Look at the masthead of nearly any scientific or medical journal and it will confirm what most of us know: the number of women on the editorial boards are increasing, but parity with men is still a work in progress. Indeed, a study published just last year found that less than a third of the editors-in-chief of leading medical journals in 27 of 41 specialty areas were women.¹

Building the next generation of strong leaders – in science, medicine and publishing – requires women and underrepresented minorities hold leadership positions. This year marks the first time that four women will be at the helm of JACC Journals: Julia Grapsa, MD, PhD, FACC, editor-in-chief of JACC: Case Reports; Bonnie Ky, MD, MSCE, FACC, editor-in-chief of JACC: CardioOncology; Candice Silversides, MD, FACC, editor-in-chief of JACC: Advances and Biykem Bozkurt MD, PhD, FACC, incoming editor-in-chief of JACC: Heart Failure.

"We know that diversity on editorial boards will not only improve our relevance, but it will also convey a sense of balance and fairness and provide role models for future generations of women," says Bozkurt. "Diverse editorial boards also demonstrate that our actions are in line with our values for equity, and it increases the likelihood of competitive submissions."

In a series of interviews with Cardiology, each of the editors-in-chief discuss the value of having women in leadership roles, the importance of finding a good mentor and the challenges that persist in achieving work-life balance.

Women Helping Women

"Women are underrepresented in clinical trials as well as in the leadership of trials and publications," says Grapsa. An analysis published in JACC in 2020 revealed that just 10.3% of steering committee positions are held by female physicians among 200 cardiovascular medicine trials published in three high-impact journals.²

For these editors-in-chief, such statistics and the need for equity are top of mind. "I try to promote diversity in all aspects," Ky shares. "This is important in terms of the makeup of the journal's board, editorial invitations, commissioned reviews and published research. We want excellence and expertise, and that needs to come from a wide variety of people, each with unique perspectives, across various disciplines."

Grapsa adds, "Women in leadership positions in publishing are able to encourage women to submit their papers to high-quality journals."

Mentorship: A 'Critical Vehicle'

A mentor whose values align with their own ranks as one of the more important ways to grow a career in medicine for all four editors-in-chief.

"A mentor is critical in medicine," says Silversides. "I've been fortunate to have good people who could help me work through setbacks."

According to Silversides, a mentor has your back and helps keep you on track in your career. While having women as a mentor is important, and about half of hers have been, Silversides notes, most important is a person who cares about you. "I could not have reached this stage of my career without my mentors and I'm grateful to them," she says.

Bozkurt concurs, noting that mentorship is "a critical vehicle" for one's career in helping to provide solutions to the "how" of doing your job by those who have been through it before. "Mentorship is a dynamic and transformative part of one's career," she says, adding that "mosaic mentorship," or receiving guidance from multiple mentors, has served her well.

Work-Life Balance

All four editors-in-chief emphasize the need for greater work-life balance in cardiology, yet they note it can be challenging. According to Silversides, the importance of balancing career growth with family can be particularly challenging for women who are early in their careers.

"There are many challenges for women who would like to start a family and also pursue their academic career," Grapsa says. "Some women are placing their family planning on hold due to concerns about delaying training or falling behind. A healthy work environment that promotes work-life balance provides women with the opportunities they deserve."

"I was pregnant with my two children during training and it was hard," Ky says. "The challenges of raising a family in the midst of a very busy, highly demanding career are significant. At the end of the day, family has to be a priority. I love my work, I love my research and my patients, but as a culture and community we need to be accepting of each other's needs. We have to be able to say, 'it's okay, go home to your family.'"

Organizational change is needed to help address work-life balance for women and in fact for everyone in medicine. An article published in JACC in 2019 has helped to disseminate recommendations from ACC's Women in Cardiology Leadership Council and Diversity Inclusion Task Force to help spur this change.³

Among the "10 Recommendations to Enhance Recruitment, Retention and Career Advancement of Women Cardiologists," are the need for employers and organizations to increase career flexibility, develop informal and formal mentoring resources, and implement strategies to promote women leaders in cardiology. The recommendations for flexibility stress incorporating work-life balance into career planning (such as parental leave for both men and women to promote gender equality in the domestic sphere).

Pursuing Publishing

For women who are interested in pursuing publishing and research as a career path, the editors-in-chief resoundingly agree: Don't get discouraged, the sky's the limit. "Never abandon your ambition," Grapsa says. "If you want to work in publishing or research, find a good mentor to support you. Always speak up." "Be courageous and be bold," Bozkurt says. "It is time for a change. We need women and those underrepresented in medicine to be able to showcase their scholarship and research."

"The more women who are in publishing, the more that other women will realize this is a potential career option," says Silversides. "It's a different career trajectory, but well worth considering." Silversides adds that years ago she wouldn't have thought of publishing as part of her career path. "This opportunity with JACC: Advances has been a really exciting, interesting and fun new aspect of my work," she says.

What are their plans for their journals? All four editors are looking to curate the most impactful and innovative science, extend their global communities, advance patient care and encourage all authors to submit rigorous science to their respective journals.

There is still a lot of work to be done to counteract the challenges women face in medicine. Together, they believe that building diverse leadership in journals – including their work to diversify the editorial boards of their journals – will help to improve the quality of the journal, strengthen the opportunities for women and other underrepresented minority groups, and pave the way for future generations to lead.

References

1. Pinho-Gomes A-C, Vassallo A, Thompson K, et al. Representation of women among editors in chief of leading medical journals. JAMA Netw Open 2021;4:e2123026.
2. Denby K, Szpakowski N, Silverman J, et al. Representation of women in cardiovascular clinical trial leadership published by high-impact medical journals. J am Coll Cardiol 2020;75(11 Supplement 1):3492.
3. Sharma G, Sarma AA, Walsh MN, et al. J am Coll Cardiol 2019;74:1839-42.