180. Narratives in Cardiology: Raising Women Leaders in Academic Cardiology with Dr. Anu Lala

CardioNerds (Amit Goyal and Daniel Ambinder), Dr. Leticia Helms (Internal medicine resident at Columbia University), Dr. Silia DeFilippis (AHFT FIT at Columbia University), and Dr. Anu Lala (AHFT faculty and program director at Mount Sinai Hospital) to discuss diversity and inclusion in academic cardiology and more in this installment of the Narratives in Cardiology Series. The President of the New York ACC Chapter Dr. Hima Vidula discusses D&I initiatives at her chapter. Episode introduction and audio editing by CardioNerds Academy Intern, Shivani Reddy.

Although women compose 50% of medical students in the United States, cardiology remains a male dominated field. Gender disparity is even more prominent when we look at leadership positions. In this episode we discuss why and how cardiology (and advanced heart failure) can be such a rewarding field for women. The episode reflects on the significant contributions women have made to the field in the past and how they continue to move the field with respect to clinical care and research.

The PA-ACC & CardioNerds Narratives in Cardiology is a multimedia educational series jointly developed by the Pennsylvania Chapter ACC, the ACC Fellows in Training Section, and the CardioNerds Platform with the goal to promote diversity, equity, and inclusion in cardiology. In this series, we host inspiring faculty and fellows from various ACC chapters to discuss their areas of expertise and their individual narratives. Join us for these captivating conversations as we celebrate our differences and share our joy for practicing cardiovascular medicine. We thank our project mentors Dr. Katie Berlacher and Dr. Nosheen Reza.

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180. Narratives in Cardiology: Raising Women Leaders in Academic Cardiology with Dr. Anu Lala

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Quotables – Raising Women Leaders in Academic Cardiology with Dr. Anu Lala

  1. “We all have multiple roles – and those roles don’t always have to be completely distinct and separate from one another. You know, our ability in one role, maybe it makes us better at another.”
  2. “I felt like being there was like in medical Disneyland for research.” – Anu Lala
  3. “Heart failure is unique in that it truly requires that cross disciplinary collaboration at the precipice of what is often life and death.” – Anu Lala
  4. “It points to the importance of seeing people do things before you who look like you.” – Anu Lala
  5. “All human beings want to feel heard. They want to feel seen and they want to feel like their voice matters.”  – Anu Lala
  6. “consciously deliberately disruptive”
  7. “I like the idea of calling it work-life harmony.”

Show notes – Raising Women Leaders in Academic Cardiology with Dr. Anu Lala

  1. How do women compare to men in cardiology in 2022?
    • Although nearly 50% of US medical graduates and more than 40% of internal medicine graduates are women, the field of cardiology remains male dominated.
    • Approximately 20% of general cardiology fellows are women, which is comparable to women in surgical subspecialties like neurosurgery (17%), thoracic surgery (21%), and orthopedic surgery (15%) (Reza 2021).
    • Additionally, women hold significantly fewer leadership positions and are less likely to be promoted to senior academic ranks.
    • Out of LBCT presented at ACC 2021, zero had a female first author and zero were presented by women (Kaur 2021).
  2. What may make heart failure unique with respect to the recruitment of women?
    • Heart failure is the only subspecialty of cardiology that was founded by a woman. Dr. Sharon Hunt is often described as the founder of the subspecialty.
    • She posited a few reasons why heart failure may attract a higher proportion of women including presence of models and mentors for women, women have been included since the inception of the field, and one that requires collaboration (Hunt 2019).
    • The number of women in HF training programs ranges between 26 to 36% which is much higher than that of women in other subspecialties like EP and interventional cardiology (Reza 2021).
  3. How can we increase diversity in clinical trial leadership?
    • Women only represent 1 in 10 authors of cardiovascular trials in high impact journals (Van Spall 2021).
    • Build diverse research team.
    • Hold stakeholders accountable including academic institutions, professional societies, industry sponsors, funding agencies, and scientific journals (Van Spall 2021).
    • Be deliberate about editorial authorship as well as equal representation of women on manuscripts.
  4. How can we increase the diversity of participants in clinical trials?
    • We know that increasing the diversity of women investigators in clinical trials is associated with increased enrollment of women participants (Reza 2020).
    • Increased enrollment of diverse populations is key to increasing the generalizability of findings (Van Spall 2021).
    • Build partnerships with the community and community-level providers.
    • Meet social and cultural needs such as family and child care responsibilities; socioeconomic and financial barriers; as well as absenteeism from work (Reza 2022).
    • Provide sex-specific materials to encourage enrollment.
    • For a related discussion, enjoy Ep #135. Underrepresentation in Clinical Trials & Guidelines with Dr. Clyde Yancy.
  5. How has the COVID-19 pandemic affected women in academic medicine?
    • Women often bear disproportionate demands of personal life including schooling and caregiving duties and affected by school closures (Reza 2021).
    • Data have suggested that female academic productivity has been affected as measured by decreased publication authorship which may translate into decreased research support (DeFilippis 2021).
    • The decreased submission of manuscripts has been particularly pronounced among junior cohorts of women in academics (Squazzoni 2021).

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