Feature | A First-Year Cardiology Fellow’s Perspective: Where Did the Women Go?

The transition to becoming a first-year cardiology fellow is both exciting and intimidating. As a woman, it can feel like entering the set of Mad Men: an arena dominated by men, where women are present but not in the spotlight.

As a medicine resident, the gender distribution at my program appeared to be more or less fair – both amongst the residents, as well as the attendings. It was during my fellowship interview trail that I realized the paucity of women in cardiology, mostly by the interviewers expressing their encouragement for a woman applying for cardiology.

I feel fortunate to have been matched in a program where the female interventional cardiologists actually out-number the men. Remarkably, in my first year fellowship class, the women out-number the men! I know, however, that this is an exception and not yet the rule.

There was a time when a female doctor was rare. Rounding on the cardiology consult service, with a female tenured professor, we paused to look at my hospital’s homepage dedicated to Elizabeth Blackwell, MD, – the first woman to graduate medical school in the U.S. That was in 1849. If cardiology fellowship feels like the set of Mad Men to me today, I wonder how Elizabeth Blackwell felt in the mid-nineteenth century.

Today, on average, women make up approximately 47 percent of a medical school class. Also they do not require a unanimous vote by their male counterparts for the admission (unlike Blackwell). Despite that, per the American Board of Internal Medicine statistics, in 2013-14 only 21 percent of the first year cardiology fellows were women. Interestingly, this is a significant up-trend compared to the 13 percent proportion in 1994 – 95.

Without a doubt, women have come a long way. However, cardiology continues to be an internal medicine subspecialty that sees a significantly smaller percentage of women, compared to most others. Cardiology procedural fields have even less representation by women, with only 8 – 10 percent of the practitioners in these disciplines being women in 2013 – 14.

Going through medical school and residency, I hadn’t given much thought to being a woman. However, over the last few months I’ve realized it is because of women like Blackwell, who had the courage to bring change to a field traditionally dominated by men, that the road was paved for subsequent generations to follow. Although women are not as under-represented now as they have been in the past, there is still much to be achieved in terms of bringing the viewpoints, sensitivities and influence of women in cardiology to the forefront. I feel proud to be playing a (very small) role in the current evolution of women in cardiology.

This article was authored by Saira Samani, MBBS, a Fellow in Training (FIT) at the University of New Mexico in Albuquerque, New Mexico, and Bina Ahmed, MD, FACC, assistant professor of medicine at the Geisel School of Medicine in Dartmouth.