Sex Differences in Interventional Cardiology

Study Questions:

What are the factors that influence fellows-in-training (FITs) to pursue a career in interventional cardiology (IC), and how do these differ by sex?


The American College of Cardiology Women in Cardiology Leadership Council and the investigators conducted an online survey of cardiovascular FITs to assess FIT perspectives regarding professional and personal decision elements that influence cardiology subspecialty choices. A logistic regression model with the explanatory variables entered simultaneously was used to predict IC choice.


Of 574 respondents, 33% anticipated specializing in IC. Men were more likely to choose IC than women (39% men, 17% women; odds ratio, 3.98; 95% confidence interval, 2.38-6.68; p < 0.001). Men were more likely to be married (p = 0.005) and have children (p = 0.002). Among married FITs, male IC FITs were more likely to have spouses who do not work (p = 0.003). Although men were more likely to be influenced by positive attributes to pursue IC, women were significantly more likely to be influenced negatively against pursuing the field by attributes including greater interest in another field (p = 0.001), little job flexibility (p = 0.02), physically demanding nature of job (p = 0.004), radiation during childbearing (p < 0.001), “old boys’ club” culture (p < 0.001), lack of female role models (p < 0.001), and sex discrimination (p < 0.001).


The authors concluded that many factors uniquely dissuade women from pursuing IC compared with men, largely related to the culture of IC as a subspecialty.


This survey study reports that there are significant demographic differences among current fellows who plan to pursue IC and those who do not, with male sex being the strongest predictor of IC choice. Although IC specialty decision making among men is positively influenced by numerous, women are significantly more likely than men to be influenced negatively by multiple unique factors. Furthermore, women are more interested than men in having facilitated opportunities for direct mentorship with leaders in the field, regardless of whether they pursue IC or not. Targeted resolution of the specific barriers identified may provide the most impact in reducing sex imbalances in this field and encourage more women to choose IC.

Clinical Topics: Invasive Cardiovascular Angiography and Intervention

Keywords: Angioplasty, Balloon, Coronary, Cardiology Interventions, Choice Behavior, Fellowships and Scholarships, Leadership, Marriage, Mentors, Sex Characteristics, Sexism, Spouses, Women

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