Ethnic and racial minority cardiologists face professional discrimination and exclusion

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Ethnic and racial minority cardiologists report career satisfaction but face professional discrimination and exclusion. This was the main finding of the American College of Cardiology (ACC) professional life survey, published in the Journal of the American College of Cardiology (JACC).

Underrepresented racial and ethnic minorities in the cardiovascular workforce continue to experience a lack of representation and face discrimination, inequitable job negotiations, and burnout in their professional lives, according to an analysis of the 2015 professional life survey conducted by the ACC.

“Despite calls for racial and ethnic diversification in medicine or cardiology, there has been little change. Putting into place methods to support those who are underrepresented in medicine is critical moving forward,” said Kevin Thomas, associate professor of medicine at the Duke University Research Institute, Durham, USA and lead author of the study.

The ACC’s third decennial professional life survey was conducted by the ACC Women in Cardiology section and on behalf of the ACC Diversity and Inclusion task force to assess the professional experience of cardiologists. The survey included 2,245 respondents who provided racial/ethnic data. Of the respondents, 1,447 identified as white, 564 as Asian or Pacific islander, and 37 as multiracial. Underrepresented racial and ethnic minorities those identifying as Black, Hispanic, or Native American, counted for 197 of the respondents.

The researchers assessed career satisfaction and advancement, personal and family issues, discrimination, mentoring, job negotiations and burnout rates of the underrepresented racial and ethnic minorities, compared with the other racial and ethnic groups.

“This particular group has never been singled out in analysing the data from the 2015 professional life survey, and the results are very revealing about how much work there is still left to do,” said Thomas.

Over 91% of underrepresented racial and ethnic minority respondents were satisfied with their career and felt their level of advancement and career opportunities were similar to their peers. Along the same lines, 85% of underrepresented racial and ethnic minority respondents were satisfied with their family lives outside of work. These results are at odds with previous research and data showing underrepresented racial and ethnic minorities are at a disadvantage for job and financial advancement. The researchers said that prior studies have focused on advancement and leadership in academic settings, whereas this study included cardiologists in private practice and academics who may have different experiences.

However, over half (52.3%) of underrepresented racial and ethnic minority respondents reported experiencing discrimination, compared with 36.4% of white respondents. Women of all racial and ethnic groups were more likely than men to report discrimination (57‒69.2% compared with 13.9‒44.6%, respectively). When broken down, men were more likely to report race and religion-based discrimination, whereas nearly all women reported gender discrimination, and underrepresented racial and ethnic minority women in addition reported frequently experiencing race-based discrimination in the workplace.

Compared with white cardiologists, underrepresented racial and ethnic minority cardiologists were less likely to negotiate or prioritise salary, benefits, and work hours in their first job (white cardiologists reported 20.6%, 23.3%, 31.3% in each category respectively, vs. 13.6%, 10.9%, 19.3% respectively from underrepresented racial and ethnic minority cardiologists). As their careers advanced, underrepresented racial and ethnic minorities placed more emphasis on salary, benefits, and work hours compared with white cardiologists, which according to researchers is potentially a marker that underrepresented racial and ethnic minorities are placed at a disadvantage in these categories at the start of the careers, showcasing there is a greater need to overcome systemic barriers.

White cardiologists were more likely than underrepresented racial and ethnic minorities to report higher rates of burnout, however, underrepresented racial and ethnic minorities experienced more isolation and non-inclusive work environments. The researchers said greater learned resiliency over their lifetime from underrepresented racial and ethnic minorities may contribute toward reporting lower rates of burnout.

Authors of the study note that it had several limitations, including a response rate of 21% which may limit representativeness of each group. Similarly, combining Black, Hispanic and Native American individuals into one group obscures the unique experiences between each of these groups, and comparing underrepresented racial and ethnic minorities to whites can perpetuate the idea of the white race being the standard. Finally, the 2015 professional life survey was not specifically designed to assess racial and ethnic diversity topics.


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