Cardiology ranks second for the greatest underrepresentation of women in Accreditation Council for Graduate Medical Education (ACGME)-accredited training programs, and there has been "little change over the past decade," according to research published Feb. 17 in Circulation.

Muhammad Shahzeb Khan, MD, et al., used data from the Association of American Medical Colleges to examine the representation of men and women in training programs for general cardiovascular disease medicine, interventional cardiology, electrophysiology, advanced heart failure/transplantation, adult congenital heart disease and pediatric cardiology. They also examined the proportion of women trainees within each cardiology specialty and subspecialty from 2017 to 2018 vs. 2007 to 2008.

Results showed that among all adult cardiology trainees from 2017 to 2018, 21.4 percent were women and 78.6 percent were men. Interventional cardiology and electrophysiology had the most skewed sex distributions of the adult cardiology subspecialties, with women making up 10.2 percent of trainees in interventional cardiology and 11.6 percent in electrophysiology. In comparison, 31.2 percent of advanced heart failure/transplantation trainees, 46.7 of adult congenital heart disease trainees and 51.9 percent of pediatric cardiology trainees were women.

The number of women trainees in adult cardiology has increased modestly in the past decade, with 15.9 percent in 2007-2008, vs. 21.4 percent in 2017-2018, but cardiology still ranks second for the greatest underrepresentation of women, preceded only by orthopedic surgery.

"This prevalent disparity within cardiology, particularly for the procedural cardiovascular subspecialties, mirrors that of surgical specialties in many ways," write the authors. "Underrepresentation of women in surgery has been attributed to several factors such as implicit biases that lead to associations of men with surgery, microaggressions that affect the climate of women in surgical specialties, concerns about lifestyle/family factors, and lack of women role models in the field."

The authors conclude that moving forward, "the professional development of women cardiologists will need to be addressed at all stages." They suggest that, "Fellowship program directors should work with ACGME to provide transparent family medical leave policies and flexible training pathways. Research funding agencies should advertise non-sex-biased funding opportunities and ensure sex equity in review committees. Scientific journals should ensure sex balance in editorial boards and unbiased review process for women authors. Scientific conferences should ensure sex representation among their invited speakers to improve visibility of women in cardiology. Professional societies should continue to publish data on sex disparities in funding, publications, leadership roles, and salary compensation and be advocates for favorable change. Fellows-in-training and early- and mid-career cardiologists can contribute toward sex equity by nurturing a supportive culture in their workplaces and diversifying their professional collaborations."

According to Toniya Singh, MBBS, FACC, chair of ACC's Women in Cardiology Section and member of ACC's Diversity and Inclusion Task Force, "It is a positive development to see that the number of women in cardiology as actually increased from 15.9 percent in 2007-2008 to 21.4 percent in 2017-2018. I think the authors bring up really important points regarding the perception of the culture in cardiology, particularly with regards to lifestyle/family factors and the lack of role models. The ACC has taken the lead in working through these issues. The mission of ACC's Women in Cardiology Section has been to create opportunities for mentoring and sponsoring women who are interested in following in cardiology as well as being a staunch advocate for women cardiologists. This paper is extremely important as it brings to light specific issues and offers excellent solutions to help move the needle in the right direction."

Keywords: Fellowships and Scholarships, Advisory Committees, Mentors, Workplace, Leadership, Education, Medical, Graduate, Accreditation, Sex Distribution, Salaries and Fringe Benefits

< Back to Listings