Author + information
- Received August 6, 2016
- Revision received October 27, 2016
- Accepted November 14, 2016
- Published online January 23, 2017.
- Sandra J. Lewis, MDa,
- Laxmi S. Mehta, MDb,
- Pamela S. Douglas, MDc,
- Martha Gulati, MD, MSd,
- Marian C. Limacher, MDe,
- Athena Poppas, MDf,
- Mary Norine Walsh, MDg,
- Anne K. Rzeszut, MAh,
- Claire S. Duvernoy, MDi,∗ (, )
- on behalf of the American College of Cardiology Women in Cardiology Leadership Council
- aNorthwest Cardiovascular Institute, Portland, Oregon
- bDepartment of Medicine, Division of Cardiovascular Medicine, The Ohio State University, Columbus, Ohio
- cDepartment of Medicine, Division of Cardiology, Duke University School of Medicine, Duke Clinical Research Institute, Durham, North Carolina
- dDepartment of Medicine, Division of Cardiology, University of Arizona-Phoenix, Phoenix, Arizona
- eDepartment of Medicine, Division of Cardiovascular Medicine, University of Florida College of Medicine, Gainesville, Florida
- fDepartment of Medicine, Section of Cardiology, Lifespan Cardiovascular Institute/Brown University, Providence, Rhode Island
- gSt. Vincent Heart Center, Indianapolis, Indiana
- hMarket Strategy Division, American College of Cardiology, Washington, DC
- iDepartment of Medicine, Cardiology Section, VA Ann Arbor Healthcare System/University of Michigan Health System, Ann Arbor, Michigan
- ↵∗Reprint requests and correspondence:
Dr. Claire S. Duvernoy, Cardiology Section, VA Ann Arbor Healthcare System, University of Michigan, 2215 Fuller Rd, 111a, Ann Arbor, Michigan 48105.
The American College of Cardiology third decennial Professional Life Survey was completed by 2,313 cardiologists: 964 women (42%) and 1,349 men (58%). Compared with 10 and 20 years ago, current results reflect a substantially lower response rate (21% vs. 31% and 49%, respectively) and an aging workforce that is less likely to be in private practice. Women continue to be more likely to practice in academic centers, be pediatric cardiologists, and have a noninvasive subspecialty. Men were more likely to indicate that family responsibilities negatively influenced their careers than previously, whereas women remained less likely to marry or have children. Men and women reported similar, high levels of career satisfaction, with women reporting higher satisfaction currently. However, two-thirds of women continue to experience discrimination, nearly 3 times the rate in men. Personal life choices continue to differ substantially for men and women in cardiology, although differences have diminished.
- professional life survey
- professional satisfaction
- practice setting
- women in cardiology
Cardiovascular physicians and the practice of cardiovascular medicine have experienced unprecedented changes in both the explosion of scientific evidence and changes in reimbursement models over the past 20 years (1). It is unclear how these changes have affected the experience of cardiologists, or their personal and professional lives. The American College of Cardiology (ACC), led by the Leadership Council of the Women in Cardiology (WIC) Section, conducted the third decennial Professional Life Survey (PLS) to define current workforce demographics and career choices, determine levels of cardiologists’ career satisfaction, identify family and professional barriers to success, and pinpoint areas of concern for the College to guide development of initiatives with high member value.
The first PLS, launched in 1996, was driven by concerns about a possible impending shortage of cardiologists in the United States, as well as the need to understand drivers of satisfaction for a career in cardiology for men and women (2). An ACC-sponsored Bethesda Conference in 2003 identified continuing concerns regarding the under-representation of women and minorities in cardiology (3,4). In response to the 1996 PLS and the Bethesda Conference, the WIC section was created in 2005; the following year, a second PLS was conducted (5). The purpose of this second survey was to better inform the design and implementation of strategies for future training and support of cardiologists by gaining a deeper understanding of the personal and professional lives of men and women in cardiology, including career decisions and satisfaction. The second survey also sought to examine issues identified by the Bethesda Conference; under-representation of women and minorities remained a critical workforce issue.
The first survey identified several areas of opportunity to improve the professional lives of cardiologists. Practice management issues were high on the list of perceived needs for those responding to the survey, and issues such as job negotiations and leadership training were identified by both men and women as topics for which the ACC should provide educational programs. Specific sex differences and concerns were identified as well. These issues included occupational radiation exposure, discrimination, family concerns (such as barriers to childbearing and childcare needs), lack of advancement, disparity in compensation, and stresses of the profession. Educational opportunities that addressed issues arising from the survey were requested. The second survey found high levels of career satisfaction for men and women in cardiology and increasing positive effects of mentors, but ongoing areas of differences between men and women, including discrimination, academic equality, satisfaction with advancement and compensation across all practice settings, and likelihood of having a family.
Since the second survey, the ACC and its WIC Section have addressed these issues with specific programming and outreach efforts, including ACC WIC Leadership Conferences and, since 2014, annual Leadership Workshops, which provide content specific to the needs identified in the survey. A virtual mentoring program for WIC members was developed to provide more formalized mentoring; fellows-in-training (FITs) have been incorporated into all ACC committees, and FIT programs have been developed for the ACC Scientific Sessions as well. WIC developed a visiting professor program to highlight opportunities for women in cardiology and allow women to advance their academic portfolios. WIC state chapter networks were developed in conjunction with the ACC Board of Governors; ACC annual scientific sessions now contain numerous WIC opportunities, such as the WIC lounge, educational and mentoring sessions, brown-bag lunch sessions, and speed mentoring sessions. A regular newsletter spotlights WIC members and activities. However, cardiology continues to be dominated by men; in 2013, 13% of cardiologists were women, compared with over 35% of internists, over 30% of hematologist/oncologists, 18% of general surgeons, and over 50% of obstetricians/gynecologists (6).
A particular focus of the current survey was to determine whether ACC efforts, and ongoing societal changes, are associated with mitigation of the observed differences between men and women in cardiology, 20 years after the first survey.
Prior ACC PLS were performed in 1996 and 2006, and have been previously reported (2,5). The majority of the 1996 and 2006 PLS questionnaires were largely replicated verbatim to allow comparisons across time periods. Some questions were slightly amended to reflect more recent practice and specialty changes. Specific questions about practice models were added. As opposed to the initial mailed paper survey, both the 2006 and current surveys were hosted on a web server, and were accessed online via a link supplied through e-mail invitations. Invitations to participate were e-mailed to a total of 11,539 U.S. ACC physician members. Of these, 741 e-mails were returned as undeliverable; consequently, the actual base of 10,798 included 2,796 women, an age-matched sample of 6,025 men, and a sampling of 1,977 FITs. Between September and October 2015, each member of the sample was sent an e-mail invitation, and up to 3 follow-up reminder invitations were sent to those who had not yet completed the survey.
Analysis of responses across time periods and by men and women in the current dataset was performed using SPSS Statistics for Windows version 23.0 (IBM, Armonk, New York). For the 2006 and 2015 comparisons, z-tests were used to calculate significant differences, and the Bonferroni-Holm method was used to adjust for multiple comparisons. The thresholds for statistical significance were set at p ≤ 0.05, p ≤ 0.01, and p ≤ 0.001 levels. Because only the percentages, and not the raw data from the original 1996 dataset, were available, statistical comparisons with the earlier results were conducted using a formula to estimate z-scores in which the aggregate data was inputted into the following formula, and the score was down-weighted by 0.87 to estimate the Bonferroni-Holm correction when comparing 1996 to other time periods.
All tables report percent responses. “Missing,” “don’t know,” and “N/A” responses were not included in the tabulations and statistical analyses.
Demographics and job descriptions
The 2015 survey was sent to 10,798 individuals, including 8,821 (2,796 women and 6,025 men) cardiologist members, as well as 1,977 FITs. A total of 2,313 physicians completed the survey, including 964 women (42%) and 1,349 men (58%); of these, 94 women and 202 men were FITs, representing 13% of the total number of respondents. The overall response rate to the survey was 21%, which was lower than the response rates of 31% in 2006 and 49% in 1996. The current survey response rate was 30% for women, 18% for men, and 15% for FITs, with higher response rates for women, as in 2006 (42% for women and 23% for men) and 1996 (54% for women and 46% for men).
The age distribution of responding men and women was similar and, despite inclusion of FITs as in the prior survey, demonstrated aging of the ACC physician member community, as significantly greater percentages of respondents were 60 years of age or older in the current survey than in 2006 and 1996 (Figure 1, Central Illustration). Most respondents reported being white (63% in 2015 vs. 76% in 2006; data not available in 1996) or Asian/Pacific Islander (21% in 2015 vs. 14% in 2006); of the remaining 16%, there were significant sex differences in the self-reported racial makeup, with women more likely to be black (4% vs. 2%; p < 0.01), and men more likely to be Hispanic (6% vs. 3%; p < 0.01).
A lower percentage of women identified themselves as practicing adult cardiology compared with men (80% vs. 85%; p ≤ 0.01), whereas a higher percentage of women were self-identified as pediatric cardiologists (13% vs. 7%; p ≤ 0.001). Women were more likely to practice part-time than men (10% vs. 4%; p ≤ 0.001), and there were equal percentages of women and men not currently in practice (10% for both) (Table 1).
The majority of respondents reported spending time on direct clinical practice, although research and teaching occupied a higher percentage of time for women (14% for women vs. 10% for men; p ≤ 0.05), whereas men and women spent similar amounts of time in administrative activities. Women were more likely to work in a medical school/university practice (43% vs. 34%; p ≤ 0.001), and less likely to work in a hospital-owned (33% vs. 37%; p ≤ 0.01) or physician-owned (17% vs. 23%; p ≤ 0.001) setting. Survey respondents were less likely to report working in private practice than in 1996 or 2006 (Central Illustration). Women were more likely to practice general clinical cardiology (48% vs. 39%; p ≤ 0.001) or echocardiography (10% vs. 3%; p ≤ 0.001) than were men, who were more likely than women to practice interventional cardiology (23% vs. 8%; p ≤ 0.001) or electrophysiology (10% vs. 6%; p ≤ 0.01). Women spent more time in outpatient clinical practice than men (53% vs. 48%; p ≤ 0.001), whereas men spent significantly more time in hospital/inpatient care (36% women vs. 41% men; p ≤ 0.001). Respondents were significantly less likely in 2015 than in 1996 to report practicing invasive, noninterventional cardiology, continuing a trend that was noted in 2006.
Cardiologists overall were satisfied with their work lives, as 88% of women and 90% of men reported being moderately to very satisfied, whereas only 1% of women and 2% of men were very dissatisfied (Table 2). Most respondents were satisfied with their financial compensation (63% of women vs. 65% of men; p = NS). Women and men indicated different levels of satisfaction with family life, with men more likely to report being very satisfied (54% of men vs. 45% of women; p ≤ 0.001) and women more likely to report moderate satisfaction (38% of women vs. 33% of men; p ≤ 0.05). Women were significantly less likely to report achieving a higher level of advancement compared with their peers, and were more likely to report lower or much lower advancement than colleagues (Table 2). Both women and men were likely to strongly encourage (41% for both) or somewhat encourage (31% of women and 33% of men) cardiology as a career choice to those seeking medical career guidance.
The proportion of women who were moderately or very satisfied with their careers rose from 80% to 90% between 1996 and 2006, and remained high in 2015 (88%). The proportion of men who indicated that their level of advancement was higher or much higher than contemporaries declined for each decade, from 52% in 1996 to 45% in 2006, and to 39% in 2015 (p ≤ 0.05); however, men’s career satisfaction did not change over time. Overall career satisfaction for women was no different in 2015 than that reported by men; yet, women were less likely to feel that they had advanced higher than contemporaries in the profession, and were more likely to report that their advancement was less than that of their peers. These proportions did not change significantly over the past 20 years.
Respondents were asked to rate a series of job features that they regarded as important at the time of negotiation for their first job, and again as if a job were being renegotiated at the time of the survey. For one's first position after training, the most highly rated items for both women and men, respectively, were job description (97% vs. 96%; p = NS), benefits (80% vs. 79%; p = NS), and salary (78% vs. 83%; p ≤ 0.01). Women and men also highly rated vacation time (72% vs. 67%; p ≤ 0.05), support staff (65% vs. 62%; p = NS), and time to promotion/partnership (60% vs. 65%; p ≤ 0.05). The perceived importance of all of these items when negotiating for a first position has risen significantly in comparison with prior surveys.
When asked about the importance of items for job renegotiation (i.e., negotiations taking place when a cardiologist applied for a subsequent job, rather than their first job after completing fellowship), the relative importance of some items shifted significantly for both men and women as compared with their relative importance during negotiations for first job. Salary, benefits, vacation time, and work hours rose in importance (all ranked >90%; p = NS between women and men), whereas time to promotion (70% vs. 64%; p ≤ 0.01), academic rank (57% vs. 43%; p ≤ 0.001), seniority (64% vs. 50%; p ≤ 0.001), and administrative duties (68% vs. 60%; p ≤ 0.001) were more important for women than for men.
Respondents were asked a series of questions about mentoring, including the presence of mentors, sex of mentors, and the roles played by mentors in their career development. Similar numbers of men and women had mentors during subspecialty training, but women were significantly more likely to have a woman as a mentor (23% vs. 5%; p ≤ 0.001) and to have a pediatric cardiologist mentor (11% vs. 7%; p < 0.01). Men were more likely than women to report that mentors had a positive influence on their participation in research (68% for women vs. 75% for men; p < 0.05%) (Table 3). Over the past 20 years, both women and men more frequently identified female mentors (14% to 18% to 23% for women vs. 1% to 2% to 5% for men, 1996 to 2006 to current survey, respectively; p ≤ 0.05 for comparison of 2015 with 1996 for both sexes). Respondents noted an increase over time in mentoring related to noncareer role models, and career planning and decision making. Career encouragement declined for both sexes.
Men remained just as likely in 2015 to report that their mentors served as negative role models in areas such as family and lifestyle (noncareer) as in 1996 and 2006, but for women, mentors became significantly less likely to exert a negative influence as family and lifestyle role models in the present survey (Table 3).
In 2015, men were not asked about occupational radiation exposure. As compared with 10 and 20 years ago, fewer women planned conception and pregnancy for times in their career during which they were not exposed to radiation (21% in 1996 vs. 18% in 2006 and 16% in 2015; p ≤ 0.05 for 1996 vs. 2015). There was no significant change in the percentage of women who made modifications to their work schedules to reduce radiation exposure (44% in 1996 vs. 42% in 2006 vs. 39% in 2015; p = NS). Women were less likely in 2015 than in 1996 to obtain information regarding radiation exposure risks, although the majority of women in the current survey continued to inform themselves (81% for 1996 vs. 76% for 2006 and 75% for 2015; p ≤ 0.05 for 1996 vs. 2015). About one-quarter of women chose career or training paths with minimal radiation exposure, a proportion that has remained unchanged over the past 20 years. One-third of women performed procedures using radiation while pregnant, a proportion that is unchanged from 10 and 20 years ago.
A large majority of women reported experiencing some form of discrimination, at a rate almost 3× as frequently as men, and the types of discrimination experienced were strikingly different. Sex and parenting discrimination was significantly more likely to have been experienced by women compared with men, whereas men were significantly more likely to have experienced racial and religious discrimination (Table 4). Although the proportion of men reporting any form of discrimination did not change over the past 20 years, there was a significant decline in the number of women reporting discrimination overall between 1996 and 2015 (71% vs. 65%, respectively; p ≤ 0.05). Women in practice longer were significantly more likely to say that they had experienced discrimination (72% of women in practice ≥11 years vs. 56% of FITs and women in practice <10 years; p ≤ 0.001 for comparison).
Personal and family issues
In the current survey, significantly more men than women reported being married (89% vs. 75%; p ≤ 0.001). Furthermore, men were much more likely to have children than women (87% vs. 72%; p ≤ 0.001), and, for most men, spouses provided all childcare (57% vs. 13%; p ≤ 0.001). Women with children at home were significantly more likely than men to report that they engaged paid full-time care, utilized a daycare center, or had paid part-time care (Table 5). Women were significantly more likely to interrupt their training than men, and these interruptions were typically for childbirth. Family responsibilities affected women to a greater degree than men, as 37% of women said family responsibilities had a negative effect on career advancement (37% vs. 20%; p ≤ 0.001).
Women were also more likely than men to indicate that family responsibilities hindered both their ability to do professional work (38% vs. 29%; p ≤ 0.001) and to travel for professional advancement (46% vs. 41%; p ≤ 0.01). Significant differences persisted across surveys in personal and family issues for women and men, although some differences became less marked over time. Women were more likely to report having children in the current survey than in 1996 or 2006 (63% vs. 66% vs. 72% for 1996 to 2006 to 2015, respectively; p ≤ 0.05 for between-survey comparisons). From 1996 to 2006 to the present survey, there was a growing trend for men to indicate that family responsibilities hindered their ability to do professional work and negatively influenced their career advancement; significantly more men reported that family responsibilities hindered their ability to travel for continuing medical education, committee work, or professional advancement in 2015 than in 1996 (41% vs. 29%; p ≤ 0.001) (Central Illustration).
In parallel with substantial changes in society and medicine over the past 20 years, our data illustrate changes in the personal and professional lives of cardiologists over the past 2 decades. The workforce is aging, practice settings have changed, and men are increasingly balancing career and family. However, in many areas, little has changed. Women continue to be less likely to marry and to have children, more likely to require paid or unpaid help with childcare, and more frequently experience discrimination. For both sexes, career satisfaction remains high.
Demographics, practice setting, and work hours
Cardiology remains a field dominated by men; in 2013, the Association of American Medical Colleges ranked the field 33rd of 41 specialties in the field in terms of the percentage of women (6). The 2003 ACC Bethesda Conference and the initial 1996 ACC PLS identified a lack of ethnic and sex diversity, an aging workforce, and discrimination as critical issues for cardiology, all of which remain relevant in 2016. According to ACC demographic data, 34% of female cardiologists were over 50 years of age in 2006 versus 50% in 2016, and 56% of men were over 50 years of age in 2006 versus 74% in 2016 (Online Table 1) (7). In a 2009 publication of the ACC Board of Trustees Workforce Task Force, proposals to alleviate the looming cardiology workforce shortage included the need to fund more fellowship training slots, use nonphysician providers more widely, provide more part-time work opportunities, develop “short-track” fellowship training pathways and loan forgiveness programs, and improve the pipeline by reaching into colleges, high schools, and even middle schools to improve medical school entry for women and under-represented minorities (8). Although some of these initiatives have indeed come to fruition, many have not.
Men and women continued to differ significantly in their choices of practice setting and type of cardiology. Although the choice of subspecialty for women is often thought to reflect concerns over radiation exposure, pregnancy/child care, and perceived differences in work hours and schedule predictability, in a recent report from a European Society of Cardiology survey, women responded that they avoid interventional cardiology primarily because they are not being given the opportunity to enter this field, rather than because they are avoiding radiation (9). When men were asked in the same survey why women do not go into interventional cardiology, male respondents indicated that they believe it is because women want to avoid radiation. This finding indicates important perceptual differences that should be addressed by professional societies and training programs.
Career satisfaction and advancement
Objective data support the dissatisfaction that women reported with respect to their financial compensation in this survey. As demonstrated recently by Jagsi et al. (10), there is a marked sex disparity in cardiologists’ salaries that persists after correcting for type and amount of work performed. As shown in the survey, a higher proportion of female cardiologists worked in an academic setting, where salaries are typically lower than a private-practice or other hospital-employed model. Even within the academic setting, however, recent careful analyses show significant disparities in salary, with a pay differential between female and male cardiologists almost exactly the same as that seen in private practice ($33,749 in a fully-adjusted model for academic cardiologists vs. $37,717 for cardiologists in private practice) (10,11). Women also continued to be less likely to report a higher level of career advancement than peers. Studies have shown that this feeling is also supported by objective data, with women being less likely to achieve higher ranks and doing so at a slower rate than men in academic medicine (12).
Successful mentoring relationships continued to be valued by the majority of survey respondents, both men and women. The present survey suggests that women have been willing to accept a disproportionate share of responsibility for mentoring early-career cardiologists. Although this may improve satisfaction levels, it may also mean that women are spending more time in mentoring than men, a commitment that may negatively affect productivity-based compensation and advancement.
Although still an area of concern for both women and men, radiation exposure is less of an issue affecting pregnancy and conception choices for women in the current survey. Since the 1996 survey, both the ACC and the Society for Cardiovascular Angiography and Interventions have published consensus documents regarding radiation exposure and safety in cardiology. The Society for Cardiovascular Angiography and Interventions consensus document focused almost entirely on pregnancy-related risks, whereas the ACC document included information concerning cancer risk and cataract risk as well (13,14). Concerns about radiation may continue to influence the small numbers of women choosing interventional cardiology, although this is likely not as significant a factor as it is perceived to be by men practicing interventional cardiology (9).
Discrimination in the cardiology community is of great concern, given that almost two-thirds of women report experiencing this at some point in their career or training. Although lower than what was reported by the U.S. surgical community, where 68% of women surgeons in practice reported experiencing discrimination in a recent survey (15), the rate of reported discrimination is much higher for women than for men and is significantly higher than levels of discrimination recently reported among a group of young, successful academic faculty in all fields, where 30% of women and 4% of men reported experiencing any form of discrimination (16). It is critical that experiences of discrimination be reported and addressed because the perception that discrimination is a rare phenomenon could, ironically, increase stigmatization and discourage reporting (16). In this respect, the experiences of other medical societies may be most germane and may suggest that focused attention on changing the culture of a profession is difficult, but is entirely feasible. As an example, the Royal Australasian College of Surgeons has undertaken a multiyear initiative, including extensive research and a detailed action plan, to end a perceived climate of discrimination, bullying, and sexual harassment, and to improve respect and patient safety. This undertaking could serve as a model for the cardiovascular community (17,18) and could help to make the field more attractive to women. The percentage of male cardiologists who reported experiencing any form of discrimination has remained unchanged over the past 20 years.
Personal and family issues
Although not dramatic, the trends reported in our survey with regard to marriage and children among women versus men indicate that the availability of lifestyle choices is greater now than in the past for both men and women, and should reassure young physicians struggling to decide whether or not to specialize in cardiology. The survey did not seek information about sexual orientation, and thus cannot provide insights into the prevalence of or challenges facing lesbian, gay, bisexual, and transgender cardiologists in the United States.
Over the past 20 years, men have become significantly more likely to report that family responsibilities negatively affect their careers. This change may mean that men are accepting and shouldering different roles in their families than previously. However, in a recent analysis of sex differences in domestic and parenting responsibilities among early-career physician-researchers, Jolly et al. (19) found that even among “Generation X” high-achieving physicians, women still spent significantly more time on parenting and domestic responsibilities, and men remained significantly more likely to have a nonworking or part-time working spouse than women, whose spouses overwhelmingly worked full-time outside the home.
Interruption of training and practice by 1 or more months remains more common among women than men, likely reflecting the realities of pregnancy and childbirth among women. The fact that very few men reported taking off any time at all reflects the reality that parental leave in the United States remains largely maternal.
Although the 3 PLS represent the largest compilation of longitudinal data regarding the cardiology workforce, as in most surveys, responses could not be independently verified. In 2015, survey response rates were lower than in prior surveys, and we cannot exclude the possibility that the experiences of nonresponders may differ substantially from those of responders. In particular, the age demographic of responders may not be the same as that of nonresponders, which is something we were unable to control for, and FIT responses may be substantially different than those of practicing cardiologists, but have been included in the total to ensure consistent reporting across time periods. We suspect that the decreased response rates reflect steadily increasing numbers of questionnaires and emails, with consequent e-mail fatigue on the part of cardiologists. As the first survey was conducted on paper via mailing to the recipients, and the format of some questions was modified slightly (e.g., by providing additional response categories or adding multiple possible responses rather than a single response), the ability to trend the data accurately may be affected in some cases. Finally, these surveys were only sent to domestic ACC members, who represent over 85% of U.S. cardiologists, but not the entire community.
Over the past 20 years, cardiology remains a career choice associated with high levels of satisfaction. The cardiology workforce is aging, and most cardiologists now no longer report working in a private practice setting. Significant sex differences remain in the subspecialty practice roles reported by men and women. Personal life choices continue to differ substantially for men and women, although these differences have diminished over the last 20 years. Discrimination continues to be an issue reported by a clear majority of female cardiologists. Addressing the changing demographics and practice settings of the work force, increasing diversity, and achieving parity in race and sex continue to be important goals for the cardiology community. This study provides comparisons over 2 decades in the microcosm of medicine that cardiology in the United States represents. These data inform our community and allow databased discourse as we assess and plan for the ongoing challenges facing the lives of men and women in cardiology.
The views expressed in this paper by the American College of Cardiology Women in Cardiology Leadership Council do not necessarily reflect the views of the Journal of the American College of Cardiology or the ACC.
This work was conducted through the Women In Cardiology Council of the American College of Cardiology. The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Abbreviations and Acronyms
- American College of Cardiology
- Professional Life Survey
- Women in Cardiology
- Received August 6, 2016.
- Revision received October 27, 2016.
- Accepted November 14, 2016.
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