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Research Mentor Name

Luis Afonso

Research Mentor Email Address


Institution / Department

University of Southern California, Keck School of Medicine

Document Type

Research Abstract

Research Type


Level of Research




Under-represented minority (URM) physicians, specifically African American, Asian (Filipino, Hmong, Vietnamese), Native American, Hispanic, and/or Pacific Islander, constitute only about 10% of practicing cardiologists. Although cardiology programs may face challenges recruiting under-represented minority applicants, concerted efforts to increase diversity may increase the likelihood of graduating minority cardiologists. However, there remains uncertainty regarding how best to recruit under-represented minorities and incentivize minority applicants to apply for cardiology fellowship training. As a result, the goal of this study is to survey current cardiology fellowship program directors regarding their views of diversity and recruitment of URMs.


A questionnaire containing items that assess cardiology fellowship program demographics and characteristics, attitudes regarding diversity in cardiology, strategies to increase diversity, and responsibility to increase diversity was developed for submission to cardiology fellowship program directors. The list of cardiology program directors was abstracted from the FREIDA AMA Residency & Fellowship Database. An email containing a link to the electronic survey was submitted to current program directors. Data was collected from September to November 2020. Data was analyzed using standard statistical methods.


A total of 58 program directors (PDs) responded from 250 cardiology fellowship programs, constituting a 23.2% response rate. The majority of PDs (n=40, 69%) strongly endorsed the importance of diversity in their fellowship programs. The majority of the PDs (n=38,65.5%) believed that allowing applicants the opportunity to interact with URM cardiology fellows, directly recruiting URM to apply to their fellowship program (n=33,56.9%), and involving current program fellows in informal recruitment of URMs (n=32,55.2%) increased diversity. These strategies were implemented by 58.6% (n=34), 51.7% (n=30), and 63.8% (n=37) of PDs, respectively. Most PDs (n=40,70.2%) agreed that holistic review of applicants played an important role in diversifying the cardiology applicant pool and 75.4% (n=43) implemented this method. However, deemphasizing USMLE scores when reviewing URM applications (n=19,32.8%), expanding the fellowship selection committee to include URM reviewers (n=22,37.9%), and considering more IMG applicants (n=15,25.9%) were supported by fewer PDs. Furthermore, the majority of PDs (n=35, 60.3%) reported actively increasing the number of URM faculty members. Lastly, 66.7% (n=38) and 75.4% (n=43) of respondents indicated that residency and fellowship programs have the most responsibility to increase URM representation in cardiology fellowships respectively, while the ACGME, attending physicians, physician professional organizations, and government have less responsibility.


The results of this study underscore the importance of diversity and inclusion in cardiology fellowship programs nationwide according to the views of program directors. Several of the strategies endorsed and implemented to increase URMs may be used to inform cardiology fellowship program directors of which interventions are being used in other programs, which programs are most supported by their peers, and which initiatives may yet need to be implemented. These findings may also be of value to medical students and resident physicians interested in applying to cardiology fellowships. Future research is needed to determine which strategies are most effective to increase URMs in cardiology fellowship programs in the United States.


Medicine and Health Sciences