Author: CSANZ Admin

Did you know that we have a vibrant and enthusiastic Working Group dedicated to improving equity for women at all levels of the career journey?   

Our goal is to engage a higher representation of women in Cardiology, given we have the lowest level of representation amongst all Medical specialties. Currently, only 15% of all cardiologists are women, with only 5% specialising as interventional cardiologists.

Chair:  Dr Sonya Burgess, an interventional cardiologist based in Sydney.

Steering Committee:  Dr Sarah Zaman, Dr Clara Chow, Dr Anastasia Mihailidou, Dr Rebecca Kozor, Dr Swati Mukherjee, Dr Belinda Gray, Dr Elizabeth Shaw, Dr Ruth Arnold, Dr Alicia Chan, Dr Cara Barnes, Dr Louise Segan, Dr Jain Manali, Dr Anastasia Vlachadis-Castles, Dr Lynne Pressley and Dr Rebecca Jedwab.

The focus of the Working Group is to have the CSANZ Board, and members, to support women and improve representation of women in cardiology at all levels – from conference invitations to committee membership, policies, equity and future leaders.

There are plans to coordinate preparing a WiC day focused on interview skills CV preparation for advanced trainee, fellowships, and early career positions, with a workshop and skills day led by Dr Rebecca Kozor and Dr Sonya Burgess.

We also wish to encourage having a network where the offline conversations, mentoring, and sponsorship can grow.

We look forward to welcoming you to our WiC Working Group.  There are no exclusions!  If you are interested to join us on our mission, please contact:  [email protected]  or contact her via the Nepean Hospital on +612 4734 2000.

One of the most rewarding changes we have seen, as we try to achieve more equity and diversity in cardiology, is that it generates mentoring and support. We have had women in Cardiology at all levels reaching out to members of this group with questions, requests for data, support and further plans for research and networking.

In Australia and New Zealand, women are still under-represented at trainee level and published modelling, based on Australian data, suggests the rate of change is underwhelming. We currently are unlikely to reach gender parity for at least 50 years, and our rate of change is worse than that of Surgery.  

There is longstanding evidence of inequity for women seeking careers in Cardiology.

Research shows women are under-represented at consultant, trainee level and professor promotion. Research also shows that in Cardiology we have ongoing cultural issues, including conscious and unconscious bias, that as a specialty we are yet to successfully address. These issues have an impact on outcomes for our colleagues, trainees, students and patients.

Importantly, changes are happening, in individual departments and hospitals throughout our countries, in our policies and systems, and in our conference committees as we all try to facilitate positive change.

One recent example of a WiC initiative supported by NSW cardiology heads of department, led by Dr Tom Ford, were changes to the under-representation of women at the Heads of Department “cull meeting” . This meeting considers, grades, and ranks all applicants for Advanced Training positions in Cardiology for advanced trainee positions in New South Wales. Of the large 12-15 person voting panel, there was only one-woman representative. As NSW health policy for recruitment and training aims to avoid poor representation of women on interview panels by stipulating on a 5-person panel, at least one voting panellist should be a man, and at least one person should be a woman. The CSANZ WiC group requested that for the panels, such as the cull meeting, that similar minimal ratios should be sought and the voting committee members should not be greater than 80% male (or greater than 80% female), based on the minimum 1:4 ratio within NSW policy. The CSANZ WiC group worked together with Dr Tom Ford (who chairs this meeting) and all of the Department Heads, which led to greater than 20% of the panel for were women this year for the first time. 

As a group, we are working on increasing visibility on the both the national and international stage, to provide supportive role models for the next generation of not only Cardiology trainees but all women in cardiology, including nursing, allied health and research and more equity focused research and research funding.

In 2023, we have seen members of our steering committee actively working on these goals. Our proudest moments come when we see our trainees/mentees/students doing well and breaking their own glass ceilings.

For example, in 2024 Dr Roopa Krishnamoorthy will become the first female advanced trainee to take up an interventional cardiology fellowship at Nepean Hospital, and start her journey in interventional cardiology.

Our Steering Committee members are recognised both at national & international levels, and are recognised leaders in the Cardiology field or rising stars.

• Dr Sonya Burgess, Chair WiC group, presented as faculty at TCT2023, one of the premier interventional congresses and had her STEMI papers cited in 2023 ESC guidelines, co-authored an EAPCI position paper on radiation safety (1) and secured funding and started early data collection for occupational radiation safety in pregnancy research.
• Dr Sarah Zaman is invited as one of 21 Lancet Commissioners on the Lancet Commission on Atherosclerotic Heart Disease and has been included in CSANZ STEMI guideline committee.
• Dr Elizabeth Shaw, our first Australian interventional cardiologist to perform TAVI has now also become the second female Head of Cardiology Department in New South Wales.
• Dr Anastasia Mihailidou was invited Discussant at the American Heart Association Late Breaking Science this year and Keynote presentation at the 10th National Prevention Conference in Ireland. She also was one of the invited Faculty to review the content for the World Health Organisation technical specifications for pre-market assessment of blood pressure measuring devices (2).
• Dr Ruth Arnold was the first female Head of department of Cardiology at Orange Health Service and successfully lead the initiative to include more women at the head of department cull meeting. Dr Arnold received an OAM for services to rural cardiology. With her colleague Dr David Amos, she has worked to establish an accredited rural advanced trainee position based at Orange and linked to RPAH. This is the first rural hospital to be able to recruit advanced trainees. She is hoping to expand the rurally based training program across western NSW.   
• Dr Clara Chow received an OAM for her service to medicine and research, and was appointed as a new Fellow by The Australian Academy of Health and Medical Sciences and was Digital Health Technology Award Finalist.
• Dr Rebecca Jedwab is a Critical Care Registered Nurse and PhD (Nursing) graduate from Deakin University. She is a Fellow of the Australian College of Nursing and passionate about advancing mentorship, professional development and research within her healthcare organisation.
• Dr Louise Segan received the Baker Heart and Diabetes Institute Bright Sparks Scholarship Recipient and Baker Research Forum quarterly prize winner as well as APHRS Young Investigator Award 2023. Louise is one of our rising shining stars with having first author on original research published in European Heart Journal this year (3). 
• Dr Alicia Chan is a co-author of the Australian Consensus on the Management of Heart Failure, active in the heart failure and pacing/cardiac devices space and is a board member of CSANZ and National Heart Foundation (SA).
• Dr Belinda Gray is current Chair of the CSANZ genetics council and Heart Foundation Future Leader. Dr Gray was also the Australian lead and only Australian author for the recent LIVE-HCM- large multicentre international study assessing safety of vigorous exercise in hypertrophic cardiomyopathy which will bring change in clinical practice (4).
• Dr Swati Mukheriee is the first woman of colour to qualify as an interventional cardiologist in Australia and New Zealand, and the first female interventionalist to be awarded a prestigious SCAl-USA Fellowship in recognition of interventional cardiology excellence. Dr Mukherjee is co- chair of the CSANZ Equity, Diversity and Culture Committee and member of Gender Equity in Medicine Committee of the Royal Australian College of Physicians (RACP).

References
1. Manzo-Silberman S, Velázquez M, Burgess S, et al (2023). Radiation protection for healthcare professionals working in catheterisation laboratories during pregnancy: a statement of the European Association of Percutaneous Cardiovascular Interventions (EAPCI) in collaboration with the European Heart Rhythm Association (EHRA), the European Association of Cardiovascular Imaging (EACVI), the ESC Regulatory Affairs Committee and Women as One. EuroIntervention; 19(1):53-62. 

2. WHO (2023). Technical specifications for pre-market assessment of blood pressure measuring device with cuff, automated and semi-automated. 

3. Segan L et al. (2023) New-onset atrial fibrillation prediction: the HARMS2-AF risk score. Eur Heart J; 44:3443-3452 

4. Lampert R, Ackerman MJ, Marino BS, Burg M, Ainsworth B, Salberg L, Tome Esteban MT, Ho CY, Abraham R, Balaji S, Barth C, Berul CI, Bos M, Cannom D, Choudhury L, Concannon M, Cooper R, Czosek RJ, Dubin AM, Dziura J, Eidem B, Emery MS, Estes NAM, Etheridge SP, Geske JB, Gray B, Hall K, Harmon KG, James CA, Lal AK, Law IH, Li F, Link MS, McKenna WJ, Molossi S, Olshansky B, Ommen SR, Saarel EV, Saberi S, Simone L, Tomaselli G, Ware JS, Zipes DP, Day SM; LIVE Consortium. Vigorous Exercise in Patients With Hypertrophic Cardiomyopathy. JAMA Cardiol. 2023;8(6):595-605