This post was authored by Payal Kohli, MD, fellow-in-training at the University of California San Francisco.

Despite a growth in female physicians, there are as few female cardiologists as ever. Statistics from ACC membership as well as nationwide censuses has shown that the percentage of women in cardiology has unchangingly remained within the 10-15 percent range over the last several years, dashing our hopes that this number may be slowly creeping upwards. So what seems to be the problem? Why are women continuing to go into fields like pediatrics and dermatology, while turning their backs on exciting fields like cardiology and surgery?  And, there are fewer women cardiologists going into academics than men. Don’t we need more estrogen to balance out all that testosterone?

There is the obvious challenge that female cardiologists face: achieving a work-life balance that remains compatible with societal (and sometimes marital) expectations.  It is quite impossible to be doing stat echoes on call and taking STEMI call while being seven months pregnant (although I do have some amazing colleagues who somehow manage to pull it off), who also get home in time to put dinner on the table every evening. And the ever-growing length of cardiology fellowship, compared with other disciplines even within internal medicine, is not helping matters.  Granted, a fellowship doesn’t last forever, but it still continues to pose a significant stumbling block for many female medical residents who, if they are contemplating child-bearing, often have to wait until they are no longer on call every other night before even thinking about becoming pregnant.

There is also the less obvious barrier, which I think is much more paramount for many women – the lack of strong female role models.  At every major crossroad in our lives, we look to our mentors to help guide us and get a sneak preview into our own future.  If our specialty has only a small percentage of females, then who do we turn to for this type of guidance?

Now, don’t get me wrong, I have been privileged to have some amazing male mentors in my life, but there continues to be professional and personal challenges that are unique to women, which I cannot fully comprehend from interacting with my male mentors. The old saying goes, men are from Mars and women are from Venus!

As I stand at the crossroads of academic medicine and private practice, I feel much less confident making a decision, with the majority of my uncertainty coming from the lack of women within my field who I can look to see how it’s done.  Unfortunately, I haven’t had the opportunity to work some of the amazing women in our field, like JoAnne Foody, MD, FACC, or Roxanna Mehran, MD, FACC, who have somehow overcome all barriers and demonstrated that we as women, can actually have it all – family, career, academic cardiology and even fashion (in case you hadn’t noticed, they are both very sharp dressers).  They do give me hope that it is possible.

The question becomes, what are we doing to try to fix it?  Personally, I have decided to take a more active role as a preceptor for young medical students and residents, encouraging more of them to become cardiologists.  I have also joined the ACC’s Women in Cardiology Council and hope to promote awareness and networking opportunities amongst female trainees. But else what do you think we can do to increase the number of women in cardiology and increase the opportunities for women to interact with other women?

*A version of this article also ran in the May issue of CardioSource WorldNews.