Cardiothoracic surgery linked to a lack of diversity, uneven salaries: What can be done?
Cardiothoracic surgery is less diverse than other healthcare specialties, according to new data published in The Annals of Thoracic Surgery.[1] In addition, researchers noted, women consistently take home significantly lower salaries than men.
“Diversity among providers enhances patient satisfaction and adherence to health recommendations, as well as physician well-being, job satisfaction, retention, innovation and research,” wrote first author Anastasiia K. Tompkins, BS, a researcher with the Lewis Katz School of Medicine at Temple University, and colleagues. “Despite these benefits, cardiothoracic surgery lacks diversity, with only 11.5% women and 7.2% underrepresented minorities. Though workforce diversity is an enigmatic term, the increasingly diverse patient population should have representation among the cardiothoracic surgeons who care for them.”
Tompkins et al. wrote their analysis on behalf of The Society of Thoracic Surgeons Workforce on Diversity, Equity and Inclusion, The Society of Thoracic Surgeons Workforce on Cardiothoracic Surgery Practice Models and The Society of Thoracic Surgeons Workforce on Career Development. Exploring diversity and equality among cardiovascular surgeons represents the shared interests of all three groups.
Little diversity seen among trainees and faculty
According to the group’s exploration of 2022-2023 data from the Accreditation Council for Graduate Medical Education (ACGME), cardiothoracic surgery is associated with a limited number of women and underrepresented minority trainees. Researchers tracked nearly 500 total trainees, including 256 focused on traditional thoracic surgery, 237 focused on integrated thoracic surgery and another eight focused on congenital surgery. A lack of diversity was seen in all three training groups. Among traditional thoracic surgery trainees, for example, 39% were white men, but just 1.5% were Black women and no trainees were American Indians or Alaskan Natives.
A similar lack of diversity was seen when reviewing the faculty at various U.S. cardiothoracic surgery training programs. Assistant professors, associate professors, professors, chiefs and chairs were all overwhelmingly white men, for example, and there were fewer female faculty members in thoracic surgery than expected, especially when comparing it to all other specialties.
Salaries significantly lower for women than men
When tracking the salaries of academic clinicians, academic surgeons and academic cardiothoracic surgeons, one trend was clear: Women take home lower salaries than men. In fact, researchers estimated that women earned anywhere from 80% to 87% of what men of equal academic ranks earn.
However, the issues for women in cardiothoracic surgery do not end there. They also experience higher rates of sexual harassment, more difficulty finding jobs and less supportive working environments.
“Achieving fair compensation and opportunities for women in cardiothoracic surgery is essential for equity,” the group wrote. “Equity refers to the state of having unbiased systems and processes that allocate resources, where people of similar qualifications and work receive similar compensation regardless gender, race, age, sexual orientation, religion and disability. Without equity, cardiothoracic surgery risks discouraging qualified candidates from entering the field and disillusionment of current surgeons.”
Seeking solutions
The authors emphasized that “specific interventions are needed” to bring about change to the cardiothoracic surgery workforce. Some steps have already been taken to educate high school students, undergraduates and medical students about the specialty, but they represent just the tip of the iceberg.
“Key mentoring components, including authenticity, accessibility, accountability, and motivation, help cultivate a diverse and competitive application pool,” the group explained. “Addressing salary disparities demands a comprehensive strategy focused on equity and transparency, such as establishing standardized starting salary ranges similar to the consistent salaries received by chief residents regardless of gender, race or previous experience. Ensuring parity in starting salaries can mitigate career-long earning gaps, promoting engagement while reducing turnover. Furthermore, implementing a national system for tracking compensation and promotions can uncover existing disparities and guide improvement.”
Tompkins et al. also recommended ensuring that diversity and equity remain top priorities for all retention, evaluation and compensation processes at academic programs throughout the country. By focusing on potential solutions, leaders can feel confident cardiothoracic surgery will improve over time instead of falling into the same habits again and again.
Click here to read the full analysis in The Annals of Thoracic Surgery.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.