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. 2018 Aug 1;3(8):682-691.
doi: 10.1001/jamacardio.2018.1279.

Career Preferences and Perceptions of Cardiology Among US Internal Medicine Trainees: Factors Influencing Cardiology Career Choice

Pamela S Douglas  1 , Anne K Rzeszut  2 , C Noel Bairey Merz  3 , Claire S Duvernoy  4   5 , Sandra J Lewis  6 , Mary Norine Walsh  7 , Linda Gillam  8 ; American College of Cardiology Task Force on Diversity and Inclusion and American College of Cardiology Women in Cardiology Council
Affiliations

Career Preferences and Perceptions of Cardiology Among US Internal Medicine Trainees: Factors Influencing Cardiology Career Choice

Pamela S Douglas et al. JAMA Cardiol. .

Abstract

Importance: Few data exist on internal medicine trainees' selection of cardiology training, although this is important for meeting future cardiology workforce needs.

Objective: To discover trainees' professional development preferences and perceptions of cardiology, and their relationship to trainees' career choice.

Design, setting, and participants: We surveyed trainees to discover their professional development preferences and perceptions of cardiology and the influence of those perceptions and preferences on the trainees' career choices. Participants rated 38 professional development needs and 19 perceptions of cardiology. Data collection took place from February 2009, through January 2010. Data analysis was conducted from May 2017 to December 2017.

Main outcomes and measures: Multivariable models were used to determine the association of demographics and survey responses with prospective career choice.

Results: A total of 4850 trainees were contacted, and 1123 trainees (of whom 625 [55.7%] were men) in 198 residency programs completed surveys (23.1% response; mean [SD] age, 29.4 [3.5] years). Principal component analysis of survey responses resulted in 8-factor and 6-factor models. Professional development preferences in descending order of significance were stable hours, family friendliness, female friendliness, the availability of positive role models, financial benefits, professional challenges, patient focus, and the opportunity to have a stimulating career. The top perceptions of cardiology in descending order of significance were adverse job conditions, interference with family life, and a lack of diversity. Women and future noncardiologists valued work-life balance more highly and had more negative perceptions of cardiology than men or future cardiologists, who emphasized the professional advantages available in cardiology. Professional development factors and cardiology perceptions were strongly associated with a decision to pursue or avoid a career in cardiology in both men and women.

Conclusions and relevance: Alignment of cardiology culture with trainees' preferences and perceptions may assist efforts to ensure the continued attractiveness of cardiology careers and increase the diversity of the cardiology workforce.

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Conflict of interest statement

Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Dr Bairey Merz reports personal fees from American College of Obstetricians and Gynecologists, Atlantic Health System, Abbott Diagnostics, American College of Cardiology, Cardio Northern Arizona Healthcare Health System, Expert Exchange, Inova Health System, George Washington University Medical Education, Med Ed, Northwestern University, Pri-Med, the Oklahoma Chapter of the American College of Cardiology, Renown Health System, San Diego Heart Institute, the Society of Vascular Medicine, St. Francis Medical Center in Hartford, University of Minnesota, University of California-San Francisco, University of Capetown, University of Colorado, Advisory Committees on Research on Women's Health, National Institutes of Heath–Center for Scientific Review, Springer International, Decision Support in Medicine LLC, Women’s Ischemia Study Evaluation Heart Failure With Preserved Ejection Fraction, Treatment With Ranolazine in Microvascular Coronary Dysfunction (MCD): Impact on Angina Myocardial Ischemia (RWISE), Microvascular, Normal Control, Flight Attendant Medical Research Institute, the US Department of Defense, California Institute for Precision Medicine and consultant fees from NHLBI Research Triangle Institute International. No other disclosures were reported.

Figures

Figure 1.
Figure 1.. Importance of Professional Development Considerations and Agreement With Survey Statements on Perceptions of Cardiology
A, Professional development factors for all respondents by β value for the factor weight; this model explains 59% of variance. B, Professional development factors by sex by β value. C, Agreement with perceptions of cardiology for all respondents by β value for the factor weight; this model explains 62% of variance. D, Perceptions of cardiology by sex by β value.
Figure 2.
Figure 2.. Odds Ratios for Choosing Cardiology
Items are ranked by order of importance to overall choice. Overall accuracy is 89.4% (sensitivity, 75,3% and specificity, 93.8%); for men, accuracy is 89.1% (sensitivity, 82.9%; specificity, 92.3%); for women, accuracy is 96.8% (sensitivity, 84.2%; specificity, 98.4%).
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