‘How Important It Is For Us to Recognize and Celebrate our Heroes and She-roes!’ – Maya Angelou

I have been blessed with the opportunity to serve as the editor of the Women in Cardiology Career Development Section – a platform to voice concerns that have pestered me over years and have possibly been plaguing my fellow female cardiology colleagues.

I have pondered on multiple occasions whether this is what I undeniably want to do with my professional life. No matter how much a society evolves, it perceives its females as the nurturers, custodians and keepers; and no matter how commodious my dream and sizable my passion, I dread the very notion of floundering when it comes to my obligations.

I will not deny that the thought has not crossed my mind, "Am I even a fit?"

While there are publications focused on female contributions, participation and impact on medical sciences above and beyond their male counterparts, I beg to argue why there is a need for a study to look at gender disparity in our 21st century society, especially in a profession so imperial. It is imperative that we candidly scrutinize and iron out these rifts, so that every physician – male or female, black or white, young or old – have their undivided assiduity to assimilating patient care.

Where else would you find the answers to your intimate angst but from the corporeal wisdom of our female leaders? I was able to get in touch with some of the most embossed names in cardiology to procure their insight into these incessant female-fellow's tea-table themes. I thank Annapoorna Subhash Kini, MBBS, MRCP, FACC; Claire S. Duvernoy, MD, FACC; Cindy L. Grines, MD, FACC; Kavitha Chinnaiyan, MD, FACC; and Roxana Mehran, MD, FACC, for their time and advice.

I am amazed how conglomerate their approach to our questions is, which delightedly gives us options.

Concern 1: Major challenge that dwindles female participation in the field of cardiology?

The unknowns regarding child bearing are a potential major limitation, not ignoring the hassles in promotions and advancements in this predominately male-dominated field, advises Mehran. Grines points out the limited exposure to interventional cardiology in medical school and lack of female role models as major contributing factors. She suggests, "The best approach probably is to ignore the barriers and follow your heart." Per Duvernoy, overall, the field is viewed not as a family-friendly career but almost an old-boys-club feel. Additionally, while this may hold true for most procedural sub-specialities, the omen of "not-welcome" makes it more challenging for women. With all these hastles to trounce, Kini acknowledges the importance of increased involvement in leadership roles, improved networking and increased mentoring. Chinnaiyan further clarifies, "Equality in a profession does not mean sameness. Women are perfectly capable of meeting the demands of the profession and must realize that it is indeed possible to balance career and family with a little planning, foresight and wise choices in terms of fellowship or practice situations."

Concern 2: Balancing work and family.

Managing motherhood with work can be challenging; however, there are definite time-tested ways to make it work. Stating the priorities clearly with strong communication to your significant other cannot be overemphasized. Kini points out that as times change, patterns change, and the dynamics of balance change as well. It is something we learn as we evolve. She emphasizes that letting work and personal life spill over each other a little bit may not be bad after all. "Sharing work news with children, taking them occasionally to work, business trips and conferences, might help them find their own path in life." Mehran gives entire credit to her "great life partner" and their strategy of "divide and conquer." She emphasizes that the balance truly lies in "choosing the right life partner." Duvernoy also believes in a "passively organized, synchronized and transparent" system where the colleagues understand her personal obligations. She explains that to attain that level of balance, you need a close-knit relationship of mutual obligation with your male counterparts. Grines provides us with a completely distinct approach that has proven effective for her – the concept of "compartmentalization." She does not let her personal life overlap with her professional life. Her home is a "sacred place for family and friends." Grines' mantra in life has been "110 percent at work place" when present there and "110 percent at home" during her protected personal time. Chinnaiyan re-iterates that knowing schedule in advance and support of your colleagues and department goes a long way.

Concern 3: Managing a healthy lifestyle with a busy schedule.

Grines believes in a short and intense exercise routine with "interval training" as little as 10 minutes daily. Time has never been a limiting factor for her. Additionally, she believes in incorporating the exercise regimen to everyday little activities – jogging with the stroller or pulling the cart behind your bike. Yoga retreats from time to time, apart from regular meditation and exercise, have done wonders for Chinnaiyan. Duvernoy rides her bicycle to work daily, in addition to 30 minutes of the treadmill five days a week. For her, staying at a cycling distance from the work place has been a boon in disguise. Kini adheres to a healthy eating routine with daily intake of fresh vegetable and fruit juice. She has a versatile regimen ranging from weekly cardio and weight training to a run in the park. Mehran agrees that physical fitness is a way of loving yourself and no one should feel guilty about it. Kini emphasizes that indulging in yoga and Pilates goes a long way in helping to maintain posture while wearing heavy lead for hours.

Any final messages from the leaders:

Duvernoy mentions that the single most important characteristic is to have a "thick skin" – the group you deal with may be "rough and coarse." It is important to have a strong personality and never come across as "meek." Kini mentions that "skills and dedication" go a long way and it is very heartwarming when her male counterparts appreciate and recognize her work. She believes that your professional genius collects you more accolades and cultivates respect for you in your group. Mehran emphasizes on mentoring more female cardiologists to excel in the fields of research, clinical practice and leadership. When she sees her students evolve as leaders, she is filled with pride. "Let's not forget that professional societies such as the American College of Cardiology which are championing for women by bringing men, women, program directors and other concerned parties to the discussion table," states Chinnaiyan. Grines shares her memory of several debates against the luminaries in cardiology, including Eric J. Topol, MD, FACC, and Eugene Braunwald, MD, MACC. She adds, with her wit, "I tried to be factual but also infuse humor, and it worked!"

In summary, let's procure our dreams with dedication, fearlessness and planning. And just like we conquer our House, let's conquer the House-of-Cards!

This article was authored by Nishtha Sareen, MD, FACC, an interventional cardiologist at William Beaumont Hospital, DMC Huron Valley Sinai Hospital and St. Joseph Mercy Oakland Hospital in Michigan.