Current Demographic Status of Cardiologists in the United States
Current Demographic Status of Cardiologists in the United States
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DOI：
10.1001/jamacardio.2019.3247
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发表时间：
2019-10-01
期刊：
影响因子：
24
通讯作者：
Douglas, Pamela S.
中科院分区：
文献类型：
--
作者：
Mehta, Laxmi S.;Fisher, Kara;Douglas, Pamela S.
重要性 增加心脏病学劳动力的多样性将扩大申请者人才库，并可能减少医疗保健差距。目的 在美国人口和可用的实习生渠道的背景下，按性别和种族/族裔评估美国心脏病学医生劳动力的人口统计数据。设计、设置和参与者这项横断面研究使用了来自美国医学院协会、美国医学会和美国内科医学委员会的数据，按性别和年龄对医学生、住院医生、研究员和心脏病专家进行了分层。种族/民族。此外，还评估了 2006 年至 2016 年成人和儿童心脏病学的比例变化。数据分析时间为 2018 年 8 月至 2019 年 1 月。主要结果和措施 2016 年按性别和种族/族裔划分的心脏病专家和实习生的百分比，以及 2006 年至 2016 年之间的比例变化。结果 尽管女性内科住院医生比例很高（25252 人中的 10765 人 [42.6%]），但女性医生的代表性不足成人普通心脏病学奖学金（2720 名中的 584 名 [21.5%]）和程序专科奖学金（介入心脏病学，305 名中的 30 名 [9.8%]；电生理学，175 名中的 24 名 [13.7%]）。从 2006 年到 2016 年，女性成年心脏病专家的比例略有增加（从 8.9% 增加到 12.6%；斜率，0.36；P < .001），但仍然较低。儿科住院医师职位中女性医生的比例异常高（8832 名中的 6439 名[72.9%]）。趋势显示，女性儿科心脏病专家数量有所增加（从 40.4% 增加到 50.5%；斜率，1.25；P < .001），这导致女性儿科心脏病专家的比例增加（从 27.1% 增加到 34.0%；斜率，0.64；P < .001）。成人和儿科心脏病学研究金中代表性不足的少数群体成员的百分比（分别从 11.1% 到 12.4%；斜率 0.15；P = .01；以及从 7.7% 到 9.9%；斜率 0.29；P = .009）较低，并且随着时间的推移仅略有增加。此外，在执业成人和儿科心脏病专家中，代表性不足的少数族裔成员所占比例不到 8%。尽管亚裔占美国总人口的 5.2%，但他们并不被认为代表性不足，因为他们占美国医学院毕业生的 22.1%（n = 18999 人中的 4202 人）、内科住院医师的 38.1%（25252 人中的 n = 9618 人）、成人心脏病学研究员的 40.4%（2720 人中的 n = 1098 人）、 19.9% 的成人心脏病专家（n = 30016 名中的 5973 名）、22.6% 的儿科住院医师（n = 1998 年的 8832 名）、28.0% 的儿科心脏病专家（n = 436 名中的 122 名）和 20.1% 的儿科心脏病专家（n = 2860 名中的 574 名）。 结论和相关性 女性尽管女医学生和内科住院医师队伍数量庞大，但在成人心脏病学领域，医生的代表性仍然不足。儿科心脏病学领域的女性人数不足，但数量有所增加。一些种族/族裔少数群体的成员在成人和儿科心脏病学领域的代表性仍然不足，来自这些群体的学员和医学生的比例也很低。需要采取不同的策略来解决代表性不足的少数群体和女性心脏病学持续缺乏多样性的问题。
Importance Increasing cardiology workforce diversity will expand the talent of the applicant pool and may reduce health care disparities.Objective To assess US cardiology physician workforce demographics by sex and race/ethnicity in the context of the US population and the available pipelines of trainees.Design, Setting, and Participants This cross-sectional study used data from the Association of American Medical Colleges, the American Medical Association, and the American Board of Internal Medicine to stratify medical students, resident physicians, fellows, and cardiologists by sex and race/ethnicity. Additionally, proportional changes from 2006 through 2016 were assessed for adult and pediatric cardiology. Data analysis took place from August 2018 to January 2019.Main Outcomes and Measures Percentage of cardiologists and trainees by sex and race/ethnicity in 2016, as well as changes in proportions between 2006 and 2016.Results Despite a high percentage of female internal medicine resident physicians (10765 of 25252 [42.6%]), female physicians were underrepresented in adult general cardiology fellowships (584 of 2720 [21.5%]) and procedural subspecialty fellowships (interventional cardiology, 30 of 305 [9.8%]; electrophysiology, 24 of 175 [13.7%]). The percentage of female adult cardiologists slightly increased from 2006 through 2016 (from 8.9% to 12.6%; slope, 0.36; P < .001) but remained low. Female physicians made up a disproportionately higher number of pediatric residency positions (6439 of 8832 [72.9%]). Trends showed an increase in female pediatric cardiology fellows (from 40.4% to 50.5%; slope, 1.25; P < .001), which resulted in an increase in the percentage of female pediatric cardiologists (from 27.1% to 34.0%; slope, 0.64; P < .001). The percentages of members of underrepresented minority groups in adult and pediatric cardiology fellowships (from 11.1% to 12.4%; slope, 0.15; P = .01; and from 7.7% to 9.9%; slope, 0.29; P = .009; respectively) were low and increased only slightly over time. Additionally, members of underrepresented minorities made up less than 8% of practicing adult and pediatric cardiologists. Although Asian individuals are 5.2% of the US general population, they are not considered underrepresented because they are 22.1% of US medical school graduates (n = 4202 of 18999), 38.1% of internal medicine resident physicians (n = 9618 of 25252), 40.4% of adult cardiology fellows (n = 1098 of 2720), 19.9% of adult cardiologists (n = 5973 of 30016), 22.6% of pediatric resident physicians (n = 1998 of 8832), 28.0% of pediatric cardiology fellows (n = 122 of 436), and 20.1% of pediatric cardiologists (n = 574 of 2860).Conclusions and Relevance Female physicians remain underrepresented in adult cardiology, despite a robust pipeline of female medical students and internal medicine resident physicians. Women in pediatric cardiology are underrepresented but increasing in number. Members of several racial/ethnic minority groups remain underrepresented in adult and pediatric cardiology, and the percentages of trainees and medical students from these groups were also low. Different strategies are needed to address the continuing lack of diversity in cardiology for underrepresented minority individuals and women.