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 United States (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 using the American Association of Medical Colleges (AAMC) 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 sub-specialty, publications, National Institutes of Health (NIH) 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 vs 53.5 years, p<0.001), had fewer total publications (mean number: 16.5 publications vs. 25.2 publications, p<0.001), were similarly likely to have NIH funding (proportion with at least one NIH award: 10.8% vs. 10.4%, p=0.77), and were less likely to have a registered clinical trial (percentage with at least one clinical trial: 8.9% vs. 11.1%, p=0.10). Among 3180 men, 973 (30.6%) were full professors compared to 100 (15.9%) of 630 women. In adjusted analyses, women were less likely to be full professors than men (adjusted OR: 0.63, 95% CI: 0.43, 0.94, p = 0.02; adjusted proportions 22.7% vs. 26.7%, absolute difference −4.0%; 95% CI: −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.
Objective To evaluate the impact of COVID‐19 pandemic migitation measures on of ST‐elevation myocardial infarction (STEMI) care. Background We previously reported a 38% decline in cardiac catheterization activations during the early phase of the COVID‐19 pandemic mitigation measures. This study extends our early observations using a larger sample of STEMI programs representative of different US regions with the inclusion of more contemporary data. Methods Data from 18 hospitals or healthcare systems in the US from January 2019 to April 2020 were collecting including number activations for STEMI, the number of activations leading to angiography and primary percutaneous coronary intervention (PPCI), and average door to balloon (D2B) times. Two periods, January 2019–February 2020 and March–April 2020, were defined to represent periods before (BC) and after (AC) initiation of pandemic mitigation measures, respectively. A generalized estimating equations approach was used to estimate the change in response variables at AC from BC. Results Compared to BC, the AC period was characterized by a marked reduction in the number of activations for STEMI (29%, 95% CI:18–38, p < .001), number of activations leading to angiography (34%, 95% CI: 12–50, p = .005) and number of activations leading to PPCI (20%, 95% CI: 11–27, p < .001). A decline in STEMI activations drove the reductions in angiography and PPCI volumes. Relative to BC, the D2B times in the AC period increased on average by 20%, 95%CI (−0.2 to 44, p = .05). Conclusions The COVID‐19 Pandemic has adversely affected many aspects of STEMI care, including timely access to the cardiac catheterization laboratory for PPCI.
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