Perceptions on Accessible Mentorship and Barriers to Subspecialty Training: A Comparison Study in URiM and Non-URiM...

Physicians who are underrepresented in medicine (URiMs), defined by the Association of American Medical Colleges as Black, Hispanic, and Native American, are significantly underrepresented in pediatric cardiology. This project, to identify improvement opportunities in recruitment and retention, examined the impact of mentorship, subspecialty exposure, specialty culture, and financial constraints on URiMs' decisions to enter pediatric cardiology. A cross-sectional survey was distributed primarily through the Society of Pediatric Cardiology Training Program Directors (SPCTPD) from 10/1/24 - 2/17/25. Participants included fellows and those recently matched into fellowship. Of 109 survey responses during the study period, 5 (4.6%) were excluded due to incomplete responses, and 104 were included in the final analysis. URiMs accounted for 19 (18.3%) of the respondents. Compared to other trainees, URiMs decided on subspecialty training prior to residency (p = 0.03). They were more likely to seek out mentors who shared similar racial/ethnic backgrounds (p = 0.0002) but had difficulty finding such mentors (p < 0.0001). URiMs were more likely to have made trade-offs in career aspirations due to concerns about medical school debt (p = 0.002) and low financial compensation in pediatrics (p = 0.004). Furthermore, URiM trainees were more likely to express concern that their racial/ethnic background influenced experiences within a subspecialty rotation (p = 0.001). URiM trainees face unique challenges in accessing culturally congruent mentorship, navigating financial constraints, and finding inclusive training environments. Strengthening early mentorship, developing targeted financial support programs, and fostering an affirming specialty culture are essential strategies to promote demographic heterogeneity within pediatric cardiology and, ultimately, mitigate disparities in pediatric patient outcomes.