Representation of Women in Internal Medicine Specialties in North America, the United Kingdom, and Australasia: Cardiology's Outlier Status and the Importance of Diversity

Sarah Zaman; Elizabeth Shaw; Katherine Ellenberger; Maraed Rosa; Melissa Leung; Vu Kwan; Rhea Liang; Shrilla Banerjee; Alexandra Bastiany; Martha Gulati; Sharonne Hayes; Cindy Grines; Roxana Mehran; Sonya Burgess

doi:10.1016/j.amjcard.2022.08.030

Representation of Women in Internal Medicine Specialties in North America, the United Kingdom, and Australasia: Cardiology's Outlier Status and the Importance of Diversity

Am J Cardiol. 2022 Dec 15:185:122-128. doi: 10.1016/j.amjcard.2022.08.030. Epub 2022 Oct 8.

Authors

Sarah Zaman¹, Elizabeth Shaw², Katherine Ellenberger³, Maraed Rosa⁴, Melissa Leung⁵, Vu Kwan⁶, Rhea Liang⁷, Shrilla Banerjee⁸, Alexandra Bastiany⁹, Martha Gulati¹⁰, Sharonne Hayes¹¹, Cindy Grines¹², Roxana Mehran¹³, Sonya Burgess¹⁴

Affiliations

¹ Westmead Applied Research Centre, University of Sydney, Sydney, New South Wales, Australia; Department of Cardiology, Westmead Hospital, Westmead, New South Wales, Australia; University of Sydney, Sydney, New South Wales, Australia.
² University of Sydney, Sydney, New South Wales, Australia; Department of Cardiology, Hornsby Ku-ring-gai Hospital, Hornsby, New South Wales, Australia; Sydney Adventist Hospital, Sydney, New South Wales, Australia.
³ Department of Cardiology, Nepean Hospital, Kingswood, New South Wales, Australia.
⁴ University of Sydney, Sydney, New South Wales, Australia.
⁵ University of New South Wales, Sydney, New South Wales, Australia; Department of Cardiology, Liverpool Hospital, Liverpool, New South Wales, Australia.
⁶ University of Sydney, Sydney, New South Wales, Australia; Department of Gastroenterology, Westmead Hospital, Westmead, New South Wales, Australia.
⁷ Department of Surgery, Gold Coast Hospital and Health Service, Robina, Queensland, Australia; Bond University, Gold Coast, Robina, Queensland, Australia.
⁸ Department of Cardiology, Surrey and Sussex Healthcare NHS Trust, Redhill, United Kingdom.
⁹ Thunder Bay Regional Health Sciences Centre, Northern Ontario School of Medicine, Ontario, Canada.
¹⁰ University of Arizona, Phoenix, Arizona.
¹¹ Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
¹² Northside Health, Atlanta, Georgia.
¹³ Icahn School of Medicine at Mount Sinai, New York, New York.
¹⁴ University of Sydney, Sydney, New South Wales, Australia; Department of Cardiology, Nepean Hospital, Kingswood, New South Wales, Australia. Electronic address: Sonya.Burgess@health.nsw.gov.au.

PMID: 36216603
DOI: 10.1016/j.amjcard.2022.08.030

Abstract

Decades of research demonstrate the value of workplace diversity. Reports from individual countries show that women are underrepresented in internal medicine workforces. However, large pooled international studies are not available. This study investigates the current representation of women in the internal medicine workforce internationally and identifies specialties in which underrepresentation is evident. Peer-reviewed studies, government reports, and medical association reports were used to determine proportions of specialists and doctors training in internal medical specialties and in comparator surgical specialties. Data were available from Australia, Canada, England, New Zealand, the United States, Wales, Scotland, and Northern Ireland. A total of 380,263 doctors were studied, including 268,822 practicing specialist physicians (also known as attendings or consultants) and 53,226 doctors in internal medicine specialty training programs (also known as residents, fellows, advanced trainees, or specialist registrar trainees). Among practicing physician specialists, the rate of representation of women was 35% (95,195/268,822, p <0.001). Among trainees, the rate of representation of women was 43% (22,728/53,226, p <0.001). Among physician specialties evaluated, cardiology (15%, 4,152 of 27,328), gastroenterology (20%, 3,765 of 18,893), and respiratory/critical care (24%, 5,255 of 21,870) had the lowest representations of women compared with men (p <0.001 for all). Cardiology and particularly the subspecialty of interventional cardiology were clear outliers as the internal medicine specialties with the lowest representation of women at practicing specialist and trainee levels. In conclusion, this study is the largest international study of women in internal medicine specialties. It found that cardiology, gastroenterology, and respiratory/critical care specialties have the most substantial underrepresentation of women. These data are a global call to action to establish more successful strategies to provide a diverse and representative cardiology workforce.

MeSH terms

Cardiology*
Female
Humans
Internal Medicine
Male
North America
Physicians*
United States
Workforce