Two Generations of Women in Cardiology
As the number of women entering the medical field continues to increase, it’s difficult to overlook the fact that this surge in female physicians does not extend to cardiology. There has been a plateau due to concerns over work-life balance and a fellowship that has little room for flexibility. Sandra J. Lewis, MD, FACC, chair of the Women in Cardiology (WIC) Member Section and her daughter, Lisa Rosenbaum, MD, discuss what it’s like to be a female cardiologist and how it’s more manageable than one may think.
What originally made you interested in becoming a cardiologist?
SL: It’s one of those serendipitous stories. Before starting medical school I worked as a research assistant on a research project at Yale University where I found myself finishing the day’s tasks in about an hour. I did the New York Times crosswords, got bored and started wandering around the research wing, then hanging out in the cardiovascular surgery lab. Learning about the effects of a closed artery on heart function, of ischemia, and watching interventions that reversed ischemia and saved heart muscle – it was magic. And, the combination of a surgical approach with interventions and a more cerebral approach with diagnosis and treatment of heart disease was a perfect balance for my personality.
LR: It’s funny because I wish I could give you an answer that suggested a similarly thoughtful approach, but for it me it was very visceral. I got goose bumps the first week of medical school learning about cardiology. Many people assumed it was an inevitability with my mother being a cardiologist, but my father is a rheumatologist and in a lot of ways I’m more like him. It could’ve gone either way but I love cardiology and that hasn’t changed.
What was it like for you, Dr. Lewis, to see your daughter follow in your footsteps as a cardiologist? And how are you impacted, Dr. Rosenbaum, by having your mother for a mentor and resource?
SL: Lisa has really made her own footsteps. Perhaps that is one of the best things about cardiology – you make your own path. But it has been fun! How great is it that I get that 2 a.m. call from her to discuss a tough case?! I’m so proud of her and the way she thinks.
LR: I think I’m the luckiest person in the world! I always saw her as an outstanding doctor. As a child, we would often run into her patients and they would gush about her. But particularly during fellowship, I realized how special it was to share a profession. She’d be the person I called in the middle of the night to discuss what to do and how to treat a patient. And now she calls me too! We’re really lucky to get to play things off one another and I learn from her every day. It’s such a privilege for me.
SL: Just this morning we were emailing back and forth journal articles and headlines, discussing the latest news. We’re always having a conversation. She also started to send me her friends.
LR: That’s the other thing! At some point I realized not everyone has the mentor and mother I have so I started loaning her out!
What was it like to be a female in the field when you first began, Dr. Lewis, compared to the experience of your daughter’s generation? And do you feel, Dr. Rosenbaum, that there are still barriers to females in cardiology today?
SL: I hope the women of my generation have made it easier for people in Lisa’s generation. When I was entering medical school, women had just started entering medicine in larger numbers but it was very uncommon. I was really lucky to have three other women in my fellowship group – we called ourselves the “fellow-ettes” and now we’re lifelong friends! We’d help each other out and cover for each other to avoid radiation when we were pregnant. We pretended that our careers had no impact on pregnancy and child rearing, but that just wasn’t the case. It’s a problem even today – how do we manage to get through fellowship and start families in a program with no wiggle room? We haven’t figured out how to balance the demands of pregnancy and family life yet. It’s easier for men.
LR: I guess I’ll speak for myself and then I can try to speak for my generation. I have always had this keen sense that my mother fought battles that I don’t need to fight. I’ve had sort of a charmed experience and nothing has really held me back. But that’s just me; I wouldn’t want to say it’s that way for all women of my generation. My life is so much easier than hers was and I didn’t feel impacted by the fact that I am female in cardiology. I will say that during my first year of fellowship it was unfathomable to me to think that my mother had me during that same year of her training, and then my sister three years later. And women obviously still do both – have a family and be a cardiologist. My mother is being humble but she’s really spearheaded many initiatives to try and tackle these family issues.
Will we see numbers of female cardiologists continue to grow?
SL: I really worry about this. The numbers of women entering the field have plateaued. I hear a lot of concerns about work/life balance and a lot of residents feel like they don’t want to enter this field. I think women need to humanize cardiology and let people know about the wonders of this profession. The perception is that there is no life outside of cardiology but it doesn’t have to be that way. Within cardiology some will focus an all-consuming passion on their careers while others will be able to combine cardiology with a satisfying work/life balance. The ACC’s WIC Section conducts a professional life survey every 10 years. We are about to launch this for the third time. Based on past results, women are less satisfied and have more concerns with their profession. I think the fact that the number of women entering cardiology has plateaued is a concern.
LR: I agree with my mom. From the institutions I’ve been in, I think that there is a definite sense that it’s hard to be a woman in cardiology. The fellowship is brutal and the perception is that there’s no work/life balance. It seems like women need to have that goose bump feeling that I got to make it worthwhile. I think that if there are issues that are specific to cardiology that are scaring women off, then we need to address those to the extent that we can.
SL: It’s hard because you can’t make all STEMIs come in from 8 a.m. to 5 p.m., but we’ve been thinking through what can be done to make it easier. Some of my colleagues suggest we have a “float fellow” in fellowship to cushion the programs a little bit. For example, if you know someone is sick or needs bedrest from pregnancy, the floating fellow would ensure there isn’t too much work for too few people. Other possibilities need to be examined.
Finally, can you offer any advice to women who are interested in becoming cardiologists?
SL: I recommend finding a woman mentor or role model, be it a fellow, a research person or whomever. Perhaps try to find a few different people. I recently watched a wonderful interaction at a WIC event where the women fellows took residents under their wings and said “this is what you need to get a fellowship, let’s work on this project together, come write up this case with me.” This support will help the residents feel they belong in cardiology.
LR: That’s exactly what I was going to say! What distinguishes my mother and my mentor relationship is that she’s my friend. I think there’s this notion of professionalism and formality attached to mentorship but I think that what works best is to find someone who is both a mentor and a friend. My mom and I will talk about how male cardiologists golf together and do various activities as friends and women want this comradery too. Seek a mentor who cares about you and goes beyond the role of an editor for your CV. I had it handed to me by virtue of my birth, but I think this type of support system is what really helps people survive. People want to know it is okay and we’re not alone.
Join the WIC Section for a free WIC Leadership Workshop in Washington, DC, from February 6 – 7, and learn strategies for a successful career in cardiology. Learn more and register at ACC.org/WomenLeaders.
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