May 17, 2017 | Sara Negrotto, MD
Career Development

In the words of Madeleine Albright, "It took me quite a long time to develop a voice, and now that I have it, I am not going to be silent." As a first-year cardiology fellow, I am very thankful for the many women in medicine, especially cardiology, who used their voice to establish a presence that paved the way for more women to be accepted into this male dominated field.

As women in cardiology, we all have different experiences. However, I think Charlotte Whitton had great insight when she said, "Whatever women do, they must do twice as well as men to be thought half as good." There is a stigma that women must prove that they earned their professional title in order to earn respect, whereas men are often inherently respected. However, once a woman has proven she has the knowledge and capability of being an excellent physician, she must be careful not to come across too "aggressive" or "overconfident".

There was a recent study done on emergency medicine residents which showed that as women gained more experience and knowledge, i.e., as they progressed in their training, their evaluations grew worse, while their male counterparts had improved evaluation marks. This occurred regardless of the gender of the physician performing the evaluation. I believe this is a reflection on how confidence and assertiveness in female physicians can be thought of as a negative quality and reflects the inherent gender bias in society.

There is also an uphill battle for women in cardiology who want to pursue motherhood, which involves balancing of time at work, considerations of expected radiation exposure while pregnant, and the logistics of breastfeeding, to name a few. In fact, studies have shown that women in cardiology are more likely to be single and less likely to have children compared to their male counterparts. It has also been well documented that there is a significant gender pay gap in cardiology with women making 20 percent less, which often gets attributed to time off for maternity leave, part-time work, or more flexible schedules (3). The reality is that both genders would like to achieve work-life balance, and there should be equal pay for equal work.

Additionally, over the past several years, the number of women pursuing a career in cardiology has become stagnant. Approximately 20 percent of cardiologists are female and less than 10 percent are in procedural fields. While the gender gap seems to be closing, there is still work to do. As more discussion is occurring regarding the hurdles women face pursuing a career in cardiology, there seems to be more acknowledgement of the issues by both genders. There have been an increasing number of male advocates getting involved in ACC's Women in Cardiology Section, speaking up on current issues and reaching out to mentor women throughout their career. This is very exciting as input from both genders is needed in order for us to close the gap.

While I think most of us can agree that there has been progress towards decreasing genders disparities, it still exists. Along with the hurdles mentioned above, gender differences remain especially for female presence in leadership roles particularly as department chairs and in professional societies. Both genders need to work together to change society's innate bias of gender roles, and learn to respect and empower women as equally as we would their male counterparts. Like Madeleine Albright, we need to use our voice to take the focus off the gender of the physician and place more focus on the commitment to learning and delivering quality health care.

This article was authored by Sara Negrotto, MD, a Fellow in Training at Vanderbilt Medical Center in Nashville, TN.