With an increase in cardiovascular disease prevalence and growing patient diversity, there is a question of how cardiology can continue successful recruitment of resident physicians.

A recent study published in JAMA Cardiology examined trends in career preference for and perception of cardiology among internal medicine trainees. Using answers collected from 1123 physicians (55.7% men) via survey, Pamela S. Douglas, MD, from the Duke University School of Medicine in Durham, North Carolina, and colleagues gathered data on the demographics, training, professional development needs, and perceptions of cardiology as a career. Survey categories covered factors such as age, sex, race and ethnicity, year of medical school graduation, marital status, and number of children. The researchers’ goal was to better understand which trainees were considering or choosing cardiology, which trainees were not, and to uncover reasons why.

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The study results indicated that there were a number of professional development considerations trainees cited in their decision of which specialty field to pursue. These included stable hours, family- and female-friendliness of the field, availability of positive role models, financial benefits, ability to be challenged professionally, and patient focus.

Trainees’ top perceptions of cardiology were adverse job conditions, interference with family life, and lack of diversity, making their perceptions somewhat at odds with their professional development goals. Together, these perceptions and professional development factors were strongly associated with the decision to either choose or avoid a career in cardiology across all demographics.

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Through their study, the investigators concluded that although some perceived barriers of pursuing cardiology may filter candidates, those barriers would also discourage candidates from even considering the field, hampering overall recruitment. Although the researchers pointed to overall high satisfaction among cardiologists, the trainees’ negative perceptions of the field indicate areas that can be addressed by the community, such as work-life balance and mentorship. Organizations such as the American College of Cardiology are putting a greater emphasis on physician well-being, whereas other organizations such as the Institute for Healthcare Improvement are acknowledging that change is partly the responsibility of healthcare systems.

Overall, the research on internal medicine trainees’ perceptions of cardiology points to factors the community can address when considering the capacity and diversity of the future cardiology workforce.


Douglas PS, Rzeszut AK, Bairey Merz CN, et al; for the American College of Cardiology Task Force on Diversity and inclusion and the American College of Cardiology Women in Cardiology Council. Career preferences and perceptions of cardiology among US internal medicine trainees. Factors influencing cardiology career choice [published online May 30, 2018]. JAMA Cardiol. doi: 10.1001/jamacardio.2018.1279.