Fellowship directors endorse the need for increasing diversity in cardiology

Reviewed by Emily Henderson, B.Sc.Jul 30 2021

Underrepresented minorities remain few in number among practicing cardiologists and across cardiology fellowship training programs in the United States, with fellowship directors agreeing that increased diversity is needed in the field and is particularly necessary within graduate medical education cardiology fellowship training programs.

Underrepresented minorities, specifically African American, Native American, Hispanic and/or Pacific Island physicians comprise only about 12% of the cardiology workforce. There are cardiology fellowship programs in the U.S. that have never trained an underrepresented minority fellow until recently, said study author Arif Musa, a fourth-year medical student at the Wayne State University School of Medicine.

Cardiovascular disease is a leading contributor to morbidity and mortality throughout the United States. Minority communities are often disproportionately affected and not able to access care until the disease has progressed greatly. Moreover, cardiology remains one of the least diverse specialties with regard to representation of African American, Native American, Hispanic and/or Pacific Islander cardiologists. Given the role of cardiology fellowship training program directors in selecting and ranking applicants to their programs, our study sought to identify which strategies program directors preferred to increase underrepresented minority representation in cardiology."

Arif Musa, a fourth-year medical student, Wayne State University School of Medicine

The study, "Increasing Diversity in Cardiology: A Fellowship Director's Perspective," was published this month in Cureus Journal of Medical Science by a team that included Musa's Class of 2022 classmates Amman Bhasin and Louis Massoud; Class of 2021 graduate and WSU Family Medicine resident Azar Razikeen, M.D.; Cedars-Sinai Medical Center attending cardiologist Arshia Noori, M.D.; Henry Ford Health Internal Medicine residents and School of Medicine alumni Ali Ghandour, M.D. '20, and David Gelovani, M.D. '20; WSU Professor of Medicine and Division of Cardiology Chief Luis Afonso, M.D., and WSU Professor of Medicine Randy Lieberman, M.D., both attending cardiologists at Detroit Medical Center; and Ajay Vaidya, M.D., attending cardiologist and association program director of the Cardiology Fellowship program at the University of California Keck School of Medicine.

The findings were presented at the 70th American College of Cardiology annual meeting in May.

A 15-item survey was submitted to all American College of Graduate Medical Education- accredited cardiology fellowship programs via email to compile the study data. The cross-sectional study was performed to identify which strategies were supported and implemented by cardiology fellowship program directors to increase representation, to determine which entities hold the responsibility to increase diversity according to program directors, and to quantify representation in cardiology fellowship programs.

According to the study, program directors endorsed several avenues that would alleviate the gap. They included increasing the number of underrepresented faculty (73.2%), mentorship by underrepresented faculty (69%), holistic application review (67.6%), opportunities for applicants to connect with other minority fellows (54.9%), increased involvement of underrepresented minority faculty in the application selection process (54.9%) and recruitment by current fellows (54.9%) were endorsed by program directors.

Program directors allocated the most responsibility to increase diversity to fellowship programs (71.8%), but most also allocated responsibility to internal medicine residency programs (63.3%) and medical schools (53.5%).