Women in Cards

[drbon]

I'm a female MS-3 really interested in cardiology (I can listen to a debate about the pros and cons of stenting a guy with an occluded circumflex artery at it's origin with the the left main all day long and not be bored) and recently expressed this interest to my attending, a cardiologist. Immediately he went into this whole shpeal about how cardiology is extremely competitive (not news to me) and how it requires a certain level of "testosterone." He went on to say that in the past 10 years the program at his hospital, which is by no means a top tier or even a mid-tier program, has only had 3 female fellows. Out of these 3, 1 quit and 2 got pregnant halfway through - which to him was completely unacceptable because it "messed up the whole system." So I'm just wondering....is this the general feeling of cardiologists everywhere? Are women not really welcome in this virtual fraternity? If I go through three years of IM residency and bust my a$$ just like everyone else will I still have a much harder time than my male collegues in getting a cards fellowship just because I'm a woman?

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[Qtip96]

your attending is simply an a$$hole. in truth, there is still a huge gender gap. most applicants are male primarily because fewer women apply. in fact, most academic programs WANT more women. all academic credentials being equal, you would have a better shot than a male colleague at getting into a competitive program.

so hang tough. if cardiology is truly what you want to do, then keep at it.

 

[drbon]

thanks for the support
is there a reason why women generally aren't interested in cards? are the hours really horrendous or something (can't be worse than surgery or even ob/gyn)? maybe i'm not seeing things correctly, but besides the long training, it seems like a pretty sweet life afterwards...

 

[pillu]

I am a female FMG applicant and would be able to tell you how it went come June 07. I guess there might be handful of programs like the one you are at, that dont welcome women. But rest of them do, at least they may offer lip service. Can you please share (PM me if you prefer) with me the name of your program, so I dont waste my money there. At this point I need to find out which programs to avoid that either dont like women or FMGs. Thank You.

 

[Wrigleyville]

What is it about cardiology that draws you to it, and what are your goals in life? Don't let an attending dissuade you from your dreams if cardiology is what you really want to do. But you need to make an informed decision based on what a cards fellowship and career entails, not on the excitement of discussing cardiology issues on rounds or in conference.

What your attending was trying to communicate in a ham-fisted way was that if you have plans to start a family and raise kids you should think about the hours/flexibility in fellowship/practice and decide which it is that you value the most. If kids/family are unimportant to you, don't worry about it. If they are, then you need to recognize that you'll have to make some sacrifices down the line.

 

[jennie 21]

I think what was said above about academic cardiology programs wanting more women is true. I just finished a cards elective at my med school, NYU, and I'd estimate that roughly a third of the fellows here are female. They
seem to be well-respected and I don't think they have a harder time than anyone else. None of the ones I've met have kids though, although a couple are married or engaged. The fellows were talking one day about how some of the places they'd interviewed all the applicants interviewing that day were male, and how programs are definitely looking for qualified female applicants to balance things out. So if anything I think being female might bring a small advantage. You do have to be prepared though that it's a male-dominated specialty, and be comfortable in that atmosphere. The attendings at my program are overwhelmingly male even though the fellows are not. It's a pretty competitive, macho atmosphere, lots of big egos, and you have to be comfortable and able to hold your own in that kind of environment (or find a program that is not that way).

I'm an MS4, going into IM, and potentially interested in specializing in cards down the line. The hours/lifestyle are a bit of a concern for me though. It is still a boys' club, and not nearly as flexible as many other medicine subspecialties. The life of an interventional cardiologist is similar to a surgeon. The life of a non-invasive cardiologist doesn't seem so bad from what I can tell. So it depends somewhat if you're more interested in stenting/procedures or in echo/stress tests and medical management. Personally I'm much more interested in the non-invasive side of things. Like you, I enjoy the intellectual side of cardiology a lot. However, I'm also interested in having a family and a flexible schedule and I'm not sure at this point if the lifestyle even of a non-invasive cardiologist will be compatible with what I want, family-wise, especially since my husband is planning on going into cardiology as well. I'll have to wait and see how it works out. I'm hoping that during residency, I'll have enough exposure to fellows and attendings in cardiology to get a realistic idea of what that life would look like, so then I can make an informed decision.

 

[drbon]

so can anyone comment on the lifestyle of a non-invasive cardiologist? what's a typical day/week like in terms of workload, call, etc?

 

[medstud2006]

On my cardiology rotation, the fellow was about to leave for PATERNITY LEAVE, so perhaps the culture is changing. This might not be true at big-gun academic programs, but this was a solid mid tier program. Your attending sounds like one of the crotchety old men who are also complaining about how the 80 hour work week is "destroying" medicine.

 

[gwen]

its true, they really do want more females. my husband is a cards fellow and although they have only 1 female in their class right now, i know for a fact that they will most certainly pick a girl over a guy given the choice...as unfair as it may be.

cards fellowship is tough. even though my husband is on an "easy" rotation right now (echo), he rarely gets home before 6 or 7. one time i almost had a heart attack (pun intended) when he called at 4:30 saying he was coming home. i'm a physician myself so at least i understand his hours and can put up with it. being married to a non-physician may be more difficult. my sister is married to a medicine resident and they get into fights all the time about his hours.

non-interv. cards is definitely not as rough as interventional, but you will still be pretty busy. you should definitely try to find a female cardiologist to follow around. some females have a very "tough" approach to their careers, it comes first to some of them. some handle their careers as just that, a career. this isn't with cards only, i remember having an ob-gyn attending telling us how she delivered her baby girl and was rounding at 5am the very next day. she also said that she'd sometimes come home at 4am and wake up her infant and say "it's mommy time". i find that to be extremely selfish the way she treated her family. but obviously her preference is her career over family. she also went on to say "i love it when everyone's anal sphincters are so tight when i walk into the room". we (as med students) really didn't need to hear that, but she loved being an attending with power.

so if you're very family oriented, i'd suggest you follow a few female cardiologists or any female attendings around. get a feel for how they handle their lives. you may pick up good tips from some of them and you may also learn what you don't want to be like from the others.

good luck!

 

[ice_23]

As for the original poster's statement about the attending who said you needed "testosterone" to be in the field, I think that's ridiculous. I am not sure why there are so few women in cardiology. While there are certainly factors that are less female-friendly (long training, radiation, etc.), I don't think the actual subject area is particularly masculine. If you have any more questions about this, feel free to post or PM me.

That attending is being an idiot. What exactly constitutes "masculine" or "feminine" knowledge anyway? Even male/female anatomy and physio is simply anatomy and physiology. It's just an irrational way to defend the status quo.

-Ice

 

[drbon]

mdgrl....what are the hours like in your fellowship?

 

[nope80]

bump

 

[josephf1]

the first writer is a bit cracked - debate about stenting blah blah and not getting bored? are u serious? 3 pipes. Thats interventional. Shovign a wire down them and blowing up a little balloon. I did 100+ Caths and wanted to kill myself.
What you are missing here is what kills people in cards. CALL. In IM, you usually do a night week here and there, you have long call, short call, etc. In fellowship, you work all day, are oncall all night. Than work the whole next day. Sometimes with no sleep prior since you could be up shoving a wire in 1 of 3 said 3 pipes as mentioned above. In private practive, you may be on call 2 nights a week. And a weekend. Thats Saturday day, than Sat night, Than Sunday day, than Sun night, Than work monday. How you gonna raise a kid?
After a while, tha fatigue builds, you get cranky, you dont look so good, No one will want to date you. Youll come home at 6 to see the Nanny feeding the kids dinner. IF you have kids.
Whats more important?
Shoving a wire down a pipe? Or raising your kids?
Some of us grew up never seeing our dads.
But now our moms as well?
My advice - dont have kids.

 

[C5toC9]

Wow, that's depressing

 

[duckie99]

the first writer is a bit cracked - debate about stenting blah blah and not getting bored? are u serious? 3 pipes. Thats interventional. Shovign a wire down them and blowing up a little balloon. I did 100+ Caths and wanted to kill myself.
What you are missing here is what kills people in cards. CALL. In IM, you usually do a night week here and there, you have long call, short call, etc. In fellowship, you work all day, are oncall all night. Than work the whole next day. Sometimes with no sleep prior since you could be up shoving a wire in 1 of 3 said 3 pipes as mentioned above. In private practive, you may be on call 2 nights a week. And a weekend. Thats Saturday day, than Sat night, Than Sunday day, than Sun night, Than work monday. How you gonna raise a kid?
After a while, tha fatigue builds, you get cranky, you dont look so good, No one will want to date you. Youll come home at 6 to see the Nanny feeding the kids dinner. IF you have kids.
Whats more important?
Shoving a wire down a pipe? Or raising your kids?
Some of us grew up never seeing our dads.
But now our moms as well?
My advice - dont have kids.

lol at that post... and interestingly I think the original poster ended up going into pediatrics.

Now, I'm not a female but there is something to be said for the life differences both sexes go through. As said in the above post (though exaggerated to a degree), cards fellowship is another 3-4 years of training with really long hours. After 4 years of med school and 3 years of residency lots of people will be pushing their early 30s by the point of fellowship. And so with training the way it is, I can definitely understand how something like that is a huge turnoff for women who may want to have children and a family. It's even tougher for those who already have kids I imagine.

According to FREIDA: Cardiology is 20.7% female. Interventional cardiology is 12.1% female. So obviously these issues sort of work themselves out.

 

[nope80]

Joseph, is what you are saying also applying to noninterventional?

 

[P Diddy]

Joseph, is what you are saying also applying to noninterventional?

Joseph is jaded. Cardiology fellowship is an order of magnitude better than residency, unless you're in a cardiology residency (i.e. Texas Heart).

As a non-interventional attending, depending on the setting, call is home call. In private practice, you may or may not have to admit cardiology patients. Some practices have hospitalists admit their patients with cardiology as the consulting service.

Regarding salary, in the Bay Area, one of the private practice groups I know of pays roughly 100K/day of week worked. You can work out the math. Kaiser pays roughly 350K to start for Cardiology with an excellent benefits program.

Cardiology is an amazing field. If you love hospitalist work, go for it, but don't do it because you think you'll make more money or have a better lifestyle as a hospitalist. Do you know what their weeks on are like?

p diddy

 

[joejabjab]

As a non-interventional attending, depending on the setting, call is home call.

p. diddy,

Do the interventional cardiologists you work with take general cardiology call too? If so, how often? Thanks!

 

[P Diddy]

p. diddy,

Do the interventional cardiologists you work with take general cardiology call too? If so, how often? Thanks!

no, but that varies with the practice. some practices have interventionalists only cover interventional night call (i.e. STEMI). other private practices will have the interventionalists split STEMI call and add the interventionalists to the general call pool at a less frequent rate. Realize that in some private practices semi-elective caths are done on weekends, which means the interventionalist on call has to do them.

p diddy

 

[nope80]

How easy is it to find part time cards job after fellowship? Is this something that practices look positively on or negatively? Ive looked all over and its hard to find info on the prospects of part time jobs in cardiology and how they are formatted exactly.

 

[P Diddy]

How easy is it to find part time cards job after fellowship? Is this something that practices look positively on or negatively? Ive looked all over and its hard to find info on the prospects of part time jobs in cardiology and how they are formatted exactly.

No one really advertises for a part-time position, because practices usually want someone to take a full share of overall work (including call), and fellowship graduates usually want a full time position to pay the bills. As for the format, there is no template, and you need to get that information from your network as anything I say may not be applicable to wherever you live.

There are three options:

1. The easiest would be if a practice advertised a part time position; then you would just apply for it. I have personally never seen such an advertisement, but that doesn't mean it has never happened. The best way to find such a position would be word of mouth (ie your attending's brother from another mother's wife is a local cardiologist and is stepping back because she had triplets; he likes you, they like you, and voila!).

2. The second easiest would be locums. There are quite a few locums positions where you cover a weekend or more in bumbledumb Iowa and fly out before depression sets in (a difficult calculus).

3. The final way would be to apply for a full time position, and then a year or so in ask to cut back. This would go smoother if you worked hard that year and were seen as a valuable asset, if you had a good (real of imaginary) reason for doing part time work, and if your part-time time (sorry) were potentially circumscribed (ie 2 years).

p diddy

 

[dragonfly99]

I have seen a few part time cardio jobs advertised, but it's quite infrequent. They are almost all in small towns where a group is looking for someone to cover a few days a week. Not sure what the area/patients do for a cardiologist the other 2 or 3 days per week...
Locums would also be an option.
The other thing one sees is people in the latter half of their career scaling back...but that is usually ppl who have worked somewhere 5 or 10 years, and then decided to cut back to 4 days a week or something.
I work with people who are part time, and does kind of monkey with other people's schedules, potentially. They pretty much take almost as much call as I do, otherwise it would really screw up my schedule. But on days the others are not in clinic, I have to handle their patient telephone calls and medication refills, which is kind of a burden.

 

[nope80]

Thanks dragonfly!

I'm wondering, how does the call schedule work exactly for full time vs part time? How have the part gigs you have seen been set up in terms of schedule? I would imagine that this would be common amongst women w small children (although not too many of them in cards). But if you are doing half the work and getting paid half, it should be okay from everyone else's perspective right?

 

[gutonc]

FWIW, I took a PT job (not in Cards, Onc) but take the same call as the rest of the group, not half the call.

I would also argue that it's really hard to pull back your work hours once you've established yourself. Partially because you're going to have a patient panel that needs f/u and you're going to need to also be available for new patients and consults. But probably not impossible.

 

[nope80]

FWIW, I took a PT job (not in Cards, Onc) but take the same call as the rest of the group, not half the call.

I would also argue that it's really hard to pull back your work hours once you've established yourself. Partially because you're going to have a patient panel that needs f/u and you're going to need to also be available for new patients and consults. But probably not impossible.

Those are really good points gutonc. How many hours a week or on average how many days do you work, if you don't mind me asking? I remember overhearing an attending gripe about her part time work - she said it was part time pay but ended up being close to full time hours.

Did you get a part time job right from the get go?

 

[dragonfly99]

If you are doing 1/2 the call, that means I (and other full time people) have to do extra call to make up for the call that you are not taking. Don't forget that.

Also, if you only work 1/2 the time, the group still has to pay for office overhead, etc., and if they are a private group then they are subsidizing your office space, etc. for the 1/2 the time you are not there. And during the time you are not there, someone has to answer your patients' phone calls and questions and do all their med refills - if you are not there 2 days a week, it's the other doctors you work with. So they are doing work for you, while you are not there. So it's not as simple as you taking 1/2 the pay for 1/2 the work.

I don't know any nonacademic cardiologists with small children. It's a problem unless your spouse or in laws are going to help you a lot....not impossible but potentially a problem. And I say this as a female cardiologist. One of the biggest problems right now in society is we haven't expected men to do their 1/2 of the child care duties...and we "let" women do any job we want but we are still supposed to be fit, pretty, well dressed and raise perfect children and do all the "mommy stuff". It's definitely a double standard.

 

[P Diddy]

If you are doing 1/2 the call, that means I (and other full time people) have to do extra call to make up for the call that you are not taking. Don't forget that.

Also, if you only work 1/2 the time, the group still has to pay for office overhead, etc., and if they are a private group then they are subsidizing your office space, etc. for the 1/2 the time you are not there. And during the time you are not there, someone has to answer your patients' phone calls and questions and do all their med refills - if you are not there 2 days a week, it's the other doctors you work with. So they are doing work for you, while you are not there. So it's not as simple as you taking 1/2 the pay for 1/2 the work.

I don't know any nonacademic cardiologists with small children. It's a problem unless your spouse or in laws are going to help you a lot....not impossible but potentially a problem. And I say this as a female cardiologist. One of the biggest problems right now in society is we haven't expected men to do their 1/2 of the child care duties...and we "let" women do any job we want but we are still supposed to be fit, pretty, well dressed and raise perfect children and do all the "mommy stuff". It's definitely a double standard.

Off topic, but why are you doing refills and answering patient phone calls? Don't you have nurses?

p diddy

 

[dragonfly99]

I don't directly answer the phones, but have to address 95% of the questions from patients, since we do not have RN's in clinic (hospital system will not pay for them - only MA's and we have on who is an LVN). By protocol of the hospital system, they aren't allowed to answer medical questions, or do med refills, they can only repeat answers that we told them/spelled out.
We have to sign off on all med refills, though sometimes they will "start" the med refill in the EMR and I just have to sign it.

RN's cost a lot more money than medical assistants, since they get paid way more.