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York M, Douglas PS, Damp JB, Fraiche AM, Gillam LD, Hayes SN, Rzeszut AK, Sulistio MS, Wood MJ. Professional Preferences and Perceptions of Cardiology Among Internal Medicine Residents: Temporal Trends Over the Past Decade. JAMA Cardiol 2022; 7:1253-1258. [PMID: 36223091 PMCID: PMC9558028 DOI: 10.1001/jamacardio.2022.3485] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 08/19/2022] [Indexed: 01/13/2023]
Abstract
Importance Internal medicine residents' professional development preferences were discordant with their perceptions of cardiology in a survey circulated a decade ago; no contemporary data exist. This information is important for effective recruitment and retention of a highly talented and diverse future cardiology workforce. Objective To identify residents' professional development preferences and cardiology perceptions, in relation to specialty choice, and compare the findings with those from a decade prior. Design, Setting, and Participants The original survey from the 2010 study was updated and sent to US internal medicine programs. Respondents (ie, internal medicine residents) rated 38 professional development preferences and 20 cardiology perceptions. Data were collected in 2020 and compared with survey results from the prior 2010 study. Multivariable models were created for specialty choice using scaled independent variables dichotomized using the top 2 options; categorical variables were recoded into binary variables for analysis. Main Outcomes and Measures Multivariable models were used to determine the association of demographic characterisitcs and survey responses with prospective career choice. Responses were examined by total group, by gender, by self-reported consideration of entering cardiology as a profession, and by comparison with a decade prior both as a group and by gender. Results A total of 840 residents (mean [SD] age, 29.24 [2.82] years; 49.8% male; 55.4% White) completed the survey. The survey incorporated a 5-point Likert scale of 1 (not important) to 5 (extremely important) for some of the questions, with additional questions on demographic characteristics. The most important professional development preferences by descending Likert score were as follows: positive role models (4.56), stimulating career (3.81), and family friendly (3.78). The cardiology perception statements with the highest agreement were as follows: interferes with family life during training (3.93) and having met positive role models or having positive views of cardiovascular disease as a topic (3.85). Multivariable analysis yielded a 22-element model predicting cardiology as career choice. Compared with the 2010 survey, the findings of this survey indicated increased importance of work-life balance components for both male and female residents, with a greater change in male residents. Contemporary residents were more likely than their predecessors to agree with negative perceptions of cardiology. Conclusions and Relevance This survey study found that both male and female residents place a high value on support for optimal work-life balance; these preferences have intensified over the past decade and factor into career choice. Negative perceptions of cardiology persist and, in some aspects, are worsening. Improving the culture of cardiology may make this specialty a more attractive career choice for all.
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Affiliation(s)
- Meghan York
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | | | - Julie B. Damp
- Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Ariane M. Fraiche
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Linda D. Gillam
- Department of Cardiovascular Medicine, Gagnon Cardiovascular Institute, Morristown Medical Center/Atlantic Health System, Morristown, New Jersey
| | - Sharonne N. Hayes
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | | | - Melanie S. Sulistio
- Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern, Dallas
| | - Malissa J. Wood
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
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Waldman CE, Min JH, Wassif H, Freeman AM, Rzeszut AK, Reilly J, Theriot P, Soliman AM, Thamman R, Bhatt A, Bhavnani SP. COVID-19 telehealth preparedness: a cross-sectional assessment of cardiology practices in the USA. Per Med 2022; 19:411-422. [PMID: 35912812 DOI: 10.2217/pme-2021-0179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aim: The COVID-19 pandemic forced medical practices to augment healthcare delivery to remote and virtual services. We describe the results of a nationwide survey of cardiovascular professionals regarding telehealth perspectives. Materials & methods: A 31-question survey was sent early in the pandemic to assess the impact of COVID-19 on telehealth adoption & reimbursement. Results: A total of 342 clinicians across 42 states participated. 77% were using telehealth, with the majority initiating usage 2 months after the COVID-19 shutdown. A variety of video-based systems were used. Telehealth integration requirements differed, with electronic medical record integration being mandated in more urban than rural practices (70 vs 59%; p < 0.005). Many implementation barriers surfaced, with over 75% of respondents emphasizing reimbursement uncertainty and concerns for telehealth generalizability given the complexity of cardiovascular diseases. Conclusion: Substantial variation exists in telehealth practices. Further studies and legislation are needed to improve access, reimbursement and the quality of telehealth-based cardiovascular care.
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Affiliation(s)
- Carly E Waldman
- Department of Internal Medicine, Scripps Clinic, San Diego, CA, USA.,Division of Cardiology, Healthcare Innovation Laboratory, Prebys Cardiovascular Institute, Scripps Clinic, San Diego, CA 92037,USA
| | - Jean H Min
- Department of Internal Medicine, Scripps Clinic, San Diego, CA, USA.,Division of Cardiology, Healthcare Innovation Laboratory, Prebys Cardiovascular Institute, Scripps Clinic, San Diego, CA 92037,USA
| | - Heba Wassif
- Department of Cardiovascular Medicine, Section of Clinical Cardiology, Heart, Vascular & Thoracic Institute, Cleveland Clinic Foundation, Cleveland, OH 44103, USA
| | - Andrew M Freeman
- Department of Medicine, Division of Cardiology, National Jewish Health, Denver, CO 80206, USA
| | - Anne K Rzeszut
- American College of Cardiology, Heart House, Washington, DC 20037, USA
| | - Jack Reilly
- American College of Cardiology, Heart House, Washington, DC 20037, USA
| | - Paul Theriot
- American College of Cardiology, Heart House, Washington, DC 20037, USA
| | - Ahmed M Soliman
- Division of Cardiology, Houston Methodist DeBakey Cardiology Associates, Houston, TX 77030, USA
| | - Ritu Thamman
- Division of Medicine, University of Pittsburg School of Medicine, Pittsburg, PA 15213, USA
| | - Ami Bhatt
- Division of Cardiology, Adult Congenital Heart Disease Program, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Sanjeev P Bhavnani
- Division of Cardiology, Healthcare Innovation Laboratory, Prebys Cardiovascular Institute, Scripps Clinic, San Diego, CA 92037,USA
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Thomas KL, Mehta LS, Rzeszut AK, Lewis SJ, Duvernoy CS, Douglas PS. Perspectives of Racially and Ethnically Diverse U.S. Cardiologists: Insights From the ACC Professional Life Survey. J Am Coll Cardiol 2021; 78:1746-1750. [PMID: 34674820 DOI: 10.1016/j.jacc.2021.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/01/2021] [Accepted: 09/02/2021] [Indexed: 11/18/2022]
Affiliation(s)
| | | | | | - Sandra J Lewis
- Northwest Cardiovascular Institute, Portland, Oregon, USA
| | - Claire S Duvernoy
- VA Ann Arbor Healthcare System, University of Michigan, Ann Arbor, Michigan, USA
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Abdulsalam N, Gillis AM, Rzeszut AK, Yong CM, Duvernoy CS, Langan MN, West K, Velagapudi P, Killic S, O'Leary EL. Gender Differences in the Pursuit of Cardiac Electrophysiology Training in North America. J Am Coll Cardiol 2021; 78:898-909. [PMID: 34446162 DOI: 10.1016/j.jacc.2021.06.033] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 06/08/2021] [Accepted: 06/16/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Despite the increase in the number of female physicians across most specialties within cardiology, <10% of clinical cardiac electrophysiology (EP) fellows are women. OBJECTIVES This study sought to determine the factors that influence fellows-in-training (FITs) to pursue EP as a career choice and whether this differs by gender. METHODS The authors conducted an online multiple-choice survey through the American College of Cardiology to assess the decision factors that influence FITs in the United States and Canada to pursue cardiovascular subspecialties. RESULTS A total of 933 (30.5%) FITs completed the survey; 129 anticipated specializing in EP, 259 in interventional cardiology (IC), and 545 in a different field or were unsure. A total of 1 in 7 (14%) FITs indicated an interest in EP. Of this group, more men chose EP than women (84% vs 16%; P < 0.001). The most important factor that influenced FITs to pursue EP was a strong interest in the field. Women were more likely to be influenced by having a female role model (P = 0.001) compared with men. After excluding FITs interested in IC, women who deselected EP were more likely than men to be influenced by greater interest in another field (P = 0.004), radiation concerns (P = 0.001), lack of female role models (P = 0.001), a perceived "old boys' club" culture (P = 0.001) and discrimination/harassment concerns (P = 0.001). CONCLUSIONS Women are more likely than men to be negatively influenced by many factors when it comes to pursuing EP as a career choice. Addressing those factors will help decrease the gender disparity in the field.
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Affiliation(s)
- Nashwa Abdulsalam
- Division of Cardiology, University of Nebraska Medical Center, Omaha, Nebraska, USA; Division of Cardiology, University of Washington, Seattle, Washington, USA
| | - Anne M Gillis
- Department of Cardiac Sciences, University of Calgary and Libin Cardiovascular Institute of Alberta, Calgary, Alberta, Canada
| | - Anne K Rzeszut
- Market Intelligence, American College of Cardiology, Washington, DC, USA
| | - Celina M Yong
- VA Palo Alto Medical Center, Palo Alto, California, USA; Department of Medicine, Stanford University and Stanford Cardiovascular Institute, Stanford, California, USA
| | - Claire S Duvernoy
- VA Ann Arbor Healthcare System/University of Michigan, Division of Cardiovascular Medicine, Ann Arbor, Michigan, USA
| | - Marie-Noelle Langan
- Division of Cardiology, Mt. Sinai School of Medicine, New York, New York, USA
| | - Kristin West
- Member Strategy, American College of Cardiology, Washington, DC, USA
| | - Poonam Velagapudi
- Division of Cardiology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Sena Killic
- Division of Cardiology, Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Edward L O'Leary
- Division of Cardiology, University of Nebraska Medical Center, Omaha, Nebraska, USA.
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Abudayyeh I, Tandon A, Wittekind SG, Rzeszut AK, Sivaram CA, Freeman AM, Madhur MS. Landscape of Mentorship and its Effects on Success in Cardiology. JACC Basic Transl Sci 2020; 5:1181-1186. [PMID: 33426375 PMCID: PMC7775959 DOI: 10.1016/j.jacbts.2020.09.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 09/22/2020] [Accepted: 09/22/2020] [Indexed: 01/27/2023]
Abstract
Mentees are more satisfied with their mentorship experience when they have had more than 3 mentors or a mentor from outside of their practice/institution. Satisfaction with the mentoring relationship is significantly associated with perceived satisfaction in achieving professional goals. Sex and race/ethnicity concordance in mentoring relationships is associated with positive outcomes. Characteristics that mentees desire in a mentor tend to change with time/career stage.
The effects of mentorship on measurable outcomes of success and the aspects of mentorship that are most valuable in promoting the careers of cardiologists are unclear. To address this, we conducted a large-scale survey of cardiologists in a real-world setting. We identified factors that enhance the mentorship experience, and found that mentee needs change with career stage. Importantly, satisfaction with the mentoring relationship is significantly associated with perceived satisfaction in achieving professional goals. Furthermore, we found that gender and race concordance in mentoring relationships is an important variable with the potential to increase diversity in the field of cardiology.
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Affiliation(s)
- Islam Abudayyeh
- Division of Cardiology, Loma Linda University, Loma Linda, California, USA
| | - Animesh Tandon
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Division of Cardiology, Children's Medical Center, Dallas, Texas, USA
| | - Samuel G Wittekind
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.,The Heart Institute, Cincinnati Children's, Cincinnati, Ohio, USA
| | | | - Chittur A Sivaram
- Cardiovascular Section, Department of Medicine, University of Oklahoma, Oklahoma City, Oklahoma, USA
| | - Andrew M Freeman
- Division of Cardiology, Department of Medicine, National Jewish Health, Denver, Colorado, USA
| | - Meena S Madhur
- Department of Medicine, Division of Cardiovascular Medicine, Vanderbilt University Medical Center (VUMC), Nashville, Tennessee, USA.,Department of Medicine, Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Vanderbilt Institute for Infection, Immunology, and Inflammation, Nashville, Tennessee, USA
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Mehta LS, Fisher K, Rzeszut AK, Lipner R, Mitchell S, Dill M, Acosta D, Oetgen WJ, Douglas PS. Current Demographic Status of Cardiologists in the United States. JAMA Cardiol 2020; 4:1029-1033. [PMID: 31509160 DOI: 10.1001/jamacardio.2019.3247] [Citation(s) in RCA: 90] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Increasing cardiology workforce diversity will expand the talent of the applicant pool and may reduce health care disparities. Objective To assess US cardiology physician workforce demographics by sex and race/ethnicity in the context of the US population and the available pipelines of trainees. Design, Setting, and Participants This cross-sectional study used data from the Association of American Medical Colleges, the American Medical Association, and the American Board of Internal Medicine to stratify medical students, resident physicians, fellows, and cardiologists by sex and race/ethnicity. Additionally, proportional changes from 2006 through 2016 were assessed for adult and pediatric cardiology. Data analysis took place from August 2018 to January 2019. Main Outcomes and Measures Percentage of cardiologists and trainees by sex and race/ethnicity in 2016, as well as changes in proportions between 2006 and 2016. Results Despite a high percentage of female internal medicine resident physicians (10 765 of 25 252 [42.6%]), female physicians were underrepresented in adult general cardiology fellowships (584 of 2720 [21.5%]) and procedural subspecialty fellowships (interventional cardiology, 30 of 305 [9.8%]; electrophysiology, 24 of 175 [13.7%]). The percentage of female adult cardiologists slightly increased from 2006 through 2016 (from 8.9% to 12.6%; slope, 0.36; P < .001) but remained low. Female physicians made up a disproportionately higher number of pediatric residency positions (6439 of 8832 [72.9%]). Trends showed an increase in female pediatric cardiology fellows (from 40.4% to 50.5%; slope, 1.25; P < .001), which resulted in an increase in the percentage of female pediatric cardiologists (from 27.1% to 34.0%; slope, 0.64; P < .001). The percentages of members of underrepresented minority groups in adult and pediatric cardiology fellowships (from 11.1% to 12.4%; slope, 0.15; P = .01; and from 7.7% to 9.9%; slope, 0.29; P = .009; respectively) were low and increased only slightly over time. Additionally, members of underrepresented minorities made up less than 8% of practicing adult and pediatric cardiologists. Although Asian individuals are 5.2% of the US general population, they are not considered underrepresented because they are 22.1% of US medical school graduates (n = 4202 of 18 999), 38.1% of internal medicine resident physicians (n = 9618 of 25 252), 40.4% of adult cardiology fellows (n = 1098 of 2720), 19.9% of adult cardiologists (n = 5973 of 30 016), 22.6% of pediatric resident physicians (n = 1998 of 8832), 28.0% of pediatric cardiology fellows (n = 122 of 436), and 20.1% of pediatric cardiologists (n = 574 of 2860). Conclusions and Relevance Female physicians remain underrepresented in adult cardiology, despite a robust pipeline of female medical students and internal medicine resident physicians. Women in pediatric cardiology are underrepresented but increasing in number. Members of several racial/ethnic minority groups remain underrepresented in adult and pediatric cardiology, and the percentages of trainees and medical students from these groups were also low. Different strategies are needed to address the continuing lack of diversity in cardiology for underrepresented minority individuals and women.
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Affiliation(s)
| | - Kara Fisher
- Association of American Medical Colleges, Washington, DC
| | | | - Rebecca Lipner
- American Board of Internal Medicine, Philadelphia, Pennsylvania
| | | | - Michael Dill
- Association of American Medical Colleges, Washington, DC
| | - David Acosta
- Association of American Medical Colleges, Washington, DC
| | | | - Pamela S Douglas
- Duke University School of Medicine, Duke Clinical Research Institute, Durham, North Carolina
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7
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Yong CM, Abnousi F, Rzeszut AK, Douglas PS, Harrington RA, Mehran R, Grines C, Altin SE, Duvernoy CS. Sex Differences in the Pursuit of Interventional Cardiology as a Subspecialty Among Cardiovascular Fellows-in-Training. JACC Cardiovasc Interv 2019; 12:219-228. [DOI: 10.1016/j.jcin.2018.09.036] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 09/23/2018] [Accepted: 09/25/2018] [Indexed: 11/28/2022]
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8
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Douglas PS, Rzeszut AK, Bairey Merz CN, Duvernoy CS, Lewis SJ, Walsh MN, Gillam L. Career Preferences and Perceptions of Cardiology Among US Internal Medicine Trainees: Factors Influencing Cardiology Career Choice. JAMA Cardiol 2018; 3:682-691. [PMID: 29847674 PMCID: PMC6143073 DOI: 10.1001/jamacardio.2018.1279] [Citation(s) in RCA: 115] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 03/24/2018] [Indexed: 11/14/2022]
Abstract
Importance Few data exist on internal medicine trainees' selection of cardiology training, although this is important for meeting future cardiology workforce needs. Objective To discover trainees' professional development preferences and perceptions of cardiology, and their relationship to trainees' career choice. Design, Setting, and Participants We surveyed trainees to discover their professional development preferences and perceptions of cardiology and the influence of those perceptions and preferences on the trainees' career choices. Participants rated 38 professional development needs and 19 perceptions of cardiology. Data collection took place from February 2009, through January 2010. Data analysis was conducted from May 2017 to December 2017. Main Outcomes and Measures Multivariable models were used to determine the association of demographics and survey responses with prospective career choice. Results A total of 4850 trainees were contacted, and 1123 trainees (of whom 625 [55.7%] were men) in 198 residency programs completed surveys (23.1% response; mean [SD] age, 29.4 [3.5] years). Principal component analysis of survey responses resulted in 8-factor and 6-factor models. Professional development preferences in descending order of significance were stable hours, family friendliness, female friendliness, the availability of positive role models, financial benefits, professional challenges, patient focus, and the opportunity to have a stimulating career. The top perceptions of cardiology in descending order of significance were adverse job conditions, interference with family life, and a lack of diversity. Women and future noncardiologists valued work-life balance more highly and had more negative perceptions of cardiology than men or future cardiologists, who emphasized the professional advantages available in cardiology. Professional development factors and cardiology perceptions were strongly associated with a decision to pursue or avoid a career in cardiology in both men and women. Conclusions and Relevance Alignment of cardiology culture with trainees' preferences and perceptions may assist efforts to ensure the continued attractiveness of cardiology careers and increase the diversity of the cardiology workforce.
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Affiliation(s)
- Pamela S. Douglas
- Duke Clinical Research Institute and Division of Cardiology, Duke University School of Medicine, Durham, North Carolina
| | | | - C. Noel Bairey Merz
- Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Claire S. Duvernoy
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan
- University of Michigan Division of Cardiovascular Medicine, Ann Arbor
| | | | | | - Linda Gillam
- Morristown Medical Center, Atlantic Health System, Morristown, New Jersey
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Aggarwal M, Devries S, Freeman AM, Ostfeld R, Gaggin H, Taub P, Rzeszut AK, Allen K, Conti RC. The Deficit of Nutrition Education of Physicians. Am J Med 2018; 131:339-345. [PMID: 29269228 DOI: 10.1016/j.amjmed.2017.11.036] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Revised: 11/24/2017] [Accepted: 11/27/2017] [Indexed: 11/24/2022]
Abstract
Globally, death rates from cardiovascular disease are increasing, rising 41% between 1990 and 2013, and are often attributed, at least in part, to poor diet quality. With urbanization, economic development, and mass marketing, global dietary patterns have become more Westernized to include more sugar-sweetened beverages, highly processed foods, animal-based foods, and fewer fruits and vegetables, which has contributed to increasing cardiovascular disease globally. In this paper, we will examine the trends occurring globally in the realm of nutrition and cardiovascular disease prevention and also present new data that international nutrition knowledge amongst cardiovascular disease providers is limited. In turn, this lack of knowledge has resulted in less patient education and counseling, which is having profound effects on cardiovascular disease prevention efforts worldwide.
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Affiliation(s)
- Monica Aggarwal
- Division of Cardiology, University of Florida, Gainesville, FL.
| | - Stephen Devries
- Gaples Institute for Integrative Cardiology, Deerfield, Ill; Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Andrew M Freeman
- Division of Cardiology, Department of Medicine, National Jewish Health, Denver, Colo
| | - Robert Ostfeld
- Division of Cardiology, Montefiore Medical Center, New York, NY
| | - Hanna Gaggin
- Division of Cardiology, Massachusetts General Hospital, Boston; Baim Institute for Clinical Research, Boston, Mass
| | - Pam Taub
- Cardiovascular Division, UC San Diego Health System, Calif
| | - Anne K Rzeszut
- Market Intelligence, American College of Cardiology, Washington, DC
| | - Kathleen Allen
- Department of Nutrition & Food Studies, New York University, New York, NY
| | - Richard C Conti
- Division of Cardiology, University of Florida, Gainesville, FL
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Tong CW, Madhur MS, Rzeszut AK, Abdalla M, Abudayyeh I, Alexanderson E, Buber J, Feldman DN, Gopinathannair R, Hira RS, Kates AM, Kessler T, Leung S, Raj SR, Spatz ES, Turner MB, Valente AM, West K, Sivaram CA, Hill JA, Mann DL, Freeman AM. Status of Early-Career Academic Cardiology: A Global Perspective. J Am Coll Cardiol 2017; 70:2290-2303. [PMID: 29073958 PMCID: PMC5665176 DOI: 10.1016/j.jacc.2017.09.030] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 08/28/2017] [Accepted: 09/14/2017] [Indexed: 01/09/2023]
Abstract
Early-career academic cardiologists, who many believe are an important component of the future of cardiovascular care, face myriad challenges. The Early Career Section Academic Working Group of the American College of Cardiology, with senior leadership support, assessed the progress of this cohort from 2013 to 2016 with a global perspective. Data consisted of accessing National Heart, Lung, and Blood Institute public information, data from the American Heart Association and international organizations, and a membership-wide survey. Although the National Heart, Lung, and Blood Institute increased funding of career development grants, only a small number of early-career American College of Cardiology members have benefited as funding of the entire cohort has decreased. Personal motivation, institutional support, and collaborators continued to be positive influential factors. Surprisingly, mentoring ceased to correlate positively with obtaining external grants. The totality of findings suggests that the status of early-career academic cardiologists remains challenging; therefore, the authors recommend a set of attainable solutions.
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Affiliation(s)
- Carl W Tong
- Department of Medical Physiology, Texas A&M University College of Medicine and Department of Medicine, Division of Cardiology-Temple Region, Baylor Scott & White Health, Temple, Texas.
| | - Meena S Madhur
- Department of Medicine, Division of Clinical Pharmacology and Division of Cardiology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Anne K Rzeszut
- Market Intelligence, American College of Cardiology, Washington, District of Columbia
| | - Marwah Abdalla
- Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, New York
| | - Islam Abudayyeh
- Division of Cardiology, Loma Linda University Medical Center, Loma Linda, California
| | - Erick Alexanderson
- National Institute of Cardiology and Medical Physiology, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Jonathan Buber
- Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Israel
| | - Dmitriy N Feldman
- Weill Cornell Medical College/NewYork-Presbyterian Hospital, New York, New York
| | | | - Ravi S Hira
- Division of Cardiology, University of Washington, Seattle, Washington
| | - Andrew M Kates
- Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri
| | - Thorsten Kessler
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
| | - Steve Leung
- Division of Cardiovascular Medicine, University of Kentucky, Lexington, Kentucky
| | - Satish R Raj
- Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | | | | | - Anne Marie Valente
- Department of Cardiology, Boston Children's Hospital, Department of Medicine, Division of Cardiovascular Disease, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Kristin West
- Member Strategy, American College of Cardiology, Washington, District of Columbia
| | - Chittur A Sivaram
- Department of Medicine, Cardiovascular Section, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma
| | - Joseph A Hill
- Department of Internal Medicine, Cardiology Division, and Harry S. Moss Heart Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Douglas L Mann
- Center for Cardiovascular Research, Department of Medicine and Washington University School of Medicine, St. Louis, Missouri
| | - Andrew M Freeman
- Department of Medicine, Division of Cardiology, National Jewish Health, Denver, Colorado
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11
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Barac A, Murtagh G, Carver JR, Chen MH, Freeman AM, Herrmann J, Iliescu C, Ky B, Mayer EL, Okwuosa TM, Plana JC, Ryan TD, Rzeszut AK, Douglas PS. Cardiovascular Health of Patients With Cancer and Cancer Survivors: A Roadmap to the Next Level. J Am Coll Cardiol 2015; 65:2739-46. [PMID: 26112199 DOI: 10.1016/j.jacc.2015.04.059] [Citation(s) in RCA: 157] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 04/30/2015] [Indexed: 11/19/2022]
Abstract
Many existing and emerging cancer therapies have a significant effect on the cardiovascular health of patients with cancer and cancer survivors. This paper examines current aspects of interdisciplinary cardio-oncology clinical care delivery and education in the United States and outlines how these data provide a platform for future development of the field. We present the results of the nationwide survey on cardio-oncology services, practices, and opinions, conducted among chiefs of cardiology and program directors, which demonstrate ranges of clinical activities and identify significant interest for increased educational opportunities and expert training of cardiovascular physicians in this field. The survey respondents recognized clinical relevance but emphasized lack of national guidelines, lack of funds, and limited awareness and infrastructure as the main challenges for development and growth of cardio-oncology. We discuss potential solutions to unmet needs through interdisciplinary collaboration and the active roles of professional societies and other stakeholders.
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Affiliation(s)
- Ana Barac
- MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington, DC.
| | | | - Joseph R Carver
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ming Hui Chen
- Boston Children's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | | | - Joerg Herrmann
- Mayo Clinic and College of Medicine, Rochester, Minnesota
| | | | - Bonnie Ky
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Erica L Mayer
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | | | | | - Thomas D Ryan
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | | | - Pamela S Douglas
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina
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12
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Tong CW, Ahmad T, Brittain EL, Bunch TJ, Damp JB, Dardas T, Hijar A, Hill JA, Hilliard AA, Houser SR, Jahangir E, Kates AM, Kim D, Lindman BR, Ryan JJ, Rzeszut AK, Sivaram CA, Valente AM, Freeman AM. Challenges facing early career academic cardiologists. J Am Coll Cardiol 2014; 63:2199-208. [PMID: 24703919 PMCID: PMC4306449 DOI: 10.1016/j.jacc.2014.03.011] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Revised: 03/01/2014] [Accepted: 03/04/2014] [Indexed: 11/26/2022]
Abstract
Early career academic cardiologists currently face unprecedented challenges that threaten a highly valued career path. A team consisting of early career professionals and senior leadership members of American College of Cardiology completed this white paper to inform the cardiovascular medicine profession regarding the plight of early career cardiologists and to suggest possible solutions. This paper includes: 1) definition of categories of early career academic cardiologists; 2) general challenges to all categories and specific challenges to each category; 3) obstacles as identified by a survey of current early career members of the American College of Cardiology; 4) major reasons for the failure of physician-scientists to receive funding from National Institute of Health/National Heart Lung and Blood Institute career development grants; 5) potential solutions; and 6) a call to action with specific recommendations.
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Affiliation(s)
- Carl W Tong
- Department of Medical Physiology and Department of Medicine/Cardiology Division, Texas A&M University Health Science Center-Baylor Scott & White Healthcare, Temple, Texas.
| | - Tariq Ahmad
- Duke University Medical Center, Durham, North Carolina
| | - Evan L Brittain
- Department of Medicine/Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - T Jared Bunch
- Heart Rhythm Program, Intermountain Medical Center, Murray, Utah
| | - Julie B Damp
- Department of Medicine/Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Todd Dardas
- Department of Internal Medicine, University of Washington Medical Center, Seattle, Washington
| | - Amalea Hijar
- Member Strategy and Career Development Department, American College of Cardiology, Washington, DC
| | - Joseph A Hill
- Department of Internal Medicine/Cardiology Division and Harry S. Moss Heart Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Anthony A Hilliard
- Department of Medicine/Cardiology Division, Loma Linda University Medical Center, Loma Linda, California
| | - Steven R Houser
- Department of Physiology, Temple University School of Medicine, Philadelphia, Pennsylvania
| | - Eiman Jahangir
- Department of Cardiology, Ochsner Clinical School-the University of Queensland School of Medicine, New Orleans, Louisiana
| | - Andrew M Kates
- Department of Medicine/Cardiology Division, Washington University School of Medicine, St. Louis, Missouri
| | - Darlene Kim
- Department of Medicine/Division of Cardiology, National Jewish Health, Denver, Colorado
| | - Brian R Lindman
- Department of Medicine/Cardiology Division, Washington University School of Medicine, St. Louis, Missouri
| | - John J Ryan
- Department of Medicine/Division of Cardiology, University of Utah Health Care, Salt Lake City, Utah
| | - Anne K Rzeszut
- Member Strategy and Career Development Department, American College of Cardiology, Washington, DC
| | - Chittur A Sivaram
- Department of Medicine/Cardiovascular Section, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma
| | - Anne Marie Valente
- Department of Cardiology, Harvard Medical School, Brigham and Women's Hospital, and Boston Children's Hospital, Boston, Massachusetts
| | - Andrew M Freeman
- Department of Medicine/Division of Cardiology, National Jewish Health, Denver, Colorado
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