Diversity is a vital element in delivering equitable and effective patient care. However, the United States (US) grapples with building a diverse healthcare workforce, which has led to persistent healthcare disparities. Women constituted only 37.6% of the active physician workforce in 20221. While other underrepresented groups comprise an even smaller proportion, 5.2% of providers identified as Black, 6.3% identified as Hispanic, and 18.8% identified as Asian.1 Diversity of the US population is growing rapidly and a workforce that reflects this evolution is necessary. By 2043, the US is expected to undergo a significant societal shift, marking a historic transition into a majority-minority nation, with no single ethnic group projected to be the majority2.

Although there have been positive trends in increasing female enrollment in medical schools, with women comprising approximately 54% of applicants in the 2019–2020 application cycle, the presence of practicing female physicians is significantly lower, highlighting the uneven distribution of progress across various medical specialties.3,4 Cardiology, in particular, struggles with persistent low representation, where only 1 in 5 adult cardiology fellows are women, in stark contrast to the equal representation seen in internal medicine residency programs.3 This gender gap widens with career progression, with women constituting only 15.5% of active cardiologists in 2021, affirming the slow change of the physician workforce's gender composition.5 Beyond the notable gender gap in cardiology, the field also faces a pronounced racial and ethnic disparity. In 2021, Black and Hispanic cardiologists were markedly underrepresented, constituting only 4.2% and 5.8% of the workforce, respectively, while Asian cardiologists comprised a higher proportion of active cardiologists 23.6%6, 7, 8. Effectively addressing the underrepresentation of these specific populations in cardiology is a complex challenge. Despite the growing diversity of the US patient demographic, their corresponding providers in cardiology remains notably insufficient. This underscores the imperative efforts to bridge the gender, racial and ethnic gaps within cardiology.

Published literature on diversity in cardiology is limited. Our goal is to illuminate substantial discrepancies and unequal representation, particularly concerning women and underrepresented in medicine (UIM) populations. Through an analysis of cardiology programs and medical school programs, we present data on gender, racial and ethnic disparities that emphasizes the pressing need to tackle diversity issues within cardiology training.