AF Association News & Events

More work needed to challenge discrimination in cardiovascular workforce

According to an analysis of the ACC Professional Life Survey, racial and ethnic minority cardiologists contend with a lack of representation, discrimination, inequitable job negotiations, and burnout in their professional lives. The analysis, published in Journal of the American College of Cardiology, also shows that underrepresented racial and ethnic minorities (URMs), compared with their white colleagues, were less likely to negotiate or prioritise salary, benefits, and work hours in their first job.

A press release reports that the American College of Cardiology (ACC) third decennial Professional Life Survey was conducted — by the ACC Women in Cardiology Section and on behalf of the ACC Diversity and Inclusion Task Force — to assess the professional experience of cardiologists. The survey included 2,245 respondents who provided racial/ethnic data. Of the respondents, 1,447 identified as white, 564 as Asian or Pacific Islander and 37 as multiracial. URMs, those identifying as Black, Hispanic, or Native American, counted for 197 of the respondents.

It adds that analysis authors Dr Kevin Thomas (Associate professor of medicine, Duke University Research Institute Durham, USA) and colleagues reviewed data for the 197 URM respondents to assess career satisfaction and advancement, personal and family issues, discrimination, mentoring, job negotiations and burnout rates compared with the other racial and ethnic groups. They found that 91% of URM respondents were satisfied with their career and felt their level of advancement and career opportunities were like their peers and that 85% were satisfied with their family lives outside of work. However, they also found that over half (52.3%) of URMs reported experiencing discrimination, compared with 36.4% of white respondents.

Women of all racial and ethnic groups were more likely than men to report discrimination (57–69.2% compared with 13.9–44.6%, respectively). When broken down, men were more likely to report race and religion-based discrimination, whereas nearly all women reported gender discrimination, and URM women in addition reported frequently experiencing race-based discrimination in the workplace.

Dr Thomas, Duke University Research Institute Durham, USA) says: “Despite calls for racial and ethnic diversification in medicine or cardiology, there has been little change. Putting into place methods to support those who are underrepresented in medicine is critical moving forward... This particular group [URMs] has never been singled out in analysing the data from the 2015 Professional Life Survey, and the results are very revealing about how much work there is still left to do.”

Furthermore, compared with white cardiologists, URM cardiologists were less likely to negotiate or prioritise salary, benefits, and work hours in their first job (white cardiologists reported 20.6%, 23.3%, 31.3% in each category respectively, vs. 13.6%, 10.9%, 19.3% respectively from URM cardiologists). As their careers advanced, URMs placed more emphasis on salary, benefits and work hours compared with white cardiologists, which according to researchers is potentially a marker that URMs are placed at a disadvantage in these categories at the start of the careers and showcasing there is a greater need to overcome systemic barriers.

White cardiologists were more likely than URMs to report higher rates of burnout. However, URMs experienced more isolation and non-inclusive work environments. The researchers said greater learned resiliency over their lifetime from URMs may contribute toward reporting lower rates of burnout.  

Thomas et al offered four recommendations for professional organisations and health systems based on their findings:

  • Collect gender and racial and ethnic identities of members using classifications similar to the 2020 U.S. Census
  • Partner with racial and ethnic-specific professional organizations to develop and implement diversity and inclusion efforts
  • Implement bias and antiracism training among leaders
  • Develop leadership pathways for women and URM members




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