Despite the wide variety of clinical aspects fellows in training (FITs) learn during fellowship, the nonclinical aspects such as career planning remain unclear. Exploring different career paths is an important task for FITs, and it is helpful to define career priorities. One should consider location, compensation, work-life balance, research, career growth and education. It may be challenging to achieve all career goals, but aiming to achieve most is a good start.

A study published in 2018 in JAMA focusing on medicine residents showed that female residents held more negative perceptions about the cardiology specialty, including lack of diversity and inability to achieve work-life balance,  compared to male residents, and these perceptions steered women away from choosing it as a future career¹.

To lessen this negative perception of our specialty and achieve diversity and inclusion, the ACC published a health policy statement on career flexibility in cardiology in 2022. The statement encourages transparent policies regarding individual hours and work commitments. It also suggests implementing strategies that accommodate flexibility in career choices and work hours for all cardiologists in all their career stages regardless of their gender or role.

Cardiologists choose to work part-time for different reasons; one of the biggest reasons being work-life balance. They should feel welcome to do so without any judgment or stigma attached to their decision. Regardless of gender or career level, career choice should be flexible. The statement also supports policies that ensure that cardiologists who choose to work part-time maintain candidacy for leadership opportunities and promotion. It argues that compensation for the nontraditional positions should be dictated by the same standards applied to traditional positions².

Career choice depends on individual preferences and priorities. Women in cardiology may find academic settings conductive to research and teaching, while group practices can offer support and collaboration. Solo practice provides autonomy.

In addition, according to the ACC Professional Life Survey, women cardiologists are more likely to work part-time, spend more time conducting research or teaching, and work in a medical school or university practice³. But are those the right choices for you?

Part-time vs. Full-time

Part-time cardiology practice is becoming more common as the demand for flexible work arrangements grows. It is structured in various ways such as reduced clinic days, limited on-call responsibilities or a combination of both. This model is popular for achieving better work-life balance and is especially beneficial for those managing multiple roles or responsibilities. Many health care institutions recognize the importance of accommodating diverse lifestyles and are increasingly open to part-time options for both men and women in the field. Part-time arrangements can be applied across different career models, and this enhances flexibility.

Academic vs. Non-Academic and Clinical vs. Research Tracks

Certain academic practices have developed other tracks that aim to hire fully clinical physicians with minimal academic responsibilities and often at remote locations. Hence, having an academic opportunity doesn't always mean "academic job." Cardiologists should choose carefully depending on the priorities they have. On the other hand, having lead interests in conducting research, writing grants, being primary investigator and becoming a physician scientist can be a reason to choose academic practices, as long as there is protected time to grow these interests.

Developing a certain niche can occur in academic and nonacademic practices depending on the career model. If certain niches are priorities, cardiologists should take them into account early in their career search. A focused expertise within general cardiology can lead to advancement within both the academic and nonacademic worlds.

Advancement matters: it is especially important for women to have female role models in the field. Women as program directors and in other chief positions can attract more female residents to cardiology, especially as some navigate family planning and consider pregnancy.

Although there is a perceived thought of "better work-life balance" in academic practices, this is not always true. Work-life balance can be achieved across many career settings. For example, private or hybrid corporate practices may offer more autonomy for schedule. There are hybrid practices as well that offer "academic" affiliation for a percentage of the time and leave the rest as mostly clinical. Compensation, on the other hand, may be compromised in academic career choices.

Benefits, whether it's medical insurance, loan repayment, retirement plans or college fund may also affect decision-making.

It is helpful to identify your priorities when considering different career models. Accept that getting 100% of what you want may not be possible. Lessen the expectations you have – especially for a first job out of fellowship, but at the same time, know your worth and know that you can change jobs if it doesn't work for you. Your career is what you make it, you just need to find the right setting to thrive!

Programs who implement principles like those espoused in ACC's health policy statement set an example for how the future of cardiology should be. If applied, these principles will encourage more diversity and attract more women to the field.

References:

1. Douglas PS, Rzeszut AK, Bairey Merz CN, et al. Career Preferences and Perceptions of Cardiology Among US Internal Medicine Trainees: Factors Influencing Cardiology Career Choice. JAMA Cardiol. 2018;3(8):682–691. doi:10.1001/jamacardio.2018.1279
2. Writing Committee, Walsh MN, Arrighi JA, et al. 2022 ACC Health Policy Statement on Career Flexibility in Cardiology: A Report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol. 2022;80(22):2135-2155. doi:10.1016/j.jacc.2022.08.748
3. Lewis SJ, Mehta LS, Douglas PS, et al. Changes in the professional lives of cardiologists over 2 decades. J Am Coll Cardiol. 2017;69:452–462