Work-life balance: a comparison of women in cardiology and other specialties.

OBJECTIVE: Significant gender disparities exist in some medical specialties, particularly cardiology. We assessed work, personal life and work-life balance in women in cardiology in Australia and New Zealand (NZ), compared with other specialties, to determine factors that may contribute to the lack of women in the specialty. METHODS: This study is a prospective survey-based cohort study comparing cardiology and non-cardiology specialties. An online survey was completed by female doctors in Australia and NZ, recruited via email lists and relevant social media groups. The survey included demographics, specialty, stage of training, work hours/setting, children and relationships, career satisfaction, income and perceptions of specialty. RESULTS: 452 participants completed the survey (median age 36 years), of which 57 (13%) worked in cardiology. Of all respondents, 84% were partnered and 75% had children, with no difference between cardiology and non-cardiology specialties. Compared with non-cardiology specialties, women in cardiology worked more hours per week (median 50 hours vs 40 hours, p<0.001), were more likely to be on call more than once per week (33% vs 12%, p<0.001) and were more likely to earn an annual income >$3 00 000 (35% vs 10%, p<0.001). Women in cardiology were less likely to agree that they led a balanced life (33% vs 51%, p=0.03) or that their specialty was female friendly (19% vs 75%, p<0.001) or family friendly (20% vs 63%, p<0.001). CONCLUSIONS: Compared with other specialties, women in cardiology reported poorer work-life balance, greater hours worked and on-call commitments and were less likely to perceive their specialty as female friendly or family friendly. Addressing work-life balance may attract and retain more women in cardiology.

Women in Cardiology in Australia-Are We Making Any Progress?

Women remain largely under-represented in cardiology worldwide, despite gender parity among medical graduates. This is particularly notable in procedural subspecialties such as interventional cardiology and electrophysiology and is consistent at all levels of training. Cardiology continues to have the lowest proportion of females of all adult medicine specialties. This is a review of existing literature and statistics pertaining to women in cardiology and highlights the relative paucity of data or publications within Australia. Australian data from the Medical Training Review Panel reported that the proportion of females in cardiology advanced training (˜22%) has not changed over the last 9 years and that there is a significant attrition as trainees progress through the various stages of training. In 2018, females represent only 16% of first year cardiology advanced trainees in Victoria and Tasmania. This represents a decrease from 20-25% in previous years. The factors affecting gender parity in cardiology are complex and diverse, from personal reasons such as family planning, work-life balance and perceived gender bias, to recruitment inertia and an imbalance in opportunities for career progression, research, financial remuneration and leadership positions. Worldwide, a number of initiatives have been explored to address the gender divide in cardiology, including networking and mentorship programs and Women in Cardiology working groups, dedicated to addressing the issue of female under-representation in cardiology. Unfortunately, the progress we are seeing worldwide is not being realised in Australia. A collaborative approach is essential to achieve gender parity in cardiology. This involves introspection and accountability by College bodies and policy changes committed to promoting workplace diversity by welcoming and retaining female talent. We must recognise and address the current barriers and support women pursuing a career in cardiology.

Radiation exposure with the radial approach for diagnostic coronary angiography in a centre previously performing purely the femoral approach.

INTRODUCTION: Use of the radial approach for coronary angiography and percutaneous coronary intervention (PCI) is known to improve many patient outcome measures. However, there is some concern that it may be associated with increased patient radiation exposure. This study explores radiation exposure with the radial approach compared with the femoral approach in a centre previously performing purely femoral approach. PATIENTS AND METHODS: Data was collected retrospectively for all patients undergoing diagnostic coronary angiography over a six month period. PCIs and procedures with inherent technical difficulty or use of additional techniques (graft studies, optical coherence tomography, fractional flow reserve) were excluded. Dose area product (DAP) and fluoroscopy time (FT) were analysed for all remaining procedures (n=389), comparing radial (n=109) and femoral (n=280) approaches. RESULTS: The overall mean FT for transradial cases (7.45 mins) was significantly higher than for transfemoral cases (4.59 mins; p<0.001). The overall mean DAP for transradial cases (95.64 G Gycm(2)) was significantly higher than for transfemoral cases (70.25 Gycm(2), p<0.05)). Neither the FT nor the DAP decreased over the six month period. CONCLUSION: The radial approach was associated with significantly higher DAP and FT compared to the femoral approach during an initial introductory phase which was likely insufficient to develop radial proficiency. The results of this study are consistent with previous studies and may influence choice of access for non-emergent diagnostic coronary angiography before radial proficiency has been established, particularly for patients more susceptible to radiation risks.