The Opportunity of Women as One

Women as One is a nonprofit organization with the mission of promoting talent in medicine by providing unique professional opportunities to women physicians. With a start in cardiology, the overarching goal of the organization to fortify the pipeline of women leaders in cardiology through novel retention and promotion programs and to amplify and unify the efforts of related global organizations striving to reach gender equity in the field.

Women comprise a disproportionately low number of cardiologists worldwide. In the United States, they represent only 14% of active cardiologists (1). In subspecialty areas such as interventional cardiology, that percentage falls to the single digits (1). Work has been done in recent years to explore why women do not choose to enter the field, with primary reasons pointing to culture: the perception that cardiology is a field lacking in family friendliness and professional advancement opportunities for women (2). Dig deeper, and more startling statistics unveil that women cardiologists are indeed paid less than their male counterparts, experience professional discrimination more frequently, and are subject to a multitude of biases that stall their publication, grant, and promotion attainment (3, 4, 5). Not only are these disparities unacceptable in and of themselves, but the cyclic nature of this underrepresentation and underrecognition prevents cardiology as a field from realizing the benefit of a diverse workforce.

Many of the global cardiovascular professional organizations have rightly recognized the lack of women in the field as a problem and, in response, have launched initiatives to draw awareness to and drive improvement in professional diversity and inclusion. These are important efforts that serve to solidify and catalyze the field’s commitment to attracting and retaining more women in cardiology. The American College of Cardiology, American Heart Association, and European Society of Cardiology in particular have stood out as having made strong, significant commitments at the leadership level to supporting and promoting women across organizational activities and within leadership. Many subspecialty societies have also made similar strides to highlight the women in their organizations, putting programming in place to support their advancement.

Given these now widespread efforts, the existence of an independent organization such as Women as One outside of the parameters of these professional organizations may seem duplicative. The nature of professional organizations, however, is inevitably somewhat competitive because their business models rely largely on membership dues, meeting registrations, and grant funding from a shared pool of stakeholders. The consequence of this competition is the isolation of groups focused on gender equity in cardiology from each other; the lack of coordination across these efforts subsequently dilutes attempts to shine light on gender-based disparities and diminishes the overall ability to create lasting mechanisms for systemic change. Furthermore, the missions of cardiovascular professional organizations are not exclusively focused on women, because these organizations serve the entire cardiovascular community and the many educational, research, and advocacy-based needs across their constituencies. This means that efforts to address gender-based professional disparities falls on a longer priority list and may not be addressed with the urgency of other organizational priorities.

The premise of and need for Women as One is, therefore, to create a single global platform, exclusively focused on women, through which women can unite and succeed. The foundation of the organization is its Talent Directory, a sortable online database of women in cardiology. The database is used to gather feedback, share opportunities, and dive into the professional needs and preferences of women in cardiology worldwide. The Talent Directory feeds into Women as One annual programming, which currently includes a global awards program (the Escalator Awards) and procedural skills training program (CLIMB), both aimed at increasing the speed at which women in cardiology are resourced and positioned for leadership development.

Additional Women as One programming is driven by the fundamental need to attract and retain women in the field of cardiology. A radiation safety educational slide series was recently released as a first-in-kind effort to comprehensively outline radiation safety practices and abate concerns about radiation exposure for women considering entering the field. The educational slides were endorsed by 7 major global cardiovascular societies and are complemented by downloadable posters to display in work environments. A global parental leave survey was also recently launched. With such wide variances in parental leave and return-to-work practices around the world, the goal of the survey is to uncover trends and best practices so that they can be shared broadly and, ideally, set the stage for standardizing and normalizing parental leave for all cardiologists. A similar effort is also taking shape around the varied process associated with academic promotion, knowing that women account for disproportionately fewer full professors in cardiology in the United States (6).

Future Women as One efforts will focus on developing a global research network, producing research training, funding, and trial participation opportunities for women around the world. Women unsurprisingly represent a disproportionately low number of clinical trialists in cardiology. In a recent review of more than 200 cardiovascular trials, more than one-half were executed through leadership structures devoid of female physicians (7). Furthermore, only 10% of resulting publications from these studies had a first or senior female author (7). These disparities highlight the lack of women in positions to affect clinical research design and execution and their resulting impact on patient care. The goal of Women as One is to produce fruitful and ultimately impactful solutions to improve these metrics so that women can realize a seat at the table of future evidence generation.

The opportunity of Women as One is not limited, however, to the women who participate in its framework. By building a global network of women in cardiology, Women as One offers a tremendously valuable resource to partners, including professional organizations, medical device and pharmaceutical companies, and other stakeholder organizations in cardiology. The opportunity to quickly access the names and qualifications of women cardiologists who are eager to participate in educational and research activities can be of incredible import to those organizations looking to diversify the profile of the physicians who participate in these activities on their behalf. As diversity becomes a business imperative, those organizations that succeed in achieving diversity goals will maintain a distinct advantage in attracting and retaining new business growth for the future.

Beyond the matching function of the Talent Directory, Women as One also provides partner organizations with a much deeper opportunity to fully understand the interests and insights of women. Culling and sharing intelligence from women unleashes new ideas, new perspectives, and new paths that have the potential to shape the future of areas such as clinical trial design, innovation, and, ultimately, patient care. By creating a single source of this intelligence through the Talent Directory, there unfolds an opportunity to tap into these novel findings and drive new models of success across all cardiovascular stakeholders, thus catapulting the speed at which the field realizes true gender equity.

The Women as One vision is one of reciprocity. When women are put in a position to succeed, everyone succeeds. Women as One programming is aimed at positioning women for this collective success and opens its doors to all who are looking to achieve and expand on this shared goal.

To learn more about Women as One, visit www.womenasone.org.

Author Relationship With Industry

Dr. Mehran has received grants, personal fees, and advisory service fees from Abbott Laboratories; has received grants from AstraZeneca, Bayer, Bristol Myers Squibb, Chiesi, Concept Medical, CSL Behring, DSI, Medtronic, Novartis Pharmaceuticals, OrbusNeich; has received advisory service fees from Abiomed, Bristol Myers Squibb, and The Medicines Company; has received consulting fees from Boston Scientific, Cardiawave, Concept Medical, Janssen Scientific Affairs, Magenta Medical, Medscape/WebMD, Roivant Services, Sanofi, and Siemens Medical Solutions; and has received nonfinancial support/other from Regeneron Pharmaceuticals, Spectranetics/Philips/Volcano Corp., Watermark Research Partners, Claret Medical, and Elixir Medical. Dr. Morice is the chief executive officer and shareholder of Cardiovascular European Research Centre, a clinical research organization based in Paris. Ms. Ortega has reported that she has no relationships relevant to the contents of this paper to disclose.