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Altin SE, Kwong M, Hamburg NM, Creager MA, Banerjee S, Oladini L, Schneider MD, Ruddy JM. Addressing Barriers to Entry and Retention of Women in Interventional Vascular Specialties With Proposed Solutions: A Scientific Statement From the American Heart Association. Circulation 2024; 149:e986-e995. [PMID: 38375663 DOI: 10.1161/cir.0000000000001210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
Representation of women in interventional vascular fields (interventional cardiology, interventional radiology, and vascular surgery) lags behind that in other specialties. With women representing half of all medical school graduates, encouraging parity of women in these fields needs to start in medical school. Barriers to pursuing careers in vascular intervention include insufficient exposure during core clerkships, early mentorship, visibility of women in the field, length of training, lifestyle considerations, work culture and environment, and concerns about radiation exposure. This scientific statement highlights potential solutions for both the real and perceived barriers that women may face in pursuing careers in vascular intervention, including streamlining of training (as both interventional radiology and vascular surgery have done with a resultant increase in percentage of women trainees), standardization of institutional promotion of women in leadership, and professional and industry partnerships for the retention and advancement of women.
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Bravo-Jaimes K, Costello BT, Reza N, Sanghavi M, Tamirisa KP, Mehta LS, Mamas MA, Taub CC, Volgman AS, Mieres JH, Ijioma NN, Douglas PS, Hayes SN, Bullock-Palmer RP. A Practical Guide to Address Harassment and Bullying in Cardiology. JACC Case Rep 2023; 22:101988. [PMID: 37790768 PMCID: PMC10544275 DOI: 10.1016/j.jaccas.2023.101988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Affiliation(s)
- Katia Bravo-Jaimes
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida, USA
| | - Briana T. Costello
- Division of Cardiology, The Texas Heart Institute Center for Cardiovascular Care, Baylor St. Luke’s Medical Center, Houston, Texas, USA
| | - Nosheen Reza
- Division of Cardiovascular Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Monika Sanghavi
- Division of Cardiovascular Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - Laxmi S. Mehta
- Division of Cardiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Mamas A. Mamas
- Keele Cardiovascular Research Group, Keele University, Stoke on Trent, United Kingdom
| | - Cynthia C. Taub
- Section of Cardiovascular Medicine, Heart and Vascular Center, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | | | | | | | - Pamela S. Douglas
- Duke Clinical Research Institute, Division of Cardiology, Duke University Medical Center, Durham, North Carolina, USA
| | - Sharonne N. Hayes
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
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Camm CF, Joshi A, Eftekhari H, O'Flynn R, Dobson R, Curzen N, Lloyd G, Greenwood JP, Allen C. Joint British Societies' position statement on bullying, harassment and discrimination in cardiology. Heart 2023; 109:e1. [PMID: 37253631 PMCID: PMC10359534 DOI: 10.1136/heartjnl-2023-322445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
Inappropriate behaviour is an umbrella term including discrimination, harassment and bullying. This includes both actions and language and can affect any member of the cardiovascular workforce/team. Evidence has suggested that such behaviour is regularly experienced within UK cardiology departments, where inappropriate behaviour may represent longstanding cultural and practice issues within the unit. Inappropriate behaviour has negative effects on the workforce community as a whole, including impacts on recruitment and retention of staff and patient care. While only some members of the cardiology team may be directly impacted by inappropriate behaviour in individual departments, a wider group are significantly impacted as bystanders. As such, improving the culture and professional behaviours within UK cardiology departments is of paramount importance. As a negative workplace culture is felt to be a major driver of inappropriate behaviour, all members of the cardiovascular team have a role to play in ensuring a positive workplace culture is developed. Episodes of inappropriate behaviour should be challenged by cardiovascular team members. Informal feedback may be appropriate where 'one-off' episodes of inappropriate behaviour occur, but serious events or repeated behaviour should be escalated following formal human resources protocols.
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Affiliation(s)
- Christian Fielder Camm
- Keble College, University of Oxford, Oxford, UK
- Cardiology Department, Royal Berkshire NHS Foundation Trust, Reading, UK
| | - Abhishek Joshi
- Barts Heart Centre, St Bartholomew's Hospital, London, UK
| | - Helen Eftekhari
- Cardiology Department, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
- Warwick Medical School, University of Warwick, Coventry, UK
| | | | - Rebecca Dobson
- Cardiology Department, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, UK
| | - Nick Curzen
- Coronary Research Group, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Guy Lloyd
- Barts Heart Centre, St Bartholomew's Hospital, London, UK
| | - John Pierre Greenwood
- Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
- Biomedical Imaging Sciences, University of Leeds, Leeds, UK
| | - Christopher Allen
- Guy's & St Thomas' Hospital, King's College, Rayne Institute, London, UK
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Poteat T, Toribio M. Implementing LGBTQ-inclusive policies for cardiology practice and the workforce. Nat Rev Cardiol 2023; 20:365-366. [PMID: 37002416 DOI: 10.1038/s41569-023-00870-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Affiliation(s)
- Tonia Poteat
- Department of Social Medicine, University of North Carolina, Chapel Hill, NC, USA.
| | - Mabel Toribio
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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Forsythe RO, Van Herzeele I, Zayed H, Argyriou A, Stavroulakis K, Saratzis A. International Cross-Sectional Survey of Bullying, Undermining, and Harassment in the Vascular Workplace. Eur J Vasc Endovasc Surg 2023; 65:748-755. [PMID: 36871928 DOI: 10.1016/j.ejvs.2023.02.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 02/06/2023] [Accepted: 02/27/2023] [Indexed: 03/07/2023]
Abstract
OBJECTIVE Bullying, undermining behaviour, and harassment (BUH) may exist in healthcare settings, impacting on patient care. The aim of this international study was to evaluate the characteristics of BUH experienced by physicians treating vascular diseases at various career stages. METHODS This was an anonymous international structured non-validated cross-sectional survey distributed via relevant professional societies in collaboration with the Research Collaborative in Peripheral Artery Disease. The survey was disseminated through societies' newsletters, emails, and social media. Data were collected online, allowing free text entries alongside structured multiple choice questions based on previous surveys. Demographics, geographical information, and data relating to stage and training environment were collected. RESULTS Of 587 respondents from 28 countries, 86% were working in vascular surgery, mostly at a university hospital (56%); 81% were aged between 31 and 60 years, 57% were working as a consultant, and 23% as a resident. Respondents were mostly white (83%), male (63%), heterosexual (94%), and without disability (96%). Overall, 253 (43%) reported experiencing BUH personally, 75% had witnessed BUH toward colleagues, and 51% witnessed these in the last 12 months. Female sex and non-white ethnicity were associated with BUH (53% vs. 38% and 57% vs. 40% respectively; p < .001 in both cases). While working as a consultant, 171 (50%) reported experiencing BUH, more often among females, non-heterosexuals, those who were not working in their country of birth, and non-white people. Specialty and hospital type were not associated with BUH. CONCLUSION BUH remains a major problem in the vascular workplace. Female sex, non-heterosexuality, and non-white ethnicity are associated with BUH at various career stages.
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Affiliation(s)
- Rachael O Forsythe
- Centre for Cardiovascular Science, University of Edinburgh and Department of Vascular Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK.
| | - Isabelle Van Herzeele
- Department of Thoracic and Vascular Surgery, Ghent University Hospital, Ghent, Belgium
| | - Hany Zayed
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Angeliki Argyriou
- Institute for Vascular Research, St. Franziskus Hospital, Münster, Germany
| | | | - Athanasios Saratzis
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
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Sossou CW, Fakhra S, Batra K, Nouthe B, Okoh A, Phillips-Wilson T, Kuria CN, Hawwass D, Ogunniyi MO, Singh A, Cohen M, Dawn B, Ahsan CH. Diversity in U.S. Cardiovascular Trainees and Leadership Where we are and What the Future Holds. Curr Probl Cardiol 2023; 48:101518. [PMID: 36464014 PMCID: PMC10082418 DOI: 10.1016/j.cpcardiol.2022.101518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 11/25/2022] [Indexed: 12/03/2022]
Abstract
Cardiovascular (CV) outcomes can be improved with commonality between provider and patient regarding gender and race/ethnicity. Slow growth in CV care provider diversity is an obstacle for women and underrepresented groups. The hope for more equitable outcomes is unlikely to be realized unless trends change in selection of CV fellows and program directors (PDs). We investigate longitudinal trends of gender and racial/ethnic composition of CV FITs. De-identified demographic data were compiled in a descriptive cross-sectional study from AAMC of internal medicine (IM) residents and CV FITs from 2011 through 2021 to evaluate gender and race/ethnicity trends among CV trainees. Trends of CV fellows who later became program directors were analyzed. In the US between 2011 and 2021, 53% of IM residents were male while 40% female (7% unreported). Among CV FITs, 78% were male and 21% female. Races/ethnicities among CV FITs consisted of 36% non-Hispanic white, 28% non-Hispanic Asian, 5% Hispanic, 4%Black, and 25% were classified within other race/ethnicity categories. The proportion who became CV program directors followed similarly: 79% of PDs were male and 21% female. Demographic profiles for CV FITs have not significantly changed over the past decade despite increased diversity among IM residents. Efforts to improve diversity of CV FITs and PDs need to be analyzed. Slow growth of diversity in CV FITs is outpaced by rising patient diversity, leading to disparities in care and poorer CV outcomes for women and underrepresented minorities. Recruiting, training, and retaining diverse CV FITs is necessary.
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Affiliation(s)
- Christoph W Sossou
- Las Vegas-Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, NV
| | - Sadaf Fakhra
- Las Vegas-Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, NV.
| | - Kavita Batra
- Las Vegas-Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, NV
| | - Brice Nouthe
- Department of Internal Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Alexis Okoh
- Department of Medicine, Emory University, Atlanta, GA
| | - Tasha Phillips-Wilson
- Department of Internal Medicine, St. George's University School of Medicine, True Bule, Greneda
| | - Carolyne N Kuria
- Department of Internal Medicine, Arrowhead Regional Medical Center, Arrowhead, CA, United States
| | - Dalia Hawwass
- Las Vegas-Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, NV
| | | | - Aditi Singh
- Las Vegas-Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, NV
| | - Marc Cohen
- Department of Internal Medicine, Newark Beth Israel Medical Center, Newark, NJ, United States
| | - Buddhadeb Dawn
- Las Vegas-Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, NV
| | - Chowdhury H Ahsan
- Las Vegas-Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, NV
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Douglas PS. Implementing an anti-bullying culture in cardiology. Nat Rev Cardiol 2022; 19:713-714. [PMID: 35948731 DOI: 10.1038/s41569-022-00762-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Pamela S Douglas
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA.
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Fry ETA. Gun Violence: Yes, This Is Our Lane. J Am Coll Cardiol 2022; 80:646-648. [PMID: 35926940 DOI: 10.1016/j.jacc.2022.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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