise, subspecialty, or prior speaking experience, all of which influence selection for conference roles and the multiple invites for a select few of the C&S. International invited speakers and non-urologists’ UK experts were included in the panelist numbers. As these speakers were not members, this may have inflated apparent disparities in IMG representation.

Conclusion

This study demonstrates measurable progress in ethnic minority and IMG representation at BAUS ASMs between 2022 and 2025, alongside substantial increases in the absolute number of women participating as C&S. However, when benchmarked against BAUS membership demographics, significant disparities remain: Caucasian and UK-trained clinicians continue to be predominant, while minority and IMG clinicians remain underrepresented. These findings highlight both the positive impact of BAUS’s EDI initiatives and the ongoing need for targeted strategies to ensure equitable academic visibility, especially among speaker roles.

The authors, over the 4-year study period, all of whom have led the selection of diverse C&S panels for the ASM, have continued to deliver an excellent scientific conference, both with state-of-the-art content and excellent speakers.

Future work should steer toward incorporating self-reported demographic data, more granular ethnic categories, and intersectional analyses. Qualitative research exploring perceived barriers to academic participation among underrepresented groups would further contextualize these quantitative findings. Longitudinal monitoring of ASM representation should continue to ensure that early gains translate into sustained equity.

This successful BAUS framework for equity and diversity serves as a blueprint for urology organizations in selecting panel members for scientific meetings.