ACC past president, Mary Norine Walsh, MD, MACC, is a leader, educator and author in cardiovascular medicine. She is also the director of the heart failure and cardiac transplantation programs and director of nuclear cardiology at St. Vincent Heart Center in Indianapolis, IN. In this interview, Walsh describes her path to leadership and the important role of women in cardiology.

1. Tell us about your path to leadership. How has your experience with leadership differed from your male counterparts?
My leadership roles have had a major focus on quality improvement and the medical directorship of our heart failure, transplant and nuclear cardiology programs at St. Vincent Heart Center and, more recently, Ascension Health. I have always sought leadership in areas that impact patients, and this focus has led me to collaborative work with other quality leaders in health care.

One way that my leadership experience has differed from my male counterparts is that I have not sought a role as a managing partner or service line director. In private or integrated practice, this is often the most visible role for a cardiologist and is rarely filled by a woman. It is my hope that this will change in the future.

2. During your term as ACC president, what goals did you set for yourself and how did achieve them?
In the past, presidents of the College often declared a "theme" for their presidential year. We have stopped this practice in favor of keeping a focus on the College's strategic priorities and goals. That said, I am passionate about certain aspects of cardiovascular care and practice and I hoped to use my visibility as president of the College to highlight them. Team-based care is one such passion, and the time is ripe for these models of care to be disseminated more widely. As we move from a volume-driven to value-driven payment model, team-based care is going to be more important than ever. Cardiovascular medicine is way ahead of some other fields in our models of patient care via teams, but not all cardiologists and clinicians are familiar with these models. The College can help with dissemination of best practices and show teams models that work.

3. Reflecting on your tenure as president of the ACC, which experiences do you look back on with the most satisfaction and pride? Which experiences do you look back on with the most dissatisfaction or regret?
Some of the experiences that have brought me the most satisfaction have been my travels to our international chapters. My view of global health care broadened by seeing how cardiovascular medicine is practiced around the world and interacting with cardiologists who are very engaged with the ACC. I have also enjoyed meeting with Fellows in Training, both in the U.S. and internationally. I have absolutely no regrets about my tenure. My only dissatisfaction involves cancelled flights and other airline hassles that are part and parcel of the travel I do.

4. You have been an inspiration for the ACC Women in Cardiology (WIC) Section. How did you become interested in championing for women within the field?
My first experience as a volunteer in the College was on what was then the ad hoc Task Force on the WIC Section. There, along with many others, including Marian C. Limacher, MD, FACC; Pamela S. Douglas, MD, MACC; and Janet S. Wright, MD, FACC, we began exploring the issues faced by women in our field and started efforts at mentoring and networking. I have been working on various aspects of the ACC WIC Section ever since.

5. During your career as a cardiologist, what changes have you noticed for women in the field? What changes do you foresee for the future?
There are definitely more women in our field now than when I as a fellow, and our ranks will continue to grow. The biggest change that I have seen for women is that men are now talking about women in cardiology and joining us in our efforts to support, mentor and increase the pipeline. It is no longer a "women's issue;" it is an issue that affects everyone in cardiology.

6. What do you think is the greatest barrier to women practicing cardiology today?
The greatest barrier is the persistent misperception that a woman cannot combine a full career in cardiology with a full family life. This misperception starts as early as high school and college. I have been shadowed by female high school and college students who have been discouraged from going to medical school if they want to have a family. This advice comes from people in medicine and those in other fields.

7. How do you perceive an ideal work-life balance, and do you believe it is achievable as a female cardiologist? How do you manage to find work-life balance in your career?
The ideal work-life balance is different for each person, and it is achievable. We just cannot expect to have everything at the same time. For me, time with my children was very important when they were young. During those early years, I did not attend national meetings and cut back on my academic pursuits. As they got older, I re-engaged and expanded my research and travel commitments. This choice has worked for me, but it is not a choice that others might make.

8. I recently read the book Lean In by Sheryl Sandberg. During an interview, Sandberg advised women to "go for the big job and deal with family later." How do you feel about this statement?
I do not agree with her on this. If you want to have a family, you have to make sure to do exactly that. Do not let your personal or family goals get derailed by your career goals. I believe that family is compatible with "the big job," so pursuing both in parallel is possible.

9. There has been a great interest to understand why there is such an underrepresentation of women in cardiology, particularly within positions of leadership. What do you see as the strongest barriers for this discrepancy?
I view the barriers as twofold. Women are not thought of when leadership positions are being filled, and women do not put themselves forward as candidates as readily as men.

10. As a past president of the ACC, you had the unique opportunity to play a pivotal role in seeing more women occupy key positions within cardiology. What advice do you have for women seeking leadership roles?
Understand your strengths and weaknesses and get feedback from others. By doing this, you can identify what leadership positions fit your skills and can put your name forth with a better chance at success. Also, persistence pays off. If you want a leadership role, you may need to try for it more than once before you succeed.

11. Who has been your strongest support system throughout your cardiology journey?
My husband and I will celebrate 30 years of marriage this May. He has been my partner in this journey, as have my two children. I also have a very large birth family, and they have been endlessly supportive. Equally important are my female friends, many of whom are cardiologists.

This article was authored by Hena Patel, MD, Fellow in Training (FIT) at Rush University Medical Center in Chicago, IL.