There is a need for a culture change in the cardiology workforce that aligns with preferences and perceptions of internal medicine trainees, according to a study published May 30 in JAMA Cardiology.

Members of the ACC Task Force on Diversity and Inclusion, and the ACC Women in Cardiology Section Council, surveyed 1,123 internal medicine trainees enrolled in 198 residency programs in the U.S. to determine professional development preferences and perceptions of cardiology as a career choice.

Results showed that professional development preferences included stable hours, family friendliness, female friendliness, the availability of positive role models, financial benefits, professional challenges, patient focus, and the opportunity to have a stimulating career. When asked about perceptions of cardiology, the top responses were adverse job conditions, interference with family life, and a lack of diversity.

Women and residents not choosing cardiology valued work-life balance more highly and had more negative perceptions of cardiology than men or future cardiologists, who emphasized the professional advantages available in cardiology. Professional development factors and cardiology perceptions were strongly associated with a decision to pursue or avoid a career in cardiology in both men and women.

“Unfortunately, we found that trainees perceive that the things they want most from their professional lives are often characteristics that they see as foreign to cardiology. This is sobering,” said Pamela S. Douglas, MD, MACC, lead author of the paper and chair of ACC’s Diversity and Inclusion Task Force. “To continue to attract top talent, the cardiology profession needs to address the negative perceptions of the field, including the reality underneath those perceptions. This is especially needed to attract women into our overwhelming male profession – a key consideration since about half of all residents are female.”

In a related editorial comment, Anne B. Curtis, MD, FACC, and Fatima Rodriguez, MD, FACC, explain that an organized and sustained effort by professional societies in cardiology “is necessary to draw attention to this problem.” They add that “structured programs that provide role models and mentors to medical students and residents are needed … [and] efforts to increase diversity in cardiology should focus on the excellence it creates in the workplace. Finally, both conscious and unconscious barriers to women in cardiology must be recognized and addressed.”

Regarding sex-based discrimination women face in cardiology, Roxana Mehran, MD, FACC, chair of ACC’s Interventional Section, notes in a viewpoint also published in JAMA Cardiology, that she does not “know of a single woman who has trained in cardiology and chosen interventional cardiology as her career who has not faced some level of sexual harassment or misconduct.” She explains that “Never again should anyone feel uncomfortable in the work place and intimidated into feeling inferior by the powers that be. We must find the tools to encourage talented women to become interventional cardiologists. If we do not, then nothing will change.”

In another viewpoint, Rashmee U. Shah, MD, MS, member of ACC’s Cardiovascular Disease in Women Committee, acknowledges the wage inequality that exists in cardiology and explains “over a 35-year career, the woman will earn $2.5 million less than the man.” She concludes that “We have arrived at moment when change is within arm’s reach; women and men must rally together to make the workplace fair, more productive, and better for everyone."

Keywords: Female, Career Choice, Students, Medical, Workplace, Mentors, Internship and Residency, Sexual Harassment, Work-Life Balance, Internal Medicine, Training Support, Salaries and Fringe Benefits

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