Reasons for gender inequities in invasive electrophysiology: a survey on family issues and career paths of female and male electrophysiology fellows in Germany.

Aims: Female physicians are underrepresented in invasive electrophysiology (EP) for multiple reasons. Despite an increasing focus on the topic, it is unclear what aspects are predominant. Methods and results: We conducted a survey on career paths of current or former EP fellows in Germany to elucidate how gender and family affected their careers. 231 fellows (24.2% female) were invited. 110 participants completed the survey (30.9% female, mean age 41.0 ± 5.0 years, and 79.1% with children). Female and male participants with children reported similar career goals and achievements before parenthood, but afterwards women changed their career paths more often. Major reasons were personal priorities followed by lack of flexibility at work and at home. Women covered the majority of childcare. At the time of the survey, 80.0% of women and 96.4% of men with a former career goal of invasive EP were active in invasive EP. Independent of age, women were in lower-level positions, had accomplished fewer professional achievements, were less satisfied with their work and had fewer children. 56.5% of women did not feel supported by their employers regarding family issues. 82.6% reported there was no satisfactory day care. 69.6% were unable to continue to follow their career during pregnancy, mostly due to restrictions by employers (75.0%). Dedicated policies for pregnant workers or support programmes were scarce. Conclusion: Beside the distribution of childcare at home, lack of flexibility and support by employers as well as working and fluoroscopy restrictions during pregnancy hamper women in EP and should be addressed.