A Comparative Study of Sub-Specialty Selection Among Adult Cardiology Fellows: Does Gender Play a Role?

Objectives: This study is aimed to determine the factors that influence the selection of sub-specialty training among adult cardiology FITs and whether this differs by gender. Methodology: A multiple-choice online survey was conducted on 198 cardiology Fellows-in-training (FITs) in Pakistan from January-May 2023 to assess the determinants of their career paths in clinical cardiac electrophysiology, interventional cardiology, cardiac imaging, and critical care. The survey tool was used for data collection. Results: A total of 198 FITs completed the survey; 36% anticipated specializing in interventional cardiology (IC), 28% in Electrophysiology (EP), 12% in critical care (CC), 15% in cardiac imaging (CI) and 9% were unsure. Among IC and CC group, there was male FIT dominance (70% and 54% respectively) and likelihood of getting employment after completing training was most important factor in both sub-specialties (P <0.001) . Among EP and CI group, there was predominance of women FIT (76% and 56% respectively). The most important factor that influenced FITs to pursue EP was a strong interest in the field and female role model (P <0.001), while for CI minimal radiation exposure and flexibility in job were important factors (all P<0.001). Conclusion: Female FITs are less inclined to choose interventional cardiology as future career path because of increased radiation exposure and old-boys club. Conversely there is growing trend for female FITS inclination towards choosing Electrophysiology, this is in contrast to similar study conducted internationally.