Demographic and training variations across cardiology subspecialties in Italy: a national survey

Advances in cardiovascular medicine and subspecialization have improved patient care but exposed persistent workforce disparities. Evidence on sex, age, and training mobility within cardiology is fragmented, and comprehensive analyses across subspecialties are lacking.

A nationwide survey was conducted by the Italian Association of Hospital Cardiologists (ANMCO) during its 2025 National Congress. The questionnaire included 17 multiple-choice items covering demographics, sex distribution, age, and training patterns across five subspecialties: interventional cardiology, clinical cardiology/acute care, cardiovascular imaging, heart failure, and electrophysiology. Responses were analyzed using descriptive statistics.

A total of 355 cardiologists responded, 51% of whom were women, with 53% aged >45 years. Significant sex-based differences were observed across subspecialties ( P  < 0.001). Female underrepresentation was most pronounced in interventional cardiology (69% reporting <25% women) and electrophysiology (66%), while cardiovascular imaging showed the highest female representation (>50% in 51% of responses). Age distributions also differed significantly ( P  < 0.001), with interventional cardiology, clinical cardiology, and electrophysiology dominated by the 40-50-years age range, whereas imaging showed a higher proportion of younger cardiologists. Training mobility varied but did not reach statistical significance ( P  = 0.054), with greater local stability in electrophysiology and higher external training reported in imaging and clinical cardiology. Stratification by respondent sex confirmed similar perceptions of female underrepresentation.

This survey highlights persistent gender imbalances, mid-career clustering, and heterogeneous training mobility across Italian cardiology subspecialties. Targeted national and international strategies are needed to promote equity, strengthen training pathways, and support sustainable workforce development.