Female medical students’ perspective on barriers to pursuing a career in cardiology
The BJC recently published an intriguing paper exploring the perceived barriers to a career in cardiology by trainees in other specialties, thus providing greater insight into the obstacles that deter female clinicians from pursuing cardiology. Examples of issues highlighted included negative interactions with cardiologists, restricted work-life balance and experiences of sexism during training.1
While some scenarios where trainees formed negative perceptions of cardiologists were identified, exploration of the context of such events could have been beneficial. Understanding this may have highlighted certain levels of training or locations where support and behaviour alterations could be specifically targeted.
Furthermore, cardiology placements during postgraduate training were only experienced by 49% of study participants. However, it is likely that trainees interacted with cardiologists at medical school in some capacity. Acknowledging the impact of these encounters is valuable, as having a negative experience in cardiology during this vital period in early training might later influence trainees’ perceptions of the specialty. Subsequently, this may lead to fewer females choosing a career in cardiology. Therefore, positive role models, such as mentors, could impact a medical student’s decision to pursue a particular subspecialty.2
We highlight here how poor experiences with mentors can contribute to negative perceptions of the specialty. For instance, a cardiology consultant was overheard by medical students, emphasising the idea of poor work-life balance in this field, especially for female clinicians; thereby, implying that other specialties may offer an ‘easier’ long-term career pathway. This reinforces the idea that cardiology can be unaccommodating for female clinicians. Similar instances of microaggression towards female doctors have been previously reported in literature.3
Moreover, during a cardiology rotation, an episode of prejudice was witnessed by a group of medical students. Two cardiologists were disagreeing on whether or not to perform percutaneous coronary intervention on a patient. When one of the doctors left the room, the other referred to the former as incompetent because of his sexual orientation. Such acts of discrimination portray a negative image of cardiology from as early as medical school.
In order to break down these barriers, as female medical students who aspire to train in cardiology, we agree that increased awareness and education around sexism and discrimination is vital to change the perceptions and behaviours of cardiologists. In addition, we propose that every healthcare facility should have an office or hotline where the personnel, regardless of their gender, can safely and anonymously report any instances of discrimination. The institution of such an impartial entity aims to replace a senior colleague to whom the subject of the microaggression may turn, without having any personal or professional conflict.
Addressing the issues stated by Kurdi et al. will break down barriers to cardiology, enabling more female trainees from a variety of backgrounds to consider this specialty as a viable career option. Thus, having cardiology trainees with different perspectives and interpersonal skills will allow for improved doctor–patient relationships, and, ultimately, better patient care.
Conflicts of interest
Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester, M13 9PL
Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
Intercalating Medical Student
King’s College London, Strand, London, WC2R 2LS
1. Kurdi H, Morgan H, Williams C. Women not in cardiology: where are we going wrong? A survey of the perceptions and barriers to training. Br J Cardiol 2020;27:119–23. https://doi.org/10.5837/bjc.2020.030
2. Wright S, Wong A, Newill C. The impact of role models on medical students. J Gen Intern Med 1997;12:53–6. https://doi.org/10.1046/j.1525-1497.1997.12109.x
3. Molina MF, Landry AI, Chary AN, Burnett-Bowie S-AM. Addressing the elephant in the room: microaggressions in medicine. Ann Emerg Med 2020;76:387–91. https://doi.org/10.1016/j.annemergmed.2020.04.009