Roxana Mehran, MD i s joined in conversation by Barbara Casadei of Oxford University and past president of ESC, and Athena Poppas of Brown University and past president of ACC. In this discussion, they cover the importance of continuing support and encouragement of women in the field of cardiology. Hello. It's Roxanna Moran. And here we are at the PSC Congress E. S. C. 2022 at E. S. C. T. V. Speaking on conversations with two leading women in cardiology I have with me my guests Professor Pappas from Brown University and professor Cassidy from Oxford. Hello. So nice to have you guys and for us to have a conversation and since it's just conversation um I'm gonna call you Athena and you Barbara and me I'm Roxanna rocks whatever you want. So good to have you all. So the conversation today is about women in leadership. What have we? How far have we come? Both of you are previous presidents immediate past almost immediate past presidents of the American college of Cardiology. You were just president a couple of years ago during the pandemic and you too Barbara two years of presidency here at the E. S. C. A lot has changed. You had a lot of impact. Thanks for all that you have done for women. But where are we today in cardiology both of you? I think we've made a lot of progress but I think a lot of it was very intentional. So I think there was a recognition that we were behind in cardiology. It was crazy that half of the people in medical school were women. Um but only 10 15% were going into cardiology. So I think all all different areas really took a hard look trying to get more women interested tried to look at what the barriers were and then moved through up the leadership chain. So teaching women what they can do supporting women. So, I think we've made a lot of progress. What do you think? Barbara? Yes, we've made a lot of progress, but not enough. I would say that if you walk around here, you can see the difference compared with five or 10 years ago, even where you you didn't see women at all. But I still see a lot of female young investigators. Prize winning price is doing really well and very few carrying it all the time all the way to the top. And so I think that, you know, we need to populate uh the environment of cardiology with more women at every stage, not just the junior stage and and support women to achieve positions. So, yeah, I so agree with that with what you just said that there I'm seeing and now you guys correct me if I'm wrong, I'm seeing almost like a flood gates of fantastic women that are now coming into cardiology. So thanks for all that. You have to hunt and we're all working on this. And then even in the mid, you know, mid career, we're seeing them being lifted, evaluated and also, but on the top, that very top layer, it's still a struggle to get there. Why do you think that is? Well, I think, you know, I agree with Barbara completely. We've made a lot of progress, but the work's not done. I mean, diversity besides gender, there's a lot of work we have to keep doing and it has to be intentional. So getting more women to be included in cardiology, encouraging throughout their career because it's not easy for men or women throughout their career to continue to stay in advance. So learning some of the tools are important and then supporting them and encouraging women to apply for things, I think. And there's data that women tend to hold back a little bit, wait until they're absolutely perfect to apply for something, throw your hat in the ring. I think that it's up to us all collectively men and women to continue to encourage women to apply for the next step to move on and and get that next grant to, to get the training they need so that they can become full professors. So yes, we've made good progress, but you can't jump from A to Z and we need to support them throughout. What did you say? Pull them up the ladder, pull them up the ladder. Yeah, definitely. I see a lot of great networking of our male colleagues. I'm I'm wondering, are we doing as good a job in terms of women networking together or are we just too busy? Are we getting so busy? I mean, I can tell you um, the the idea of the average situation is something that I'm thinking about all the time. I for me it was we could never be, we need to always strive for above the average, um place to be. How do we change that mental? I have two key words. The quest of the average woman. Yeah. In terms of not always looking at someone who has to be exceptional, you know, in order to make it that that's certainly one thing and the other one is the quest for the good enough, you know, that doesn't have to be perfect, it's good enough. And from that good enough then one acquires a certain, you know, freeze one cells from that idea that if not absolutely perfect, if I'm not absolutely competent, I would never go for it. I mean if I have to look back and say what would you do differently? I would say I would be more assertive. You know, there there is a certain tendency to accept the place in the in the packing order that you are placed by your older colleagues. You know, when you are in training, you know, I am here and these are the people are above me. So my job will not come. You know, and I, my advice to women is do not upset accept that position. That position. You know, the fact that someone puts you there doesn't mean that you are there, you know, do not accept it. And I have been I feel too accepting in my younger age. And so and of course the whole environment is getting you to accept it and be, you know, your place know your place is something that they tell women all the time since you are. But what do you think when when we're assertive, where thought there's a negative connotation about an assertive women? Have you have you seen that? I mean, I've definitely experienced it because I can tell you from my own experience, I've been very assertive on on several fronts and I've worked really hard to really be bold to say, well this is wrong, this is what I deserve, etcetera, but it's not really worked all the time. So I'm not so sure. Maybe maybe for myself, for myself would be to be less assertive and maybe more passive and think more about my own self, right? Well, and it's not just in medicine, right that there's this issue around, you know what stereotypes are around gender, whether male or female does the male have to be assertive? Does he get caged in by that as well? For being meek or quiet. So I think having some awareness is important. Um there's no harm in being assertive and you know, there's a way to do that whether you're a man or a woman and ask for the things you want, but to ask for those to say. Here's the reasons and to go up and ask to not wait to be asked. And I think that's what you're getting at is um if you look back, you shouldn't have to wait for somebody to say I want to promote you, you should say, I think I'm ready to be promoted and that's okay and it's okay that you didn't get it every time. So it's okay. Yes, it is. It's okay to ask. And next time you'll get it. Yeah, that's it. That's really that's really a good that's a very positive, positive thinking. Well, you know, I was thinking about asking you guys, I mean, what about where we're going in the future? Are you, are you are you write about the future? Do you feel like it's gonna be, it's all gonna be normal. Before, before we sat down for this conversation, you said, why do we have to talk about women at the home? Isn't that a normal thing? And when are we gonna get to that place? I knew, I am not sure I depends. Some days I wake up and I feel very positive some other day I feel, or there are still mountains to climb. But you know that I will then link to the other thing that to me is essential to this progress and that is to have our male colleagues with us, you know, and really understanding and trying to elevate over the stereotypes, which is normal to have a female colleagues that want to have a career that want to have that is ambitious is not a negative connotation. So I think bringing up the new generation together, you know, every single sex situate has the potential of being limiting and toxic. So to actually bringing men and women together in this quest, you know, I think is essential. So your feeling is and I know that you're feeling the same thing that we gotta work together. We should network together, not that men should be networking, and women should be networking. It should be a co networking together because I think we all want a richer, deeper cardiology or society not to make this bigger than it is. So gender, race, religion. We know that we have better boards, we have better groups when we are more diverse in thought and we bring different things to the helm. So so it's incumbent upon all of us to reach out and really embrace that. And so it's a sense of I think, you know, it's diversity, equity, inclusion, and belonging. So just being invited to the party isn't quite enough, right? Yeah, definitely not, definitely not. And when we think about the future, we don't want to just check the box. Isn't it? Great? There was a woman President of E. S. C. It would be great in 10 years that we're not even saying a woman president, it's just a president or um we just had a south asian president. Um so should it matter, let's get rid of the beginning piece we need the focus so that we have some awareness. But I would love for in 10 years that the conversations In the back of our mind. Yeah we want that. But except that if we don't pay attention to it now, it will go back to where it was before, where it was 10, 15 years of just men leading and and it's not anything against. And by the way I do want to ask you, I mean I'm hearing a lot about the canceled culture of our white males who are feeling well you know I'm never gonna get this position because I'm not a woman and I'm not a person of color. How do we how do you answer that? Barbara Barbara Barbara? Well I always have a quote that I use for this kind of comment and that is that if you are accustomed to privilege then equality feels like oppression. So it is normal. I mean I have been recently in a situation where there was a complete women only medical environment and I was there as a patient and immediately you start a completely different relationship. You feel the warmth of the privilege of being and you think I can see why they get hooked into this. You know it is human. You know once you have your very cozy environment you don't want to leave it and even a little interference. It feels like you know so much better before but I think we need to get over passing down privilege. Exactly and not feeling oppressed just because there's equality. I love that. I love that. Um well you know, I think the future is bright. So I really do. I am, I am, I can't wait for the day that we don't use. Female, male man, woman cardiologist, that we're just all in it together. I look for that day, especially on the leadership side, we're not there yet. What sort of I'm going to ask you a question. What sorts of things do we need to do? Thinking of the future? I think we've made progress. What tools do we need to do collectively to help us get there? I think as you said, I think the word that the word that I love, a lot of words you guys use that I love but intentional is the is the really important, important message here. Because if we're not intentional, it will just be something that we just take for granted and it will go away. It's just like anything else. So, I think in the next decade we need to continue the intention of reaching equality and they're not feeling oppressed by equality. I love that. I love that. I'm just gonna use it all the time. Barbra. I'm gonna sound so smart, like barbara Cassidy, but it really is a fantastic quote that we are not oppressed. If we are equal, we are promoted, we are feeling better. We're grander were bigger. We learn from each other and we have much, much more to offer. So I think that's what we have to do for the future. And I know that there are a lot of tools out there. And I think, you know, coming to a meeting like this, seeing you all here, you all look great by the way. And uh, and hopefully finding us on the beach relaxing and caring for oneself and not feeling oppressed if we're averaged as well. I mean it's okay, the quest to be, it's okay that we're not everything to every everyone, all these things are, it just gives me a little bit of a relief from the stress. The stress buttons go down for women, we have to be less stressed. I think that's a big bar down for, you know, the average performance and they're good enough so that we're not just, you know, I have had people fellows that looked at me and say, oh, I don't want to be like you, you work too hard. Yeah. And so, you know, that is not a good model. You know, you, you we need to show that this can be done in an attractive way for, for younger generations have a different ideas on how they want to live their lives. So, you know, I think it is very important not to project all of this stress and angst about our position in our workplace. Well, I feel so much less stressed now after this lovely conversation, thank you so much. So good to see you guys, I hope to see you more at this Congress and then more at all of the new Congress Is it just feels so vibrant here. The energy is is fantastic and very, very enticing to just go to every single session. Thank you for your time and thank you all for watching us keep keep watching. E S C t V.