Why Care About Being a Woman in Cardiology? Part I

Here is a scenario for you. A father and his son are in a serious car accident, and the father dies. The son is taken to the closest hospital. Upon entering the boy’s room, the surgeon says, “I cannot operate on this patient – he is my son.” How can this be? Have you figured it out?

When a few friends and I were posed this question, we guessed one answer after another until we were coming up with outlandish scenarios. It took us an embarrassingly long time to guess that the surgeon was a woman! There I was, a woman physician training to be a cardiologist, and when I heard the word “surgeon,” I immediately assumed that it was a man. Sexism is not as clear-cut an issue as we may think. Yes, there are some who are overtly sexist, but for most people, both men and women, gender biases are subtle and often subconscious. They are the product of centuries of gender politics. Each day, however, as more and more women break beyond the expectations and attain high-powered positions, perceptions are challenged and we move closer to overcoming sexism. As women in cardiology, our presence is contributing to this shift. 

This may be difficult for us to recognize. Growing up, my sister and I were driven by my parents to be ambitious. The sky was the limit when it came to our professional aspirations, and those aspirations were worth committing ourselves to. My sister eventually chose law, and I chose medicine. Along my training, I became drawn to the challenging and gratifying field of cardiology. I decided to enter cardiology, and with that, I incidentally became a symbol of women’s empowerment in a male-dominated field.

Many women in cardiology have a similar story. We did not necessarily choose the field because we wanted to take a stand for women, yet here we are, our existence implicitly taking a stand for women.

Though women are slowly gaining equal footing to men in many fields, cardiology is a field that has been lagging behind. Half of medical students are now women, yet only one fifth of cardiology fellows are women. I suspect that one of the reasons that cardiology has not progressed in this regard is that cardiology tends to attract self-sufficient, independent women who do not think much of being a woman in the field. Our successes are our own, and our setbacks are our own. We may downplay being a woman, since after all, we should not be differentiated based on gender. We may not point out gender biases because we want to be seen as strong and capable, not as complainers.

Though we are individuals with our own personalities and viewpoints, which may at times be more aligned with those of a given male colleague than those of a given female colleague, the experience of being women in cardiology binds us. Even if we may not feel that our gender is a factor in our day-to-day interactions, there are others who see us who are keenly aware of it, and as we know, it can have effects on the way we are hired and the way we are paid. Even when things are going well, there are questions that lurk, never far from our minds. Should I be living up to the expectation of being a female version of the alpha male? If I am bold and assertive, will I be perceived as aggressive? If I am mild-mannered and kind, will I be deemed weak?

Most of us may tend to view our personal problems as issues that we have to figure out how to deal with on our own. But when we connect to other women in cardiology, we find that many of the issues that we thought were individual challenges are in fact issues that many of us face. Often they are issues that are unique to women or that affect women disproportionately. We can effectively address them only by sharing our experiences and making a concerted effort to identify the challenges and potential solutions.

If we take another step back, what becomes apparent is that we are not just individuals striving to be exceptional cardiologists while dealing with the challenges of being a woman. We are part of something bigger. I am reminded of this each time the wife of an elderly patient watches me with a glimmer of pride in her eyes after finding out that I am training to be a cardiologist. We represent female empowerment, both to fellow physicians and to the community. This adds a unique dimension to our careers. Cardiology is far more accessible to women than it once was, but we are still at a frontier in a field that is male-dominated. We are shaping what it means to be a woman in cardiology. More broadly, as we take our places in cath labs and as leaders in cardiology, we are shaping what it means to be a woman today. 

This article was authored by Jenine John, MD, a Fellow in Training (FIT) at Stony Brook University Hospital, NY.

Archival Comments

Jenine John · 120 weeks ago

I would love to hear people's thoughts, especially the experiences of other women in cardiology- please leave a comment!

Supreeya Swarup · 119 weeks ago

On one of my evaluations I was deemed to be "aggressive" and after some introspection I gained clarity. It's not a bad thing to be defined as aggressive especially in a male dominated field such as Cardiology. From a fellow female training to be a Cardiologist, this article ROCKS!

Jenine John · 119 weeks ago

Thank you! I wonder how often that evaluator described men as aggressive- I found this article to be interesting. I also wonder if women are in fact generally more aggressive than men in leadership positions, and perhaps, as you bring up, that is a positive. For example I can remember instances during internship when I had both male and female seniors on a team, and it was often the women who were more exacting and more actively pushing us to be better. Of course this is based on limited experience, but I think it is something worth considering. When the term "aggressive" is used, it is worth assessing whether there is actually aggression at a level that is excessive for the workplace, or whether the evaluator's bias has led them to describe what is a positive trait with a word that can have negative connotations.

Farhala · 119 weeks ago

Hi jenine, I am a cardiology FIT in aga khan hospital Pakistan. You are right in many ways. Cardiology being the male dominant Field especially in our country where the ratio of male trainees to female trainees is far greater. Here i am the 6th trainee since our training program was started. In spite of all freedom to media social media, etc., I still feel we being female cardiologist are not equally treated and there are hurdles in our way. Majority thinks we don't admire our families as others do etc etc.

Jenine John · 118 weeks ago

Hi Farhala- your comment reminds me of a talk I heard by one of the first American female cardiologists. When she was starting, the other mothers in her neighborhood, many of whom were stay-at-home moms, did not understand why she wanted to work in a field that required her to spend long hours away from her family. It's great to hear that you are pursuing your passions despite the social pressures!

Toniya Singh · 118 weeks ago

Hi Jenine, you are spot on about stereotypes. I think we can do so much better if we network with other women cardiologists , so we can learn from each other and there is a lot of collective wisdom to be gained through that sharing process. One of the things I find that seem to be a hinderance in the process is that I think women dont really place networking with other women cardiologist high on their priority list. Once you start actually interacting with them you then start looking forward to each event.I hope you will be at the ACC WIC leadership workshop this weekend in DC . The WIC section needs all of us to be involved. I really enjoyed your article !!

Jenine John · 117 weeks ago

Thanks! I agree. The process of writing this article was illuminating for me because it pushed me to confront my own thought processes and clarify my values. I would encourage all female cardiologists to similarly examine their thoughts regarding WIC. I believe that like me, many will find that this is in fact a matter that they would like to put more effort into.

Melissa Doohan · 110 weeks ago

For me, this is certainly true: I did not choose cardiology because I wanted to take a stand for women, but many years down the track, here I am, my existence implicitly taking a stand for women. 0ver the years many of my patients have chosen me because I am a woman. Our patients deserve to be able to make that choice, whatever their gender.

And I am proud to take a stand for women especially as I am the mother of two girls.

sabeeda · 108 weeks ago

Very well written Jenine! I am presently a third year medicine resident in New York and have interviewed this season for a cardiology position. What was surprising for me was seeing the paucity of female applicants and when I mentioned I plan to be an interventionalist , the reactions I got from my co-applicants! I don't consider myself a feminist , rather the exact opposite. I feel the fact that gender is so heavily discussed when it comes to cardiology shows the huge divide that exists!

Lara · 92 weeks ago

As a general surgeon for over 20 years I experienced a lot of discrimination, both intentional and unintentional. I learned to deal with it. However, I would like to respond to your idea that you can work many hours as a physician and have a family and do a good job at both.

In reality, it is very difficult to be both a good clinical doctor and a good parent. In general, your family tends to suffer as you put your patients first. I would encourage all people both men and women to think carefully about how to structure your life when you are trying to be both a good clinical physician and a parent.

It is great, if as a women, you have married someone would is happy to take the larger share of child care. But if not, what you end up doing is having other people take care of your children for you. This is not ideal for children, but can be acceptable.

I adopted twin girls when I was older and initially thought I could do both jobs well. But I found I could not be a good parent and a good doc too.

I eventually left clinical practice and now work for the FDA. I am very happy with my choice and love both my intellectually stimulating job and being a parent who is present for their children, because in the long run both quality and quantity of time spent with your children is important.

Best of luck to all the wonderful women physician who are out there working hard for their patients.