VA Palo Alto Medical Center, Palo Alto, California; Department of Medicine, Stanford University and Stanford Cardiovascular Institute, Stanford, California.
Department of Medicine, Stanford University and Stanford Cardiovascular Institute, Stanford, California; Yale School of Medicine, New Haven, Connecticut.
JACC Cardiovasc Interv. 2019 Feb 11;12(3):219-228. doi: 10.1016/j.jcin.2018.09.036. Epub 2019 Jan 16.
The authors sought to determine the factors that influence fellows-in-training (FITs) to pursue a career in interventional cardiology (IC) and how these differ by sex.
Despite increases in the proportion of women across numerous medical and surgical specialties over the last decade, IC still ranks at the bottom in terms of representation of women. It is unclear why this maldistribution persists.
An online survey of cardiovascular FITs was conducted under the direction of the American College of Cardiology Women in Cardiology Leadership Council to assess FIT perspectives regarding subspecialty choices.
Of 574 respondents, 33% anticipated specializing in IC. Men were more likely to choose IC than women (39% men, 17% women, odds ratio: 3.98 [95% confidence interval: 2.38 to 6.68]; p < 0.001). Men were more likely to be married (p = 0.005) and have children (p = 0.002). Among married FITs, male IC FITs were more likely to have spouses who do not work (p = 0.003). Although men were more likely to be influenced by positive attributes to pursue IC, women were significantly more likely to be influenced negatively against pursuing the field by attributes including greater interest in another field (p = 0.001), little job flexibility (p = 0.02), physically demanding nature of job (p = 0.004), radiation during childbearing (p < 0.001), "old boys' club" culture (p < 0.001), lack of female role models (p < 0.001), and sex discrimination (p < 0.001).
Many factors uniquely dissuade women from pursuing IC compared with men, largely related to the culture of IC as a subspecialty. Targeted resolution of these specific factors may provide the most impact in reducing sex imbalances in the field.
作者旨在确定影响培训医师（FITs）从事介入心脏病学（IC）职业的因素，以及这些因素在性别上的差异。
尽管在过去十年中，女性在众多医学和外科专业中的比例有所增加，但 IC 专业的女性代表人数仍然垫底。目前尚不清楚为什么这种分配不均仍然存在。
在美国心脏病学会女性心血管领导委员会的指导下，对心血管 FITs 进行了在线调查，以评估 FITs 对专业选择的看法。
在 574 名受访者中，33%预计会专门从事 IC。男性选择 IC 的可能性高于女性（男性 39%，女性 17%，优势比：3.98[95%置信区间：2.38 至 6.68]；p<0.001）。男性更有可能已婚（p=0.005）并育有子女（p=0.002）。在已婚的 FITs 中，男性 IC FITs 更有可能让不工作的配偶（p=0.003）。尽管男性更有可能受到积极因素的影响而选择从事 IC，但女性更有可能受到消极因素的影响，这些因素包括对其他领域更感兴趣（p=0.001）、工作灵活性差（p=0.02）、工作性质对身体要求高（p=0.004）、生育期间辐射（p<0.001）、“老男孩俱乐部”文化（p<0.001）、缺乏女性榜样（p<0.001）和性别歧视（p<0.001）。
与男性相比，许多因素独特地劝阻女性从事 IC，主要与 IC 作为一个亚专业的文化有关。有针对性地解决这些具体问题可能会对减少该领域的性别失衡产生最大影响。
