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Negative Perceptions of Cardiology Could Be Steering Internal Medicine Residents Away from Field

An analysis of survey data recorded over the past decade from internal medicine residents indicate negative perceptions surrounding cardiology as a specialty, particularly a perceived lack of optimal work-life balance, could be harming the future of the field.

Comparing data from a cohort of 840 internal medicine residents who completed surveys in 2010 or 2020, comparison of results demonstrate the ideals of internal medicine residents had shifted in the last decade and this shift in priorities could spell danger for an overburdened field as it moves into the future.

“In 2020, surveyed IM residents highly valued career development components including (in descending order): (1) positive role models, (2) stimulating career, (3) family friendly, (4) patient focused, (5) stable hours,” wrote investigators. “In contrast residents’ strongest perceptions of cardiology were discordant to the preferences identified, as the residents’ highest rated perception of a cardiology career was that it interferes with family life.”

In the face of a physician shortage and a growing population, maintaining interest in cardiology as a specialty and diversity within the specialty remains a major priority for the field as it moves into the future. With 2020 fellowship data indicated cardiology had the lowest proportion of women fellows among internal medicine specialty fellowships, a team from Beth Israel Deaconess Medical Center sought to develop a more thorough understanding of resident preferences and perceptions of cardiology over time. With this in mind, investigators designed their study as a comparison of survey responses from a pair of surveys administered to members of US internal medicine programs in 2010 and 2020.

The 2020 survey asked respondents to rate 38 professional development preferences and 20 cardiology perceptions. Investigators noted the survey incorporated a 5-point Likert scale for some questions. Investigators also pointed out multivariable models were created for specialty choice using scaled independent variables dichotomized using the top 2 options. For the purpose of analysis, responses were examined according to total group, by gender, by self-reported consideration of entering cardiology as a profession, and by comparison with a decade prior both as a group and by gender.

Investigators obtained responses from a total of 840 residents. This cohort of respondents had a mean age of 29.24 (SD, 2.82) years, 49.8% were males, and 55.4% were White. Analysis of responses demonstrated the most important professional development preferences were presence of positive role models (4.56), stimulating career (3.81), and family friendly (3.78). When assessing cardiology perception statements,the highest levels of agreement among respondents was observed for the idea that cardiology interferes with family life during training (3.93) and having met positive role models or having positive views of cardiovascular disease as a topic (3.85).

Based on results of their multivariable analysis, investigators develop a 22-element model predicting cardiology as a career choice. Further analysis demonstrated the important of work-life balance components had increased for internal medicine residents, regardless of gender, but with the greatest change observed among male residents. Additionally, respondents to the 2020 survey were more likely to agree with negative perceptions of cardiology than their predecessors from a decade earlier.

“In 2020 male and female residents placed higher value on all aspects of work life balance including stability of hours, family friendliness of career, and on having role models exhibiting successful work-life balance. The prioritization of these values in men changed the most over time,” investigators concluded. “The 2020 residents were also more likely to report negative perceptions of cardiology than their predecessors. The ongoing discordance and increasing divergence between the residents’ professional culture preferences and cardiology career perceptions may hinder the recruitment and retention of a diverse and talented pool of applicants into cardiology.”

This study, “Professional Preferences and Perceptions of Cardiology Among Internal Medicine Residents,” was published in JAMA Cardiology.