Despite considerable efforts, gender disparity exists in cardiology all over the world. In the United States and the United Kingdom, approximately 50% of medical students and nearly 50% of internal medicine residents are female. Despite this, only 20% (United States) and 28% (United Kingdom) of cardiology fellows are female, and only 12% (United States) and 13% (United Kingdom) of board-certified cardiologists are women (1,2). There are limited data on female representation in cardiology in South America, Asia, Africa, and Australia.
The reasons for the under-representation of women in cardiology (WIC) are multiple (Figure 1). The primary objective for the collaboration of Global WIC–Early Careers is to improve female representation, for both cardiologists and patients. Our focus is directed primarily on 5 major issues we have identified, as described in Figure 1: the impact on the personal, professional, and academic life of female cardiologists and the personal and academic implications for female patients. The under-representation of women in cardiology has multiple far-reaching consequences. The quality of patient care is not only related to gender diversity in cardiology; there is also the issue of the ramifications on physicians’ well-being if the workplace lacks diversity (3). Women researchers in clinical trials are a predictor for the enrollment of female participants. The engagement of women in academia and collaboration with industry sponsors has the potential to offer a wide range of opportunities for female cardiologists, ranging from speaking, networking, and participation in research trials, resulting in higher professional visibility and the possibility for career advancement. Women also appear to have a lower likelihood of receiving guideline-based therapies.
Figure 1.
Common Reasons for the Underrepresentation of Women in Cardiology
As trainees and early career WIC, our aim is to raise awareness about the under-representation of women trainees, encourage women to pursue cardiology, and influence subspecialty selection and academic pursuits. We especially aim to seek mentorship from senior and more experienced WIC to help us improve the gender gap. Our intention is to work closely with other WIC associations and cardiovascular societies; to establish guidelines for flexible training, maternity and shared parental leave, and dedicated research time; and to create opportunities for more structured and predictable work schedules. We believe that a joint effort including both male and female representatives from diverse cultural backgrounds can promote increased representation of women on various committees and conference programs/panels and potentially create editorial/publication opportunities. Additionally, we recognize that there are particular challenges in the early careers of WIC. Global WIC wishes to support mentorship, flexible training in view of young families; networking opportunities; navigating early career challenges, research, publications; and enhancing the visibility of trainees and early career WIC worldwide. Our vision is to change the culture in cardiology to ensure gender, geographic, and cultural diversity and to plug the leaking pipeline. With support from the wider cardiology community, we desire to improve the professional and personal well-being of female cardiologists. This will ultimately improve the care women cardiologists are able to deliver to a diverse group of patients and ensure the recruitment of more women into clinical trials, which will inform future guidelines.
The Formation of Global WIC–Early Career
Global WIC–Early Career was born out of the need to focus specifically on these multiple challenges. As trainees and early career WIC ourselves, we are better positioned to not only identify the precise challenges we encounter but also to reach out to international peers at similar stages in their careers, share experiences, and in doing so, devise and facilitate solutions to the identified challenges. Although the coronavirus-2019 pandemic has wreaked havoc in the lives of many of us, the enhanced virtual networking it availed is one we have worked to our advantage. WIC have always had to up themselves a notch in terms of productivity; hence, while on maternity leave, Sarah Birkhoelzer both applied for and secured her appointment as the British Junior Cardiologists Association WIC and Flexible Training representative. As fortune and a search for opportunity would have it, the use of Twitter linked to this role resulted in an almost simultaneous connection with 2 of her WIC colleagues, Aaysha Cader, based in Asia, and Sabeeda Kadavath, in North America. The result was the formation of Global WIC–Early Careers.
Despite geographic differences and having only met virtually, we felt a genuine connection with each other, further enhanced by our shared experiences of regularly encountered challenges and an unwavering passion for advocating for WIC globally. It became very evident that although we have common challenges, there is a diversity and uniqueness peculiar to each continent. Although the conversation surrounding the importance of recruiting and creating additional opportunities for WIC has been a topic of conversation for some time in Europe and North America, the issue remains largely unaddressed at a more grassroots level in certain regions of the world. In an effort to make this initiative truly international and inclusive, we reached out to 3 other WIC, Paola Morejon (South America), Nafisa El Sammani (Africa), and Louise Segan (Australia) to form a group representing the 6 continents (Figure 2). We subsequently wrote a manifesto and planned our launch project, which, by virtue of its virtual format, ensured equal opportunity for all WIC across the world to participate, thus obviating traditional challenges such as the need for travel and related expenses as well as time away from work and family.
Figure 2.
Intercontinental Connection of Global Women in Cardiology–Early Career
Launch Project: Creating Opportunities and Enhancing Visibility and Networking
We launched our inaugural project, a global WIC case report competition, which attracted more than 60 submissions across 6 continents from aspiring cardiologists, trainees, and early career WIC. A global webinar was held on August 15, 2020, providing an international platform for 10 women from 6 continents and the opportunity to showcase their work to the global cardiology community. It was streamed live on Facebook and resulted in more than 80,000 impressions on Twitter. A subsequent virtual happy hour offered networking opportunities and collaboration for future projects. As a trainee/early career cohort, we are predominantly millennials, and we hope to harness to maximum potential the power of social media, especially Twitter (@global_WIC) and Facebook (Women in Cardiology Global Early Career) in reaching out to a global WIC community.
The launch event proved to be a platform of inclusion and diversity, and it offered amplification of scientific education, particularly for those in less advantaged regions of the world. Furthermore, the virtual format negated the commonly cited barriers including travel, funding restrictions, and family commitments. The webinar also successfully created a ripple effect of opportunities for the presenters. For WIC from low- and middle-income countries, this webinar opened up avenues for networking with global peers that did not previously exist. The winner of the case competition was invited to speak at a virtual event organized by the Victorian WIC, Australia.
The Future
Cardiovascular disease is the leading cause of death for women across the globe. The need for gender diversity in cardiology has never been greater—we need more women to advocate for our patients, to enhance their enrollment in clinical trials, and to advocate for access to education, health, and economic resources for disadvantaged populations: an important contribution to the community and society at large. Our efforts are geared toward not only plugging the leaky pipeline but also augmenting the number of women entering cardiology. We aspire to target women interested in medicine right from their formative years all through high school, college, and, eventually, medical school. We strive to support them by providing mentorship, resources, and networking opportunities. We have had the honor of connecting with renowned women cardiologists from across the globe, both as individuals and as part of various WIC collaborations, to discuss future projects. It will take an ongoing and concerted effort, and we are already indebted to the mentorship, advice, and support of mid- and late-career WIC who have supported us in this endeavor. The experience of those who have walked the path before us has been an invaluable resource and has provided a unique perspective to our vision, guiding us as we take the less traveled path.
Cardiology and medicine as a whole stand to benefit from diversity; a heterogenous workforce translates into better decisions and outcomes by virtue of varied creative and critical thinking. It fosters effective leadership and better advocacy for minority groups, including WIC. The future begins early in our careers, and Global WIC hopes to facilitate that, promoting a network of early career WIC globally because, after all, in our unity lies our collective strength.
Author Relationship With Industry
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Footnotes
The authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC: Case Reportsauthor instructions page.
References
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