Barriers and Facilitators to Women's Careers in Academic Cardiology: A Multicenter Qualitative Analysis

Women remain underrepresented in cardiology. The culture of academic cardiology is referenced as a barrier to inclusivity. Surveys provide a limited understanding of experiences faced by female cardiologists. The purpose of this study was to characterize organizational cultural barriers and facilitators to career advancement for women in academic cardiology using in-depth interviews and qualitative thematic analysis.

Twenty-three women in 3 academic cardiology divisions were interviewed using a semistructured guide tailored to the study aim. Thematic analysis of interview transcripts was performed using an inductive and deductive coding approach. Through this multistep analysis process, themes and subthemes were identified.

Three themes were identified as barriers to careers in academic cardiology. (1) Institutional and divisional practices negatively impacted careers by limiting leadership opportunities, pay and resource inequity, variable recognition and promotion, and harassment. (2) The covert culture or unintended norms within a system negatively impacted all participants through tolerance of benevolent paternalism, achievement limited to "women's work," and gender stereotypes and behavior norms. (3) Consequences of these experiences included burnout and a desire to leave their institution. Mentorship, protected time, and financial support for academic productivity were identified as career facilitators.

Professional barriers remain for women in academic cardiology, fundamentally linked to the conflict between personal values and the culture of their division. Academic cardiology divisions committed to gender equity should align policies with practice to increase both women's representation as well as success in cardiology.