Diversity Recruitment in Cardiovascular Specialties: Barriers and Opportunities in Postgraduate Training Programs

Maria Guerrero¹, Edmund T Takata², Ervin Ham³, Laura Hohenstein¹, Taylor Amore¹, Joshua Pribadi², Mirghani Mohamed¹, Param Patel¹, Kodi Baldino⁴, Analise Douglas⁵, Jeff Mather⁶, Sheelagh Pousatis⁷, William L Duvall⁵, Kwame Amankwah⁸, Saleh Rahman³, Sabet Hashim⁷, Steven Angus¹, Rocco Orlando⁹, Raymond G McKay¹⁰, Trevor S Sutton^{3

4

11}

Affiliations

¹ School of Medicine, University of Connecticut Health Center, Farmington, Connecticut, USA.
² College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, New York, USA.
³ Frank H. Netter School of Medicine, Quinnipiac University, Hamden, Connecticut, USA.
⁴ Department of Anesthesiology, University of Connecticut School of Medicine, Farmington, Connecticut, USA.
⁵ Department of Cardiology, Hartford Hospital, Hartford, Connecticut, USA.
⁶ Department of Research Administration, Hartford Hospital, Hartford, Connecticut, USA.
⁷ Department of Cardiac Surgery, Hartford Hospital, Hartford, Connecticut, USA.
⁸ Department of Vascular Surgery, University of Connecticut School of Medicine, Farmington, Connecticut, USA.
⁹ Department of Surgery, Hartford Hospital, Hartford, Connecticut, USA.
¹⁰ Heart and Vascular Research Institute, Hartford Hospital, Hartford, Connecticut, USA.
¹¹ Integrated Anesthesia Associates, Hartford Hospital, Hartford, Connecticut, USA.

PMID: 39886302
PMCID: PMC11780091
DOI: 10.1016/j.jacadv.2024.101525

Diversity Recruitment in Cardiovascular Specialties: Barriers and Opportunities in Postgraduate Training Programs

Maria Guerrero et al. JACC Adv. 2025.

. 2025 Jan 8;4(2):101525.

doi: 10.1016/j.jacadv.2024.101525. eCollection 2025 Feb.

Authors

Affiliations

¹ School of Medicine, University of Connecticut Health Center, Farmington, Connecticut, USA.
² College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, New York, USA.
³ Frank H. Netter School of Medicine, Quinnipiac University, Hamden, Connecticut, USA.
⁴ Department of Anesthesiology, University of Connecticut School of Medicine, Farmington, Connecticut, USA.
⁵ Department of Cardiology, Hartford Hospital, Hartford, Connecticut, USA.
⁶ Department of Research Administration, Hartford Hospital, Hartford, Connecticut, USA.
⁷ Department of Cardiac Surgery, Hartford Hospital, Hartford, Connecticut, USA.
⁸ Department of Vascular Surgery, University of Connecticut School of Medicine, Farmington, Connecticut, USA.
⁹ Department of Surgery, Hartford Hospital, Hartford, Connecticut, USA.
¹⁰ Heart and Vascular Research Institute, Hartford Hospital, Hartford, Connecticut, USA.
¹¹ Integrated Anesthesia Associates, Hartford Hospital, Hartford, Connecticut, USA.

PMID: 39886302
PMCID: PMC11780091
DOI: 10.1016/j.jacadv.2024.101525

Abstract

Background: Diversity in postgraduate training programs can be increased through program-based recruitment strategies. Prospective applicants often examine website content to determine if training programs are inclusive and offer a good fit. Poor overlap between program director recruitment goals and program website content as a barrier to recruiting a diverse physician workforce has not extensively been studied.

Objectives: The aim of this study was to characterize barriers to recruiting a diverse physician workforce in cardiovascular specialties in the United States.

Methods: Cross-sectional survey of program directors and evaluation of website content for training programs in adult general cardiology, cardiothoracic surgery, vascular surgery, and adult cardiothoracic anesthesiology.

Results: A total of 68 surveys were completed (response rates of 10% to 13% across specialties), and 626 websites in cardiovascular specialties were analyzed. A majority (63%) of program directors prioritized increasing diversity, although 40% of these respondents did not have a plan or resources. Program culture was cited as a barrier to recruiting a diverse workforce. The median website score for inclusion and health equity content was 4.0 out of 18.0, with a health disparities curriculum offered in <10% of websites for most specialties.

Conclusions: To advance diversity in cardiovascular specialties, training programs must have inclusive learning environments perceived by prospective applicants. Barriers to recruiting a diverse physician workforce may be decreased by addressing training program culture with an emphasis on modifying training program website content to attract more diverse applicant pools. Health disparities curricula are underutilized resources in cardiovascular specialties that may support recruitment of a more diverse physician workforce.

Keywords: cardiovascular specialties; diversity; health disparities curricula; program director survey; website content.

PubMed Disclaimer

Conflict of interest statement

The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

**Figure 1**
**Training Program Characteristics** The pie charts summarize the training model and geographic region of training programs in adult general cardiology, adult cardiothoracic surgery, vascular surgery, and adult cardiothoracic anesthesiology that completed questionnaires. The percentage of programs (n = 68) within each category is displayed.

**Figure 2**
**Frequency Distribution of Program Director Survey Responses for Adult General Cardiology Versus Pooled Adult Cardiac Anesthesiology, Adult Cardiothoracic Surgery, and Vascular Surgery Cohorts** The histogram illustrates the frequency of program director survey responses. ∗Statistical significance at P < 0.05. DEI = diversity, equity, and inclusion.

**Figure 3**
**Flow Diagram for Website Content Evaluation** Process for identifying eligible United States training programs in adult general cardiology, adult cardiothoracic surgery, vascular surgery, and adult cardiothoracic anesthesiology. ACGME = Accreditation Council for Graduate Medical Education.

**Figure 4**
**Frequency Distribution of Website Scores for Diversity, Inclusion, and Health Equity Content** The histogram illustrates the distribution of aggregate website scores for the cardiovascular specialties analyzed. Scores reflect an 18-point scoring rubric for DEI and health equity content. Mean (standard deviation) website score was 4.0 (2.4). DEI = diversity, equity, and inclusion.

**Figure 5**
**Website Scores for Diversity, Inclusion, and Health Equity by Specialty** Box plot of website content scores by specialty. Horizontal lines denote median values, and boxes extend from the 25th to the 75th percentile of each specialty’s distribution of website scores. Vertical extending lines denote adjacent values within 1.5 interquartile ranges of the 25th and 75th percentiles of each group. Dots denote observations outside the range of adjacent values. ∗Significant difference versus other specialties at P < 0.001. #Significant difference versus adult general cardiology.

**Central Illustration**
**Opportunities to Recruit a Diverse Physician Workforce in Cardiovascular Specialties** Recruitment of prospective applicants to training programs in cardiovascular specialties should include assessment of the applicant’s perception of inclusion and “fit”.

See this image and copyright information in PMC

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Diversity Recruitment in Cardiovascular Specialties: Barriers and Opportunities in Postgraduate Training Programs

Affiliations

Diversity Recruitment in Cardiovascular Specialties: Barriers and Opportunities in Postgraduate Training Programs

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

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