Study Evaluates Sex Differences in Pursuing Interventional Cardiology as a Subspecialty

February 8, 2019—An investigation that 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 was published by Celina M. Yong, MD, et al in Journal of the American College of Cardiology (JACC): Cardiovascular Interventions (2019;12:219–228).

The investigation was conducted for the American College of Cardiology Women in Cardiology (ACC WIC) Leadership Council and Society for Cardiovascular Angiography and Interventions Women in Innovations.

The study demonstrated that many factors uniquely dissuade women from pursuing IC compared with men, largely related to the culture of IC as a subspecialty. The investigators concluded that the targeted resolution of these specific factors may provide the most impact in reducing sex imbalances in the field.

The investigators noted that the background of the study is that 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 and it is unclear why this maldistribution persists.

As summarized in JACC: Cardiovascular Interventions, an online survey of cardiovascular FITs was conducted under the direction of the ACC WIC Leadership Council to assess FIT perspectives regarding subspecialty choices. There were 574 respondents to the survey, of whom 33% anticipated specializing in IC.

The investigators found:

• 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 < .001)
• Men were more likely to be married (P = .005) and have children (P = .002)
• Among married FITs, male IC FITs were more likely to have spouses who do not work (P = .003)

Also in JACC: Cardiovascular Interventions, the investigators reported that 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 = .001)
• Little job flexibility (P = .02)
• Physically demanding nature of the job (P = .004)
• Radiation during childbearing (P < .001)
• “Old boys’ club” culture (P < .001)
• Lack of female role models (P < .001)
• Sex discrimination (P < .001)