Discrimination Still Runs Rampant for Women in Cardiology

The 2015 American College of Cardiology (ACC) professional life survey—presented in a poster session today at the ACC 2016 Scientific Sessions by Sandra Lewis, MD (Northwest Cardiovascular Institute, Portland, OR)—included perspectives from 794 female and 1,227 male cardiologists.

Compared with similar surveys conducted in 1996 and 2006, women today report slightly lower—but still relatively high—rates of discrimination (71% vs 69% vs 65%). On the other hand, the rate of discrimination reported by men has remained stable at about 22% for the past two decades.

Specifically, women are more likely than men to experience discrimination related to gender (96% vs 8%) and parenting responsibilities (37% vs 8%), but less likely to experience discrimination related to race (18% vs 56%) and religion (5% vs 22%).

Lewis told TCTMD that discrimination against women is “entrenched in the culture of cardiology.” Part of it is generational, as millennials have different views on gender roles and work-life balance than older practitioners, she said. In the coming years, “some of us dinosaurs probably will fade into the dark, but we can’t perpetuate the hierarchical nastiness that sometimes happens.”

Higher Satisfaction, Less Advancement

More women who responded to the survey are satisfied today with careers in cardiology than they were in 1996 (87% vs 80%; P < 0.05), but fewer women today feel that their careers have advanced higher than their peers compared with men (23% vs 38%; P < 0.05).

Similar with what was seen in prior surveys, women are more likely than men to practice in academic centers (32% vs. 23%; P = 0.001) and noninvasive specialties (91% vs 75%; P = 0.001). Men are more likely to practice in hospital-owned models (39% vs 33%; P = 0.01) and have an interventional subspecialty (25% vs 9%; P = 0.001).

Both men and women marry and have children, but women do so at lower rates and are more likely to require outside childcare (P < 0.05 for all). Family leave policies have improved overall, with more men and women reporting some sort of policy today than in 1996.

Family life will be an important consideration for training programs to address going forward, senior author Claire Duvernoy, MD (University of Michigan Health System, Ann Arbor), told TCTMD. “The gender gap in cardiology relates more to women being scared of cardiology as a career choice, because they worry that they can’t have a family or have a life if they become cardiologists,” she said.

A new set of questions added to the 2015 survey dealt with burnout. Overall, only 20% of women and 26% of men reported no symptoms of burnout (P < 0.001), and women were more likely than men to report definite burnout (22% vs 17%; P < 0.001).

Looking at the data, first-year fellow Reyhaneh Akhavein, MD (Oregon Health and Science University, Portland), told TCTMD that she was initially disheartened, but that “it empowers you actually to know what’s going on and to ask for [change].”

Of five cardiology fellows in her program, four are female, “which is pretty unheard of,” she said, adding that training programs are becoming more female friendly. “It’s kind of discouraging, but I think that we can change the future,” Akhavein added.

• Lewis SJ. The professional life of cardiologists: insights from the third American College of Cardiology professional life survey. Presented at: American College Cardiology 2016 Scientific Sessions. April 2, 2016. Chicago, IL.

Disclosure:

• Lewis reports receiving consultant fees or honoraria from AbbVie, Amgen, Auventx, EMD Serono, Genentech, Lux, Novartis, Regeneron, Sanofi-Aventis, Sanofi-Regeneron, Santen, UCB, and XOMA.

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