Women and Underrepresented Ethnic and Racial Groups in Cardiac Electrophysiology: Few and Far Between

Despite the increasing number of female medical students over the past few decades, women continue to be underrepresented in Cardiology. Women make less than 25% of general cardiology trainees and only 13% of cardiologists in practice¹. Dr. Kamala Tamirisa, a clinical Cardiac Electrophysiologist at Texas Cardiac Arrhythmia, co-chair for ACC Women in Cardiology Advocacy Work Group and National ACC Women in Cardiology Leadership Council Member, discusses challenges and solutions to enhance gender equity and women in cardiology and electrophysiology as part of the Narratives in Cardiology series on the CardioNerds Podcast (141. Narratives in Cardiology: Empowerment & Growing Together as Women in EP with Dr. Kamala Tamirisa – Texas ACC Chapter).

There has been sparse data on the number of women and underrepresented ethnic and racial groups (UREGs) who pursue subspecialty training and practice in Cardiac Electrophysiology (EP). However, two recent studies presented in Heart Rhythm 2022 highlight the extremely low numbers of women and UREGs in EP.

Dr. Howell and her colleagues looked at temporal and geographic trends in women EP proceduralists using Medicare Data from 2013-2019. The results showed that only about 5% of 3524 EP operators in the United States are women. This number continued to be stagnant over the 7-year period, despite the 137% increase in the total number of atrial fibrillation ablationists and 75% increase in the number of EP trainees. Moreover, they found that 20% of states did not have a single woman EP operator performing at least a moderate volume of any 1 EP procedure.

In another study, Dr. Batnyam and her colleagues quantified the number of females and underrepresented racial and ethnic group applicants in Clinical Cardiac Electrophysiology Programs. The results underscore the significant difference in sex and self-identified race/ethnicity among cardiovascular fellows who pursue EP training. Women only comprised 13-15% of applicants, while UREGs are drastically lower.  In the 2021 academic year, there are only 4 (3%) Black or African Americans and 7 (5%) of Hispanic, Latino or Spanish origin. There are no applicants who identified as American Indian, Alaska Native, Native Hawaiian or other Pacific Islander.

Using @MedicareGov data, we show that 5% (n=187) of EP operators are #WomeninEP. % women was stagnant from 2013-2019. Total AF operators grew by +137%, yet women operators were unchanged (4%,n=46). #EPeeps @HRSonline how can we recruit/retain more #WomeninEP? https://t.co/4Zt7o44YKb

— Stacey Howell (@StaceyHowellMD) April 29, 2022

Dr. Kamala Tamirisa comments, “Women and underrepresented racial and ethnic groups are inadequately represented in EP and experience potential barriers to pursuing this subspecialty. These recent studies further highlight the plugged and leaky EP career pathway. It is time for actionable goals and results that will help promote more women and underrepresented racial and ethnic groups in EP.”

2 studies being presented at Heart Rhythm 2022 this weekend show findings of the low number of women & individuals from ethnic minorities in cardiac electrophysiology. The studies are published in #JACCCEP & Heart Rhythm. https://t.co/4jG1UNcuMf @Medscape

— ACC Media Center (@ACCmediacenter) May 2, 2022

EP Fellow @StaceyHowellMD's study highlights electrophysiology’s gender disparity showing that only 5% of electrophysiology operators are women with no improvement in representation from 2013-2019. Findings were presented at Heart Rhythm. https://t.co/WQqeU1pU50 #WIC #Epeeps

— UCSF Cardiology (@UCSFCardiology) May 9, 2022

References:

1. AAMC: Association of American Medical Colleges [Internet] Washington, DC: AAMC; c2019. ACGME residents and fellows by sex and specialty, 2015; 2015 [cited 2019 Feb 8].

2.  Howell SJ, Simpson T, Atkinson T, Pellegrini CN, Nazer B. Temporal and geographical trends in women operators of electrophysiology procedures in the United States. Heart Rhythm. 2022 May;19(5):807-811. doi: 10.1016/j.hrthm.2022.02.015. PMID: 35501106.

3. Batnyam U, Chang D, Cheung JW, Joglar JA, Daubert JP, Tedrow U. Quantification of Female and Underrepresented Minority Applicants to Clinical Cardiac Electrophysiology Fellowship. JACC Clin Electrophysiol. 2022 Apr 19:S2405-500X(22)00307-3. doi: 10.1016/j.jacep.2022.04.001. Epub ahead of print. PMID: 35491386