Author + information
- Received June 8, 2018
- Revision received September 23, 2018
- Accepted September 25, 2018
- Published online February 4, 2019.
- Celina M. Yong, MD, MBA, MSca,b,∗ (, )
- Freddy Abnousi, MD, MBA, MScb,c,
- Anne K. Rzeszut, MAd,
- Pamela S. Douglas, MDe,
- Robert A. Harrington, MDb,
- Roxana Mehran, MDf,
- Cindy Grines, MDg,
- S. Elissa Altin, MDc,
- Claire S. Duvernoy, MDh,
- for the American College of Cardiology Women in Cardiology Leadership Council (ACC WIC),
- Society for Cardiovascular Angiography and Interventions Women in Innovations (SCAI WIN)
- aVA Palo Alto Medical Center, Palo Alto, California
- bDepartment of Medicine, Stanford University and Stanford Cardiovascular Institute, Stanford, California
- cYale School of Medicine, New Haven, Connecticut
- dAmerican College of Cardiology, Washington, DC
- eDuke Clinical Research Institute and Division of Cardiology, Duke University School of Medicine, Durham, North Carolina
- fThe Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York City, New York
- gNorthwell Health, Zucker Hofstra Northwell School of Medicine, Manhasset, New York
- hVA Ann Arbor Healthcare System/University of Michigan, Division of Cardiovascular Medicine, Ann Arbor, Michigan
- ↵∗Address for correspondence:
Dr. Celina M. Yong, Department of Medicine, Division of Cardiology, Palo Alto Veterans Affairs Hospital, 3801 Miranda Avenue, 111C, Palo Alto, California 94304.
Objectives The authors sought to determine the factors that influence fellows-in-training (FITs) to pursue a career in interventional cardiology (IC) and how these differ by sex.
Background Despite increases in the proportion of women across numerous medical and surgical specialties over the last decade, IC still ranks at the bottom in terms of representation of women. It is unclear why this maldistribution persists.
Methods An online survey of cardiovascular FITs was conducted under the direction of the American College of Cardiology Women in Cardiology Leadership Council to assess FIT perspectives regarding subspecialty choices.
Results 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 to 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).
Conclusions Many factors uniquely dissuade women from pursuing IC compared with men, largely related to the culture of IC as a subspecialty. Targeted resolution of these specific factors may provide the most impact in reducing sex imbalances in the field.
This study was funded by the American College of Cardiology and the Women in Cardiology Section of the ACC. Dr. Yong is also supported by an American Heart Association Mentored Clinical & Population Research Award. Dr. Mehran has received consulting fees paid to the institution from Abbott Laboratories, CardioKinetix, and Spectranetics; has been a consultant to Boston Scientific, Cardiovascular Systems, Inc., Medscape, and Siemens Medical solutions; her spouse has been a consultant for The Medicines Company and Abiomed; has received institutional research funding from AstraZeneca, Bayer, Beth Israel Deaconess, Bristol-Myers Squibb, CSL Behring, Eli Lilly/Daiichi-Sankyo Inc., Medtronic, Novartis Pharmaceuticals, and OrbusNeich; has equity (<1%) in Claret Medical and Elixer Medical; has served on executive committees for Janssen Pharmaceuticals and Osprey Medical; and has received fees paid to the institution for serving on an advisory board for Bristol-Myers Squibb and a data safety monitoring board for Watermark Research Partners. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received June 8, 2018.
- Revision received September 23, 2018.
- Accepted September 25, 2018.
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