Professional Preferences and Perceptions of Cardiology Among Internal Medicine Residents

Abstract

ImportanceInternal medicine residents’ professional development preferences were discordant with their perceptions of cardiology in a survey circulated a decade ago; no contemporary data exist. This information is important for effective recruitment and retention of a highly talented and diverse future cardiology workforce.ObjectiveTo identify residents’ professional development preferences and cardiology perceptions, in relation to specialty choice, and compare the findings with those from a decade prior.Design, Setting, and ParticipantsThe original survey from the 2010 study was updated and sent to US internal medicine programs. Respondents (ie, internal medicine residents) rated 38 professional development preferences and 20 cardiology perceptions. Data were collected in 2020 and compared with survey results from the prior 2010 study. Multivariable models were created for specialty choice using scaled independent variables dichotomized using the top 2 options; categorical variables were recoded into binary variables for analysis.Main Outcomes and MeasuresMultivariable models were used to determine the association of demographic characterisitcs and survey responses with prospective career choice. Responses were examined by total group, by gender, by self-reported consideration of entering cardiology as a profession, and by comparison with a decade prior both as a group and by gender.ResultsA total of 840 residents (mean [SD] age, 29.24 [2.82] years; 49.8% male; 55.4% White) completed the survey. The survey incorporated a 5-point Likert scale of 1 (not important) to 5 (extremely important) for some of the questions, with additional questions on demographic characteristics. The most important professional development preferences by descending Likert score were as follows: positive role models (4.56), stimulating career (3.81), and family friendly (3.78). The cardiology perception statements with the highest agreement were as follows: interferes with family life during training (3.93) and having met positive role models or having positive views of cardiovascular disease as a topic (3.85). Multivariable analysis yielded a 22-element model predicting cardiology as career choice. Compared with the 2010 survey, the findings of this survey indicated increased importance of work-life balance components for both male and female residents, with a greater change in male residents. Contemporary residents were more likely than their predecessors to agree with negative perceptions of cardiology.Conclusions and RelevanceThis survey study found that both male and female residents place a high value on support for optimal work-life balance; these preferences have intensified over the past decade and factor into career choice. Negative perceptions of cardiology persist and, in some aspects, are worsening. Improving the culture of cardiology may make this specialty a more attractive career choice for all.

Recruiting a Diverse Cardiology Physician Workforce

“…Although the increases in women trainees were significant, providing hope for continued improvement, they lag well behind the percentages of women trainees in all residencies, IM, and general surgery that are now above 40%. IM residents' perceptions of an adverse culture in cardi-ology were similar in 2009 and 2020, 2,3 indicating avenues for improvement. This is supported by underrepresentation of women among IC and EP applicants (12% to 18% and 13% to 15%, respectively, in 2018 through 2021), 7 which suggest applicant choice as a driving factor in subspecialty selection, confirmed by trainee survey.…”

“…Both male and female internal medicine (IM) residents are deterred from a cardiology career by perceptions of adverse job conditions, lack of diversity, and negative impacts on family life . In a study of IM subspecialty trainees from 1991 to 2016, CVD programs had the lowest overall percentage and rate of increase of women trainees over time .…”

“…1 However, cardiovascular disease (CVD) and cardiovascular (CV) subspecialty fellowships have lagged in attracting women and individuals from racial and ethnic populations that are underrepresented in medicine (UIM).Both male and female internal medicine (IM) residents are deterred from a cardiology career by perceptions of adverse job conditions, lack of diversity, and negative impacts on family life. 2,3 In a study of IM subspecialty trainees from 1991 to 2016, CVD programs had the lowest overall percentage and rate of increase of women trainees over time. 4 In a study of UIM IM residents, the percentage of UIM trainees in IM remained low from 2006 to 2018 (12.3% to 13.7%), with CVD programs having even fewer UIM trainees (9.6% to 11.6%).…”

Comparison of medical students' considerations in choosing a specialty: 2020 vs. 2009/10

“…Previous studies have also reported that today’s medical students place more emphasis on a specialty with flexible working conditions than a higher salary. [ 4 , 33 , 34 ] Two time-comparison studies of career preferences found that medical students and residents are more likely ( P < 0.05) than their predecessors to emphasize the importance of a career that enables work–life balance, and that has stable working hours [ 9 , 15 ]. Members of Generation-Y are committed to working hard and also expect to take an active role at home and express uncertainty regarding how future plans will influence them holistically [ 35 ].…”

“…Millennials (Generation Y), described as persons born between 1980 and 1994 [ 11 , 12 ], are more inclined than previous generations to emphasize the importance of work–life balance [ 13 ] and garnering personal appreciation [ 14 ]. However, few studies have compared changes in the choice of medical specialty selection over time [ 15 ], and none have been performed in Israel. The aim of this study was to compare the importance of certain criteria used by medical students when choosing a medical specialty in 2020 vs. data collected in 2009/10 and subsequently published [ 16 ].…”