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Based on a conventional dichotomous division, modern medicine is characterized by feminization. In Italy, according to the data released online by the CED-FNOMCeO (Data Processing Center-National Federation for the Orders of Doctors and Dentists) updated on March 2, 2021, the registered medical women are 178,062 against 218,266 male colleagues; and considering the age group under 50, 60% of them are female (92,583 women versus 61,971 men).1 (Table 1)
Table 1 Classification by age and sex of female and male Doctors in Italy, registered to FNOMCeO.
| Age range | Female Doctors | Male Doctors |
|---|---|---|
| <=24 | 3 | 1 |
| 25-29 | 15,155 | 12,005 |
| 30-34 | 20,665 | 15,557 |
| 35-39 | 20,152 | 12,074 |
| 40-44 | 18,817 | 10,666 |
| 45-49 | 17,801 | 11,668 |
| 50-54 | 13,021 | 11,427 |
| 55-59 | 17,618 | 19,751 |
| 60-64 | 22,105 | 31,710 |
| 65-69 | 21,528 | 42,708 |
| 70-74 | 7,423 | 28,933 |
| >= 75 | 3,774 | 21,726 |
| Total | 178,062 | 218,226 |
Data processed and published online by CED-FNOMCeO, updated to 2 March 2021.
Consequently, more female doctors are engaging in surgical specialties that over the centuries have been predominantly male.
Furthermore, in this background it must be considered that over the past few decades, urology has developed an independent relevance from general surgery because of a high prevalence of urological pathologies and their significant social and economic impacts.2
Currently, urologists have a multitude of practice options, ranging from general urology to several subspecialties that are defined by different regional healthcare systems.2
Andrology is a clinical and/or surgical subspecialty that deals with male health, particularly concerning on male sexual and reproductive system disorders.
In Italy, there has not been any andrological residency for many years, therefore the andrological pathologies are now diagnosed and treated mainly by specialists in urology, endocrinology and psycho-sexology.
For this reason, the Italian Andrology Society (SIA) has established a residential course called Andrology Certificate Project (PCA) for the achievement of the andrological certification dedicated to members with less than 5 years of affiliation.3
The PCA combine theoretical and relational skills for a correct management of the andrological patient in accordance with the guidelines.
From 2017 to 2021 the data provided by SIA of PCA report a total of 296 enrolled, of which 24 urologists and 3 psycho-sexologists were women (9%).
In 2021 the Italian Society of Urology (SIU) by the effort of the delegates of the Italian Residents Committee, called “Senato degli Specializzandi” developed an online epidemiological Survey, which investigated composition, attitudes, and future perspective of Urology Residents in Italy.3 The data were presented at 2021 edition of SIU National Congres, reporting a total of 698 participants, of whom 118 were women (17%).4
Although the proportion of women in uro-andrology is increasing, they remain under-represented in leadership positions, not achieving similar promotion progress, and with lower remuneration compared to men.5
Future efforts should be focus on eliminating gender inequalities by empower female urologists’ qualifications and promoting academic leadership positions, especially in the subspeciality with male prevalence as the andrological one.
Another topic that should be considered by every andrologist of the future, would ideally be a complete vision of andrology in relation to all stages of andrological development already from the pediatric age, as it could have important repercussions on the health of the adult male.
