Increasing Diversity in Cardiology: A Fellowship Director’s Perspective

Abstract

BackgroundUnderrepresented-minorities (URM) remain few in number amongst practicing cardiologists and across cardiology fellowship training programs in the U.S. Increased diversity is needed across the entire field and is particularly necessary within graduate medical education cardiology fellowship training programs. ObjectivesThis cross-sectional study was performed to identify which strategies were supported and implemented by cardiology fellowship program directors (PDs) to increase URM representation, to determine which entities hold the responsibility to increase diversity according to program directors, and to quantify URM representation in cardiology fellowship programs. MethodsA 15-item survey was submitted to all American College of Graduate Medical Education (ACGME) accredited cardiology fellowship programs via electronic mail. ResultsOf 250 cardiology fellowship programs, 71 responses were received (28.4%). The number of URM faculty varied from 0-1 to more than six, and URM faculty held leadership roles in most programs (62.0%). A total of 16 respondents (22.5%) were URM program directors. Most respondents agreed that diversity was important to their training program (85.9%). The majority endorsed direct recruitment of URM applicants (60.6%), opportunities for applicants to connect with (54.9%) or be recruited by URM fellows (54.9%), holistic application review (67.6%), promoting mentorship by URM faculty (69.0%), URM faculty involvement in applicant interviewing (54.9%), and increased recruitment of URM faculty members (73.2%). Program directors allocated major responsibility to increase diversity to fellowship programs (71.8%), residency programs (63.3%), and medical schools (53.5%). ConclusionsThis study found that most cardiology programs have URM faculty in leadership roles, and nearly a quarter of the surveyed program directors were URMs. Cardiology program directors endorsed and employed numerous strategies to increase diversity and URM representation in fellowship programs. Additionally, program directors held fellowship training programs most responsible for increasing URM representation in the field of cardiology.

Diversity Differences Among Cardiovascular Fellowships Across Five Geographic Regions in the United States

“…Diverse training environments improve important skills for physicians, such as thinking, empathy, and motivation [ 18 ], which improves patient health equity and downstream patient outcomes [ 19 , 20 ]. Unfortunately, despite the advantages in patient and provider experiences, only a third of cardiovascular PDs have current plans to actively increase diversity in their programs.…”

“…Unfortunately, despite the advantages in patient and provider experiences, only a third of cardiovascular PDs have current plans to actively increase diversity in their programs. There are other barriers believed to be outside the control of an admission committee that hinder attempts to diversify groups of trainees [ 8 , 20 ]. If trainees do not see people like themselves represented in programs, they may be less likely to select programs, knowing that they may be faced with more challenges compared to their peers [ 8 ].…”

“…Cardiovascular trainees eventually progress to attending physicians, and without a diverse pool of providers who can understand and respect differences that are important to patients, patients may not receive the personalized care they need [ 20 ]. By increasing diversity in cardiovascular programs, healthcare organizations can help to ensure that patients receive high-quality care that improves outcomes and reduces health disparities.…”

Multimodality Cardiac Imaging and the Imaging Workforce in the United States: Diversity, Disparities, and Future Directions

“…31 Efforts are needed to change these perceptions. 32 Additionally, individuals from underrepresented populations may not consider cardiology or radiology, much less multimodality cardiac imaging, an attainable career goal, given the cost of education, duration of training, lack of support from advisors and mentors, and scarcity of role models. 13,14 The ACC has launched an Internal Medicine Cardiology Program designed to introduce participants to a career in cardiology by connecting them with mentors, peer networks, and resources with program cohorts targeting women, African American/Black, Hispanic/Latinx, LGBTQ+, and Indigenous Peoples.…”