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Abstract：
Introduction Diversity and inclusion in cardiovascular fellowships are necessary for addressing the healthcare needs of diverse patient populations. However, regional disparities in the diversity of these programs persist, diminishing efforts to create a representative workforce. We observe the regional differences in the diversity of cardiovascular fellowship programs, focusing on gender, doctorate designation, and graduation within the United States (US) or other. We hypothesized that males, medical doctors (MD), and US graduates would be in majority across all regions. Methods Data for cardiovascular fellowships from the Fellowship and Residency Electronic Database Access (FREIDA) system for the matriculation year 2022-2023 was obtained to assess the representation of male vs female gender, MD vs osteopathic doctor (DO) designation, and US vs non-US graduate. We then compared these backgrounds to five defined regions (Midwest, Northeast, Southeast, Southwest, and West) in the United States to define representation for backgrounds across geographic areas. Statistical significance was determined by p<0.05 with the use of SAS Studio 3.8, version 9.4 (Cary, NC: SAS Institute, Inc.), and Wilson score for confidence intervals. Results We found significant disparities across all background factors for all regions. This includes that females, DOs, and non-US graduates were underrepresented among Midwest, Northeast, Southeast, Southwest, and West regions, and the p-value was <0.001 for all variations. Specifically for Midwest, the female frequency was 155 (23.81%; CI: 21, 27; p<0.001), DO frequency was 101 (15.51%; CI: 13, 19; p<0.001), and non-US graduate frequency was 206 (31.84%; CI: 28, 36; p<0.001). For Northeast, the female frequency was 231 (29.62; CI: 27, 33; p<0.001), DO frequency was 72 (9.22; CI: 7, 11; p<0.001), and non-US graduate frequency was 239 (30.68; CI 28, 34; p<0.001). For Southeast, the female frequency was 178 (25.99; CI: 23, 29; p<0.001), DO frequency was 67 (9.78; CI: 8, 12; p<0.001), and non-US graduate frequency 279 (41.46; CI: 38, 45; p<0.001). For Southwest, the female frequency was 74 (26.71; CI: 22, 32; p<0.001), DO frequency was 21 (7.58; CI 5, 11; p<0.001), and non-US graduate frequency was 110 (39.71; CI: 34,46; p<0.001). For West, the female frequency was 107 (31.75; CI 27, 37; p<0.001), DO frequency was 15 (4.45; CI: 3, 7; p<0.001), and non-US graduate frequency was 54 (16.07; CI: 13, 20; p<0.001). Conclusion We emphasize the regional disparities for females, DOs, and non-US graduates within cardiovascular fellowships in the past matriculation year. Understanding that we have not reached diversity goals allows for further reflection and implementation of targeted interventions and initiatives aimed at promoting equal opportunities for applicants. This is true for all regions of the United States. By addressing these disparities, fellowship programs can more effectively mirror the diverse patient populations they serve and foster a healthcare environment that is inclusive and accommodating. This, in turn, contributes to the overall enhancement of healthcare outcomes.
摘要：
介绍多样性和纳入心血管研究金是必要的，以满足不同患者人群的医疗保健需求。然而,这些项目多样性的地区差异仍然存在，减少创建代表性劳动力的努力。我们观察到心血管研究金项目多样性的区域差异，关注性别，博士学位指定,并在美国（US）或其他地区毕业。我们假设男性，医生(MD),美国毕业生将在所有地区占多数。方法从2022-2023年预科课程和住院医师电子数据库访问（FREIDA）系统中获得心血管研究金的数据，以评估男女性别的代表性，MD与骨科医生（DO）指定，美国vs非美国毕业生。然后，我们将这些背景与五个定义的区域(中西部，东北,东南,西南，和West)在美国定义跨地理区域背景的代表性。使用SASStudio3.8，9.4版（Cary，NC：SAS研究所，Inc.),和威尔逊得分的置信区间。结果我们发现所有地区的所有背景因素之间存在显着差异。这包括女性，DOs,非美国毕业生在中西部地区的代表性不足，东北,东南,西南，和西部地区，所有变异的p值均<0.001。特别是在中西部，女性频率为155（23.81％；CI：21，27；p<0.001），DO频率为101（15.51％；CI：13，19；p<0.001），非美国毕业生频率为206（31.84%；CI：28，36；p<0.001）。对于东北来说，女性频率为231（29.62；CI：27，33；p<0.001），DO频率为72（9.22；CI：7，11；p<0.001），非美国毕业生频率为239（30.68；CI28，34；p<0.001）。对于东南部，女性频率为178（25.99；CI：23，29；p<0.001），DO频率为67（9.78；CI：8，12；p<0.001），非美国毕业生频率279(41.46；CI：38，45；p<0.001)。对于西南航空，女性频率为74（26.71；CI：22，32；p<0.001），DO频率为21(7.58；CI5，11；p<0.001)，非美国毕业生频率为110（39.71；CI：34,46；p<0.001）。对西方来说，女性频率为107（31.75；CI27，37；p<0.001），DO频率为15（4.45；CI：3，7；p<0.001），非美国毕业生频率为54（16.07；CI：13，20；p<0.001）。结论我们强调了女性的地区差异，DOs,以及在过去一年中获得心血管奖学金的非美国毕业生。认识到我们尚未实现多样性目标，因此可以进一步思考和实施有针对性的干预措施和举措，以促进申请人的平等机会。美国所有地区都是如此。通过解决这些差异，研究金计划可以更有效地反映他们所服务的不同患者人群，并促进包容和包容的医疗环境。这个,反过来,有助于全面提升医疗保健成果。
