The D-A-CH* with the glass ceiling: Invasive cardiology edition. The game is fair, but mostly men's flair gets air!

https://doi.org/10.1007/s00392-024-02526-y

Emyal Alyaydin (Zürich)1, A. Candreva (Zürich)1, H. Arfsten (Wien)2, M. Papathanasiou (Frankfurt am Main)3, H. Reinecke (Münster)4, B. Stähli (Zürich)5, J. Stehli (Zürich)1

1UniversitätsSpital Zürich Klinik für Kardiologie Zürich, Schweiz; 2Medizinische Universität Wien Innere Medizin II / Kardiologie Wien, Österreich; 3Universitätsklinikum Frankfurt Med. Klinik III - Kardiologie, Angiologie Frankfurt am Main, Deutschland; 4Universitätsklinikum Münster Klinik für Kardiologie I: Koronare Herzkrankheit, Herzinsuffizienz und Angiologie Münster, Deutschland; 5UniversitätsSpital Zürich Universitäres Herzzentrum Zürich, Schweiz

 

Background: While numerous reports from the National Cardiac Societies (NCSs) of Germany (D), Austria (A), and Switzerland (CH) indicate progress toward sex equality in invasive cardiology, women continue to be significantly underrepresented in cardiac catheterization laboratories (CCLs), particularly as directors.

Aim: Our study aimed at evaluating sex differences in the proportion of designated CCL directors within the D-A-CH region.

Methods: We used the NCSs' websites, official hospital homepages, and social media profiles to identify the directors of certified CCLs. Health centres with no designated CCL directors were excluded from the analysis. Sex was determined based on pronouns used in biographies and social media profiles and addressed as a binary category, allowing for sole differentiation between male and female. We distinguished between two main areas of invasive cardiology: interventional cardiology (IC) versus electrophysiology and/or device therapy (EP/DT). Statistical analysis was conducted using IBM SPSS Statistics software, version 29.

Results: Overall, 267 IC laboratories (208 (77.9%) in D, 35 (13.1%) in A, and 24 (9.0%) in CH) and 312 EP/DT centres (235 (75.3%) in D, 30 (9.6%) in A and 47 (15.1%) in CH) were identified. Among these, 55 (8.7%) had two designated directors. Women were notably underrepresented as CCL directors (in total 45 (7.1%)), particularly in CH and D, with only one female director in each IC and EP/DT in CH, and 9 (4.3%) and 26 (9.2%) respectively in D. (Fig 1 a, b). Women were less frequently directors of the associated cardiology departments compared to their male counterparts (17/45, 37.0% vs. 307/589, 52.2%, p = 0.048). The number of CCL directors holding postdoctoral degrees was high, and there were no significant differences between sexes (20 (43.5%) for females vs. 302 (51.3%) for males, p = 0.359).

Conclusions: Women are notably underrepresented as CCL directors in the D-A-CH region, particularly in Switzerland. Furthermore, the gender gap widens dramatically along the promotion pathway, despite women being equally as qualified as men.

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