Diversity in U.S. Cardiovascular Trainees and Leadership Where we are and What the Future Holds

Abstract

Cardiovascular (CV) outcomes can be improved with commonality between provider and patient regarding gender and race/ethnicity. Slow growth in CV care provider diversity is an obstacle for women and underrepresented groups. The hope for more equitable outcomes is unlikely to be realized unless trends change in selection of CV fellows and program directors (PDs). We investigate longitudinal trends of gender and racial/ethnic composition of CV FITs. De-identified demographic data were compiled in a descriptive cross-sectional study from AAMC of internal medicine (IM) residents and CV FITs from 2011 through 2021 to evaluate gender and race/ethnicity trends among CV trainees. Trends of CV fellows who later became program directors were analyzed. In the US between 2011 and 2021, 53% of IM residents were male while 40% female (7% unreported). Among CV FITs, 78% were male and 21% female. Races/ethnicities among CV FITs consisted of 36% non-Hispanic white, 28% non-Hispanic Asian, 5% Hispanic, 4%Black, and 25% were classified within other race/ethnicity categories. The proportion who became CV program directors followed similarly: 79% of PDs were male and 21% female. Demographic profiles for CV FITs have not significantly changed over the past decade despite increased diversity among IM residents. Efforts to improve diversity of CV FITs and PDs need to be analyzed. Slow growth of diversity in CV FITs is outpaced by rising patient diversity, leading to disparities in care and poorer CV outcomes for women and underrepresented minorities. Recruiting, training, and retaining diverse CV FITs is necessary.

FIG 1.

Longitudinal Trends of Overall U.S. Population Demographics Compared to Demographics of CV Trainees in the Past Decade (A). U.S. population gender composition compared to gender composition of U.S. CV FITs (B). U.S. population races/ethnicities compared to races/ethnicities of CV FITs over the past decade. Data source: 2020 U.S. Census and ACMGE Data Resource Book

FIG 2.

Longitudinal Trends of Female CV FITs for the Period of 2011 through 2020 (A). Proportional increase in male vs female cardiovascular trainees over the last decade (B). Absolute number of the total in each group for the period from 2011 through 2020 demonstrating no appreciable change in percentage of URM CV FITs (C). Gender distribution of cardiovascular fellowship PDs by region. Subjects who did not specify gender were excluded from the above analysis so each dataset may not add up to 100 percent. Data Source: ACGME Data Resource Book “2011-2021.”

FIG 3.

Diversity and Inclusion in The American College of Cardiology. ACC various initiatives aim at diversifying the cardiovascular workforce and the college’s leadership and membership in order recruit, train, and retain a cardiovascular workforce that is reflective of the communities it serves [18] www.acc.org.