Women remain underrepresented among all cardiologists in the U.S., and a recent survey suggests some reasons behind this persistent gender gap. The survey’s creator, Sarika Desai, DO, an ACC Fellow in Training, chief cardiology fellow at the Banner Good Samaritan Medical Center / Carl T. Hayden VA Medical Center in Phoenix, Arizona and the Women in Cardiology Section liason, intends to expand this area of inquiry and explore the barriers to gender parity in the specialty.

“This is the first survey of its kind to look behind the data and ask female cardiologists about their perceptions,” according to Desai, who presented the survey results during a breakout session at ACC.14.

The last 40 years has seen a steady growth in the percentage of female physicians in the U.S., expanding from 10 percent of all physicians in 1970 to 32 percent in 2010. But the cardiology specialty in particular is notable for its dramatic imbalance in the ratio of males to females. American Board of Internal Medicine statistics show that the percentage of women in cardiology over the past several years persists in the range of 10 percent to 15 percent. The percentage of female cardiologists remains approximately 15.5 percent, a figure far lower than other specialties.¹ This remains true even while coronary heart disease is easily the leading cause of mortality among females across all ages in the U.S.²

“Every patient should be able to choose whether they want a female or male cardiologist and right now I don’t think we can offer that option,” Desai explains. Desai crafted the survey to capture some of the possible consequences of this steady trend. Survey questions were also designed to pinpoint possible reasons that women might not enter the specialty in the first place.

The survey polled 39 female cardiologists/Fellows in Arizona, who were identified through the national ACC database, the ACC Arizona Chapter member list, and internet research. Twenty of the cardiologists/Fellows contacted responded, and they represented the full range of cardiac subspecialties: just over half (55 percent) were clinical, 21 percent practiced in echocardiography, and the remaining respondents were almost evenly divided among interventional, research, electrophysiology and transplant.

Survey recipients were given six questions, many aimed at capturing a snapshot of the work/family/life-balance faced generally by cardiologists, as well as specific questions designed to solicit information from females concerning pregnancy and maternity leave. A large majority of respondents (70 percent) said that they did perceive barriers to pregnancy during their cardiology fellowships, while 10 percent perceived no barriers.

As to the question of whether the respondents experienced any barriers to maintaining “personal” or “social” relationships during their fellowships, about half answered that they did experience barriers and half of respondents said they did not. Time pressures and long hours factored into the survey answers. Delving deeper into this issue, about 45 percent of respondents described their quality of life as a cardiology fellow as “difficult,” while another 45 percent responded “average” and the remainder said quality of life was “good.”

Just under half (45 percent) of respondents reported that they experienced difficulties during their fellowship that were directly related to their gender. In the open comments portion of the survey, in which respondents were invited to elaborate in their own words, some respondents to this question stated that they experienced gender-specific harassment, sexist comments about appearance, unprofessional comments about their pregnancy, and social exclusion due to gender. However, two out of three of the respondents (68 percent) who said they did experience gender-related difficulties during fellowship went on to say that these difficulties did not affect their ability to work as a fellow.

Overall, half of the respondents said they experienced a situation in which being a female resulted in discrimination by their colleagues, and half did not. This finding in particular was striking to Desai.

“That’s a substantial percentage, where 50 percent of the women said they had been discriminated against. It’s not as simple as saying that cardiology is just a demanding lifestyle,” she said. “I don’t think lifestyle completely explains it.”

Desai next hopes to develop a national survey working with the ACC to explore reasons why women very clearly opt for medical specialties other than cardiology. She said she was encouraged by the enthusiastic feedback she received at ACC.14 to pursue this important subject.

Moving forward, she hopes that a continued spotlight on gender disparity will create a movement within the specialty to facilitate mentorship — which in turn could encourage more women to pursue cardiology in the future.

“It will be important to have a cadre of mentors. We should be mentoring females much earlier in the process, while they are still medical students,” she said. “It’s too late when they are already residents. And, if there are not a lot of female attending physicians within each respective institution, then it’s harder to find a female mentor. I have been fortunate to find amazing mentors such as Noel Bairey Merz, MD, FACC, and Sandra Lewis, MD, FACC, by attending their guest lectures and through the ACC’s Women in Cardiology Section.”

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Citations

1. Challenges Faced by Women in Cardiology, Presentation, December 2009 Michigan Women in Cardiology meeting, Claire S. Duvernoy, MD, FACC.
2. Kochanek KD, Xu JQ, Murphy SL. Deaths: final data for 2009. National Vital Statistics Reports. 2011;60(3).

Keywords: Physicians, Mentors, Parental Leave, Quality of Life, Cardiology, Pregnancy, Cardiology Magazine, ACC Publications

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