Work Activities and Compensation of Male and Female Cardiologists.
ABSTRACT: Much remains unknown about experiences, including working activities and pay, of women in cardiology, which is a predominantly male specialty.The goal of this study was to describe the working activities and pay of female cardiologists compared with their male colleagues and to determine whether sex differences in compensation exist after accounting for differences in work activities and other characteristics.The personal, job, and practice characteristics of a national sample of practicing cardiologists were described according to sex. We applied the Peters-Belson technique and multivariate regression analysis to evaluate whether gender differences in compensation existed after accounting for differences in other measured characteristics. The study used 2013 data reported by practice administrators to MedAxiom, a subscription-based service provider to cardiology practices. Data regarding cardiologists from 161 U.S. practices were included, and the study sample included 2,679 subjects (229 women and 2,450 men).Women were more likely to be specialized in general/noninvasive cardiology (53.1% vs. 28.2%), and a lower proportion (11.4% vs. 39.3%) reported an interventional subspecialty compared with men. Job characteristics that differed according to sex included the proportion working full-time (79.9% vs. 90.9%; p < 0.001), the mean number of half-days worked (387 vs. 406 days; p = 0.001), and mean work relative value units generated (7,404 vs. 9,497; p < 0.001) for women and men, respectively. Peters-Belson analysis revealed that based on measured job and productivity characteristics, the women in this sample would have been expected to have a mean salary that was $31,749 (95% confidence interval: $16,303 to $48,028) higher than that actually observed. Multivariate analysis confirmed the direction and magnitude of the independent association between sex and salary.Men and women practicing cardiology in this national sample had different job activities and salaries. Substantial sex-based salary differences existed even after adjusting for measures of personal, job, and practice characteristics.
Project description:BACKGROUND:Studies demonstrate that women physicians are less likely than men to be full professors. Comprehensive evidence examining whether sex differences in faculty rank exist in academic cardiology, adjusting for experience and research productivity, is lacking. Therefore, we evaluated for sex differences in faculty rank among a comprehensive, contemporary cohort of US cardiologists after adjustment for several factors that impact academic advancement, including measures of clinical experience and research productivity. METHODS:We identified all US cardiologists with medical school faculty appointments in 2014 by using the American Association of Medical Colleges faculty roster and linked this list to a comprehensive physician database from Doximity, a professional networking website for doctors. Data on physician age, sex, years since residency, cardiology subspecialty, publications, National Institutes of Health grants, and registered clinical trials were available for all academic cardiologists. We estimated sex differences in full professorship, adjusting for these factors and medical school-specific fixed effects in a multivariable regression model. RESULTS:Among 3810 cardiologists with faculty appointments in 2014 (13.3% of all US cardiologists), 630 (16.5%) were women. Women faculty were younger than men (mean age, 48.3 years versus 53.5 years, P<0.001), had fewer total publications (mean number: 16.5 publications versus 25.2 publications; P<0.001), were similarly likely to have National Institutes of Health funding (proportion with at least 1 National Institutes of Health award, 10.8% versus 10.4%; P=0.77), and were less likely to have a registered clinical trial (percentage with at least 1 clinical trial, 8.9% versus 11.1%; P=0.10). Among 3180 men, 973 (30.6%) were full professors in comparison with 100 (15.9%) of 630 women. In adjusted analyses, women were less likely to be full professors than men (adjusted odds ratio, 0.63; 95% confidence interval, 0.43-0.94; P=0.02; adjusted proportions, 22.7% versus 26.7%; absolute difference, -4.0%; 95% confidence interval, -7.5% to -0.7%). CONCLUSIONS:Among cardiology faculty at US medical schools, women were less likely than men to be full professors after accounting for several factors known to influence faculty rank.
Project description:<h4>Background</h4>Cardiology is one of the most popular of the hospital medical specialties in the UK. It is also a highly competitive specialty in respect of the availability of higher specialty training posts. Our aims are to describe doctors' early intentions about seeking careers in cardiology, to report on when decisions about seeking a career in cardiology are made, to compare differences between men and women doctors in the choice of cardiology, and to compare early career choices with later specialty destinations.<h4>Methods</h4>Questionnaire surveys were sent to all UK medical graduates in selected qualification years from 1974-2009, at 1, 3, 5, 7 and 10 years after graduation.<h4>Results</h4>One year after graduation, the percentage of doctors specifying cardiology as their first choice of long-term career rose from the mid-1990s from 2.4% (1993 cohort) to 4.2% (2005 cohort) but then fell back to 2.7% (2009 cohort). Men were more likely to give cardiology as their first choice than women (eg 4.1% of men and 1.9% of women in the 2009 cohort). The percentage of doctors who gave cardiology as their first choice of career declined between years one and five after qualification: the fall was more marked for women. 34% of respondents who specified cardiology as their sole first choice of career one year post-graduation were later working in cardiology. 24% of doctors practising as cardiologists several years after qualification had given cardiology as their sole first choice in year one. The doctors' 'domestic circumstances' were a relatively unimportant influence on specialty choice for aspiring cardiologists, while 'enthusiasm/commitment', 'financial prospects', 'experiences of the job so far' and 'a particular teacher/department' were important.<h4>Conclusions</h4>Cardiology grew as a first preference one year after graduation to 2005 but is now falling. It consistently attracts a higher percentage of men than women doctors. The correspondence between early choice and later destination was not particularly strong for cardiology, and was less strong than that for several other specialties.
Project description:The aim of this prospective study was to explore predictors of objective career success among Swedish women and men, focussing on gender differences. Data were drawn from the 2008 and 2010 waves of the Swedish Longitudinal Occupational Survey of Health (SLOSH) with a total of 3670 female and 2773 male participants. Odds ratios and 95% confidence intervals for job promotion and an above-average salary increase between 2008 and 2010 were obtained through binary logistic regression analyses. Individual and organisational factors measured in 2008 were used as predictors in analyses stratified by sex. Mutual adjustment was performed for these variables, as well as for labour market sector and staff category at baseline. In both sexes, younger age predicted both job promotion and an above-average salary increase. Job promotion was also in both sexes predicted by being part of decision-making processes, having conflicts with superiors, and being eager to advance. Furthermore, promotion was predicted by, among men, being educated to post-graduate level and having an open coping strategy and, among women, working >60 hours/week. An above-average salary increase was predicted in both sexes by having a university education. Postgraduate education, having children living at home, and being very motivated to advance predicted an above-average salary increase among women, as did working 51-60 hours/week and being part of decision-making processes in men. Gender differences were seen in several predictors. In conclusion, the results support previous findings of gender differences in predictors of career success. A high level of education, motivation to advance, and procedural justice appear to be more important predictors of career success among women, while open coping was a more important predictor among men.
Project description:Importance:In general surgery, women earn less money and hold fewer leadership positions compared with their male counterparts. Objective:To assess whether differences exist between the perspectives of male and female general surgery residents on future career goals, salary expectations, and salary negotiation that may contribute to disparity later in their careers. Design, Setting, and Participants:This study was based on an anonymous and voluntary survey sent to 19 US general surgery programs. A total of 606 categorical residents at general surgery programs across the United States received the survey. Data were collected from August through September 2017 and analyzed from September through December 2017. Main Outcomes and Measures:Comparison of responses between men and women to detect any differences in career goals, salary expectation, and perspectives toward salary negotiation at a resident level. Results:A total of 427 residents (70.3%) responded, and 407 responses (230 male [58.5%]; mean age, 30.0 years [95% CI, 29.8-30.4 years]) were complete. When asked about salary expectation, female residents had lower expectations compared with men in minimum starting salary ($249?502 [95% CI, $236?815-$262 190] vs $267?700 [95% CI, $258?964-$276?437]; P?=?.003) and in ideal starting salary ($334?709 [95% CI, $318?431-$350?987] vs $364?663 [95% CI, $351?612-$377?715]; P?<?.001). Women also had less favorable opinions about salary negotiation. They were less likely to believe they had the tools to negotiate (33 of 177 [18.6%] vs 73 of 230 [31.7%]; P?=?.03) and were less likely to pursue other job offers as an aid in negotiating a higher salary (124 of 177 [70.1%] vs 190 of 230 [82.6%]; P?=?.01). Female residents were also less likely to be married (61 of 177 [34.5%] vs 116 of 230 [50.4%]; P?=?.001), were less likely to have children (25 of 177 [14.1%] vs 57 of 230 [24.8%]; P?=?.008), and believed they would have more responsibility at home than their significant other (77 of 177 [43.5%] vs 35 of 230 [15.2%]; P?<?.001). Men and women anticipated working the same number of hours, expected to retire at the same age, and had similar interest in holding leadership positions, having academic careers, and pursuing research. Conclusions and Relevance:This study found no difference in overall career goals between male and female residents; however, female residents' salary expectations were lower, and they viewed salary negotiation less favorably. Given the current gender disparities in salary and leadership within surgery, strategies are needed to help remedy this inequity.
Project description:BACKGROUND:Sex differences in acute coronary syndrome (ACS) have been reported, but little is known about the situation in the Netherlands. METHODS:This registry is a merge of available data on ACS patients in the electronic data capture systems of 11 centres with 24/7 interventional cardiology services. We included patients >18 years undergoing a cardiac catheterisation between 2010-2012. We evaluated sex differences in clinical and procedural characteristics and 1?year mortality. RESULTS:A total of 29,265 ACS patients (8,720 women and 20,545 men) were registered. Women were on average 4.5 years older (68.5 vs 63.0 years, p?<?0.001) and had a higher prevalence of hypertension (62.7 vs 49.8%, p?<?0.001) and insulin-dependent diabetes mellitus (9.6 vs 6.8%, p?<?0.001) than men. Women less often presented with ST-elevation myocardial infarction (43.7% vs 47.6%, p?<?0.001) and appeared to have less extensive coronary artery disease than men. Women less often underwent coronary angiography by radial access (52.5 vs 55.9%, p?<?0.001). One-year mortality was higher in women than in men (7.3% and 5.6%, p?<?0.001). More specific, the relationship between sex and mortality was age-dependent and showed higher mortality in women ?71 years, but lower mortality in older women compared with men (p-interaction <0.001). CONCLUSION:We found differences in clinical and procedural characteristics and outcome between women and men admitted for ACS, which are in line with other Western countries. The limitations of our registry, based on existing local databases, can be overcome by the use of the prospective Netherlands Heart Registry that is currently in development.
Project description:This study uses latent semantic analysis (LSA) to explore how prevalent measures of motivation are interpreted across very diverse job types. Building on the Semantic Theory of Survey Response (STSR), we calculate “semantic compliance” as the degree to which an individual’s responses follow a semantically predictable pattern. This allows us to examine how context, in the form of job type, influences respondent interpretations of items. In total, 399 respondents from 18 widely different job types (from CEOs through lawyers, priests and artists to sex workers and professional soldiers) self-rated their work motivation on eight commonly applied scales from research on motivation. A second sample served as an external evaluation panel (n = 30) and rated the 18 job types across eight job characteristics. Independent measures of the job types’ salary levels were obtained from national statistics. The findings indicate that while job type predicts motivational score levels significantly, semantic compliance as moderated by job type job also predicts motivational score levels usually at a lesser but significant magnitude. Combined, semantic compliance and job type explained up to 41% of the differences in motional score levels. The variation in semantic compliance was also significantly related to job characteristics as rated by an external panel, and to national income levels. Our findings indicate that people in different contexts interpret items differently to a degree that substantially affects their score levels. We discuss how future measurements of motivation may improve by taking semantic compliance and the STSR perspective into consideration.
Project description:Limited evidence exists on salary differences between male and female academic physicians, largely owing to difficulty obtaining data on salary and factors influencing salary. Existing studies have been limited by reliance on survey-based approaches to measuring sex differences in earnings, lack of contemporary data, small sample sizes, or limited geographic representation.To analyze sex differences in earnings among US academic physicians.Freedom of Information laws mandate release of salary information of public university employees in several states. In 12 states with salary information published online, salary data were extracted on 10?241 academic physicians at 24 public medical schools. These data were linked to a unique physician database with detailed information on sex, age, years of experience, faculty rank, specialty, scientific authorship, National Institutes of Health funding, clinical trial participation, and Medicare reimbursements (proxy for clinical revenue). Sex differences in salary were estimated after adjusting for these factors.Physician sex.Annual salary.Among 10?241 physicians, female physicians (n?=?3549) had lower mean (SD) unadjusted salaries than male physicians ($206?641 [$88?238] vs $257?957 [$137?202]; absolute difference, $51?315 [95% CI, $46?330-$56?301]). Sex differences persisted after multivariable adjustment ($227?783 [95% CI, $224?117-$231?448] vs $247?661 [95% CI, $245?065-$250?258] with an absolute difference of $19?878 [95% CI, $15?261-$24?495]). Sex differences in salary varied across specialties, institutions, and faculty ranks. For example, adjusted salaries of female full professors ($250 971 [95% CI, $242 307-$259 635]) were comparable to those of male associate professors ($247?212 [95% CI, $241?850-$252?575]). Among specialties, adjusted salaries were highest in orthopedic surgery ($358?093 [95% CI, $344?354-$371?831]), surgical subspecialties ($318?760 [95% CI, $311?030-$326?491]), and general surgery ($302?666 [95% CI, $294?060-$311?272]) and lowest in infectious disease, family medicine, and neurology (mean income, <$200?000). Years of experience, total publications, clinical trial participation, and Medicare payments were positively associated with salary.Among physicians with faculty appointments at 24 US public medical schools, significant sex differences in salary exist even after accounting for age, experience, specialty, faculty rank, and measures of research productivity and clinical revenue.
Project description:<h4>Importance</h4>Few data exist on internal medicine trainees' selection of cardiology training, although this is important for meeting future cardiology workforce needs.<h4>Objective</h4>To discover trainees' professional development preferences and perceptions of cardiology, and their relationship to trainees' career choice.<h4>Design, setting, and participants</h4>We surveyed trainees to discover their professional development preferences and perceptions of cardiology and the influence of those perceptions and preferences on the trainees' career choices. Participants rated 38 professional development needs and 19 perceptions of cardiology. Data collection took place from February 2009, through January 2010. Data analysis was conducted from May 2017 to December 2017.<h4>Main outcomes and measures</h4>Multivariable models were used to determine the association of demographics and survey responses with prospective career choice.<h4>Results</h4>A total of 4850 trainees were contacted, and 1123 trainees (of whom 625 [55.7%] were men) in 198 residency programs completed surveys (23.1% response; mean [SD] age, 29.4 [3.5] years). Principal component analysis of survey responses resulted in 8-factor and 6-factor models. Professional development preferences in descending order of significance were stable hours, family friendliness, female friendliness, the availability of positive role models, financial benefits, professional challenges, patient focus, and the opportunity to have a stimulating career. The top perceptions of cardiology in descending order of significance were adverse job conditions, interference with family life, and a lack of diversity. Women and future noncardiologists valued work-life balance more highly and had more negative perceptions of cardiology than men or future cardiologists, who emphasized the professional advantages available in cardiology. Professional development factors and cardiology perceptions were strongly associated with a decision to pursue or avoid a career in cardiology in both men and women.<h4>Conclusions and relevance</h4>Alignment of cardiology culture with trainees' preferences and perceptions may assist efforts to ensure the continued attractiveness of cardiology careers and increase the diversity of the cardiology workforce.
Project description:BACKGROUND: A discrete choice experiment was conducted to investigate preferences for job characteristics among nursing students and practicing nurses to determine how these groups vary in their respective preferences and to understand whether differing policies may be appropriate for each group. METHODS: Participating students and workers were administered a discrete choice experiment that elicited preferences for attributes of potential job postings. Job attributes included salary, duration of service until promotion to permanent staff, duration of service until qualified for further study and scholarship, housing provision, transportation provision, and performance-based financial rewards. Mixed logit models were fit to the data to estimate stated preferences and willingness to pay for attributes. Finally, an interaction model was fit to formally investigate differences in preferences between nursing students and practicing nurses. RESULTS: Data were collected from 256 nursing students and 249 practicing nurses. For both groups, choice of job posting was strongly influenced by salary and direct promotion to permanent staff. As compared to nursing students, practicing nurses had significantly lower preference for housing allowance and housing provision as well as lower preference for provision of transportation for work and personal use. CONCLUSIONS: In the Lao People's Democratic Republic, nursing students and practicing nurses demonstrated important differences in their respective preferences for rural job posting attributes. This finding suggests that it may be important to differentiate between recruitment and retention policies when addressing human resources for health challenges in developing countries, such as Laos.
Project description:BACKGROUND:Transthoracic echocardiograms (TTE) performed and interpreted by cardiology fellows during off-duty hours are critical to patient care, however limited data exist on their interpretive accuracy. Our aims were to determine the discordance rate between TTEs performed and interpreted by cardiology fellows and National Board of Echocardiography certified attending cardiologists and to identify factors associated with discordance. METHODS:Consecutive on-call TTEs acquired and interpreted by 1st year cardiology fellows over 4.6 years at an academic center were prospectively evaluated by attending cardiologists. Fellow interpretations were classified as concordant or discordant with the attending interpretation. We assessed the association of patient, imaging and fellow characteristics with discordance. RESULTS:A total of 777 TTE interpretations (730 patients) were performed/interpreted by 40 first year fellows and overread by 13 attendings. The most common indications were assessment of left ventricular function (40.9%) and pericardial effusion (37.3%). There was a major or minor discordance in 4.1 and 17.4% of studies, respectively with 42.1% of disagreements occurring in assessment of left ventricular size and function. The indication to assess left ventricular function [OR 2.19, 95% CI (1.32, 3.62), P = 0.002 vs. pericardial effusion] and greater duration of echocardiographic image acquisition (OR 1.02, 95% CI 1.01, 1.03, P = 0.004) were independently associated with overall discordance. CONCLUSIONS:In this large prospective study we found that attending cardiologists disagreed with 1 in 5 fellow TTE interpretations. Standardized tools for evaluation of echocardiograms performed by fellows are needed to ensure quality of training and patient safety.