Urologist, cancer survivor Willie Underwood III, M.D., M.Sc., M.P.H., inaugurated as AMA president

Willie Underwood III, M.D., a urologic surgeon from Buffalo, New York, was sworn in June 9 as the 181st president of the American Medical Association (AMA), pledging to unite physicians across specialties to close gaps in access, outcomes and opportunity for patients nationwide.

Underwood, only the second urologist and third Black physician to lead the AMA, assumed the presidency at the organization's annual meeting in Chicago. In remarks that drew on his personal history — from a childhood stutter and teachers who wrote him off to a prostate cancer diagnosis 14 years ago — he called on physicians to confront both medicine's promise and its failures.

“We are living through a defining moment in American healthcare, one that demands leadership grounded both in clinical experience and in a commitment to equity,” said Dr. Underwood. “As president, I will focus on bringing physicians together to close the gaps in access, outcomes and opportunity so that every patient, in every community, receives the care they deserve. We must build a system that works, not only for some of us, but for the sum of us.”

Also at the Annual Meeting, the AMA House of Delegates elected Sandra A. Fryhofer, M.D., an Atlanta-based internist and former president of the American College of Physicians (ACP), as AMA president-elect. She will serve in that role through 2027 before assuming the AMA presidency.

A house under renovation

Underwood has more than 25 years of urologic surgery experience, including 15 years specializing in robotic urologic oncology, a minimally invasive surgical approach to treating urinary tract cancers. He framed his presidency through the metaphor of an aging home.

He described purchasing a 120-year-old house in Buffalo and discovering decisions made by previous owners, some baffling, some damaging.

“When you buy an old house, you inherit everything that comes with it,” Underwood said. “Its beauty. Its craftsmanship. Its history.

“But also, its cracks. Its weaknesses. The hidden issues behind the walls,” he said. “Whether you created those problems or not, once the house belongs to you; you own it. That is true for the House of Medicine — and our country.”

He applied the same lens to the AMA, which excluded Black physicians and other minorities from membership before the Civil War and for much of the century that followed.

"We cannot build the future of medicine honestly without acknowledging that history directly," Underwood said. "Just like an old home, when the foundation is damaged, we do not walk away from it — we come together to repair it."

From Gary, Indiana, to the podium

Underwood grew up in Gary, Indiana, where he struggled with a stutter and was told by teachers he was not college material and would be in jail by age 19. He credited a circle of family — particularly his mother, grandmother and two aunts — with setting him on a different path.

"One day, they called me into a room," he recalled. "My aunt looked me directly in the eye and said: 'Willie, we need a doctor and a lawyer in the family. Your cousin is going to be the lawyer. What does that make you?'" His cousin, he noted, did become a lawyer.

Underwood said his grandfather, a World War II veteran who ran a small business on Chicago's West Side, shaped his view of what medicine should be.

"He said, 'Be a physician for the least of these,'" Underwood told the audience. "Not only for people who look like you. But for those who need you most."

He is a graduate of Morehouse College and SUNY Upstate Medical University. He holds master's degrees from SUNY Upstate and the University of Michigan School of Public Health, and completed surgical training at the University of Connecticut Health Center. He was one of the first five urologists admitted to the Robert Wood Johnson Foundation Clinical Scholars Program, a prestigious fellowship focused on health policy and population health.

A cancer survivor's perspective

Underwood disclosed that he is a prostate cancer survivor, now 14 years past his diagnosis. He said the experience deepened his understanding of health disparities — Black men face higher rates of prostate cancer, are more likely to be diagnosed at a later stage and experience worse outcomes.

“I know what it means to hear life-altering news,” he said. “I know the fear that comes with not knowing if a treatment will work. I know what it means to place your trust in a physician during the most vulnerable moments of your life — and pray their hands, and God, will heal you. I’m not telling you what I’ve read. I’m telling you what I’ve lived.”

He recalled the days after his diagnosis, holding his young daughter in her crib and wondering whether he would live to see her grow up.

“But serious illness has a way of changing how you look at obstacles, and how you search for answers in midst of a storm,” Underwood said. “Every day that you’re able to live through it is day of grace and a chance to do something better, even remarkable, with the life you have been given.”

Structural failures, not small cracks

Underwood also sounded alarms about the state of American health care, describing conditions he said have moved well beyond isolated problems.

"The cracks in our health system are no longer small fractures hidden behind the walls — they are structural failures affecting lives every single day," he said. "Families are struggling to access basic care. Communities are losing physicians faster than they can replace them. Patients are delaying treatment until illness becomes a crisis simply because they cannot afford it. And far too many physicians are burned out by a system that demands more while giving us less."

He pushed back against what he described as growing pressure to sidestep difficult conversations about unequal care.

"When outcomes are determined more by ZIP code than diagnosis, the system is failing its promise," he said. "Ignoring cracks in the foundation does not make the house stronger. It makes collapse inevitable."

He closed by invoking former AMA President Lonnie Bristow, M.D., who became the organization's first Black president in 1995. Underwood said Bristow once pulled him aside and whispered, "I was keeping that seat warm for you."

"So now let me say this to every young physician, every resident, every medical student, and every child watching tonight and wondering whether there is a place for them in medicine and in the AMA," Underwood said. "I'm keeping this seat warm for you."

Underwood was first elected to the AMA Board of Trustees in 2019 and served as board chair from 2023 to 2024.

Fryhofer elected president-elect

In another vote at the House of Delegates, Fryhofer was elected AMA president-elect. She is a board-certified internist in Atlanta.

Fryhofer previously served as ACP president from 2000 to 2001. She was the second woman to lead the organization and, at the time, its youngest president. She has served on the AMA Board of Trustees since 2018 and currently serves as the AMA's liaison to the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices, the federal panel that makes vaccine recommendations for the nation.

"Dr. Fryhofer has been a strong advocate for internal medicine, physicians, and our patients for years," ACP President Jan K. Carney, M.D., M.P.H., said in a statement. "With her background in public health, her work in vaccine advocacy, and her tenacity in speaking truth to power, she is exactly the leader that medicine needs now."

Fryhofer was a member of the ACP's delegation to the AMA from 1999 to 2018.