Spectrum of Perceptions Regarding Professional Climate: A National Survey of U.S. Cardiologists and Trainees

Characterizations of cardiology's professional climate often focus on negative experiences.

The study's primary objective was to broadly characterize cardiology climate.

The American College of Cardiology surveyed 1805 cardiologists online in 2022. Agreement with cardiology 7 workforce statements could be categorized into 4 attitudinal profiles (A-D) in 1513 (84%), using a 2-step cluster analysis maximizing log-likelihood measures of agreement. Multivariable modeling described respondents' alignment with profiles. ORs compared perceptions across profiles.

Most respondents were men (n = 1,095, 72%), heterosexual/cisgender (n = 1,380, >90%), and identified as White (n = 800, 53%). Profile A (441, 29%) perceived cardiology's climate as empowering/inclusive/no change needed. Profile D (n = 278; 18%) felt climate was stifling/exclusionary/change needed. Intermediate were B: inclusive/change needed (n = 501; 33%) and C: stifling/uncertain about change (293; 19%). Profile A was independently associated with male sex, White race, late career, and no mistreatment, C-statistic = 0.73 (95% CI: 0.70-0.75). Profile D was associated with female sex, Black, Asian, Hispanic or other race individuals, early/mid-career, and experience of mistreatment, C-statistic = 0.80 (95% CI: 0.77-0.83). Men were respected by most (93%; range across profiles 90%-96%) with less agreement about people identifying as Black, Asian, Hispanic, or other (68%; 27%-90%); women (68%; 25%-95%); people with a disability (54%; 22%-77%); and nonheterosexual (48%; 19%-69%) or transgender/sex nonconforming people (23%; 5%-36%). Primary workplace culture was perceived more positively, while organizations were seen as ineffective in improving climate.

Cardiologists' perceptions of professional climate differ widely with 37% viewing it as stifling/exclusionary and 51% desiring change. These findings, plus perceived organizational ineffectiveness, support efforts to improve the cardiology workplace climate.