Acknowledging the Contribution of Women in Cardiology

Upon receipt of the Early Career Travel Award for the ACC Legislative Conference, I immediately registered for the Women in Cardiology (WIC) Leadership Conference that was scheduled for the day before. I have heard great things about the WIC Leadership Conference over the past year and was excited to attend. The last time I attended the ACC Legislative Conference 10 years ago as a fellow, the WIC Leadership Conference did not exist. This addition is an important step for the ACC and cardiology in general.

I'm technically early in my career but have enough experience to know my trajectory and how I fit into the community. I am a 41-year-old general cardiologist in private practice, now essentially employed by a hospital system. I have a special interest in heart disease in women and have recently become the director of our Women's Heart Center. I am also a wife and mother to two sons, ages 6 and 9. When I started my fellowship, I did not have children and knew that I was equal to the other fellows in my program, all of whom were male. I was treated very respectfully and had equal opportunities. I had my first child during my last year of fellowship. I was told that I would have to make up my entire maternity leave at the end of the fellowship by staying on for a month past graduation of my class. It was a non-required, elective month. This rule was inconsistent with the rules set out by all other programs at our institution where women were not forced to make up this time at the end of the training. I had felt my first taste of discrimination.

I am married to a physician who I met in medical school. Again, when we met, I knew that we were equal in our abilities as students, residents and later physicians. Eight years into practice, I have changed my perspective to some degree. I now feel that I am equal to the men in my practice, but I have come to see that we are indeed 'different'.

I decline invitations for early and late meetings in order to be home with my family more often than my partners. I never attend dinners sponsored by pharma because it's not worth missing out on my own family dinners. I even forgo the "low hanging fruit" of reading extra imaging or stress tests in order to be available for my children. I am wracked with guilt when I miss a school event or when I spend the weekend on-call.

I still "lean in" when at work. My work ethic has not wavered. I sit at the table and volunteer for multiple committees. Fortunately, because my husband works, I do not have the additional stress of solely supporting my family financially like many of my partners do. I do have the option to limit commitments to additional income production. The most important lesson I have learned over the past 10 years in the world of cardiology is that I am an important contributor to my group and my community BECAUSE I am a woman, not DESPITE it. I am not another warm body to add to the call schedule. I bring an important female perspective to the group dynamics and to our patients. Who else would be interested in treating heart disease in women so passionately?

During the WIC Leadership Conference, we learned that women still comprise a small fraction of the physicians practicing cardiology. Women are also still paid less for the same work in cardiology. The day after our WIC Leadership Conference, I sat down at the table with our state ACC group at the Legislative Conference and told the table of mostly men about the data I learned the day before. One man remarked that cardiology was not likely an appealing subject or specialty to women and probably explained the gap. I told him that there were more women in general surgery as a percentage than in cardiology, so it was not likely the procedure-heavy aspect of cardiology that was the issue. Another colleague explained to me that women "want to be mothers, and it is too hard to do that in cardiology." I had no comment.

The answer to these gender gaps is not to tell women that "it's possible to practice cardiology and maintain work-life balance." It is really hard. Of course it's possible. A lot of us are doing it. But, not enough of us are. The answer is to acknowledge the contribution that women make to groups and communities. The answer is to seek women as additions to current practices and to adjust current models to allow women to manage their families while practicing. Maybe part-time positions should be added. Maybe we can value time spent on staff development, quality committees and development of women's heart programs in the same way we value time in the cath lab and developing TAVR programs.

When half of all medical students are women, the field of cardiology cannot continue drawing from half of the pool to fill a small proportion of cardiology job positions. Talk about a brain drain.

This article was authored by Caitlin M. Giesler, MD, FACC, director of the Women's Heart Center at Seton Heart Institute. Follow her on Twitter at @HeartDrGiesler.