Women in Cardiology [Re-release] (8 March 2024)

SPEAKER_00 0:00

If you enjoy listening to career conversations, why not become a member of the Royal College of Physicians of Edinburgh? Our membership provides you with access to the RCPE educational portal, the live evening medical updates, and you have options to view the symposia both in person or online. If you would like to learn more about this, please go to the Royal College of Physicians of Edinburgh website. Today I am joined by Dr. Kate Gaetenby, who is a consultant cardiologist based at the LGI. She specialises in heart failure and imaging, ECHO in particular, as well as obstetric cardiology. We will be talking about women in cardiology, and there is no better person as she is a member of the Yorkshire Women in Cardiology Society and also holds a position in the British Cardiology Society's Women in Cardiology Network. So, Kate, thank you for joining me today. Thank you for having me, Melina. I just wanted to kind of ask you, first of all, why did you choose cardiology as your career?

SPEAKER_01 1:17

Not sure I did choose cardiology. I think it might have chosen me actually. When I was when I was a student, I really liked cardiology, but I didn't think I was good enough to do it. I didn't think I was clever enough. I certainly didn't think I was clever enough to be an electrical doctor, and I still don't think I'm clever enough to be an electrophysiologist. But it certainly was something that always interested me. And I didn't really have a job in cardiology as an SHO. And just after I'd finished my SHO rotation in Sheffield and I'd done my PACES, I started thinking about what I wanted to do. And the thought of being a medical registrar without doing any cardiology scared me a little bit. So I ended up applying for a cardiology job, which at that point was a standalone job in Leeds. And Catherine Dickinson, who is now a good friend of mine, was at that point the consultant that was looking after me. And she sort of took me under her wing and told me that I might be good enough to do it. And I got the opportunity to go and see some procedures and go in the lab a bit. At that point, there weren't really very many registrars around at night. They were on call from home, which meant as an SHO, you were on the shop floor a lot, treating lots of people who seemed to get better from a cardiology perspective. And I think I just fell in love with it actually, and I've never really left. So that was 2005, and I've been lucky enough really to spend my entire time training in cardiology in West Yorkshire and Leeds. When I went to York as a locum registrar, I loved looking at pictures of hearts. So Echo, I think Echo was probably the first bit of cardiology that I got a real passion for. I still can't believe how beautiful the heart is on cardiac ultrasound scan and how much information that you can get. When I was a registrar, I loved looking after the really sick people, and now I'm a heart failure cardiologist. So I really enjoy the long-term relationships I have with some of my patients. I love the long-term relationships. I love seeing them through to being better if they've got proper medical therapy. And actually, I really appreciate the time I get to spend with my patients and their families towards the end of their life. And working with palliative care is a really big part of my job now. It's probably a very long-winded answer there. But those are the bits that appeal to me. I think.

SPEAKER_00 3:44

And can I ask, when you said you were scared of going into cardiology, was it something that it was because you hadn't seen a lot of, or because there's this underlying, I think, fear amongst all junior doctors that it's very difficult and it's very complicated, and which in actual fact, once you get to the bottom of it, it's not that bad.

SPEAKER_01 4:05

I think a bit of both. I'm not sure as a junior doctor I really encountered very many friendly cardiologists. So I think that was that was one thing. Sorry, when I say as a junior doctor, I mean as an SHO in my rotation. Certainly once I came to Leeds, that all changed. I don't think I encountered very many friendly cardiologists, so it seemed a little bit otherworldly, a bit um elitist, I think probably is the right word. And yeah, it just seemed very complicated and not very accessible. And I don't think I ever met anyone who looked like me who was a cardiologist. And perhaps that some way made me think that it wasn't for me.

SPEAKER_00 4:44

Yeah, yeah. And that's actually really interesting because I don't know if you've read this paper published by uh Shireen JG in Hart last year, and she really, really nicely describes the differences that we have within the specialty, especially with regards to you know the proportions of female to male cardiologists, and she quotes numbers as low as 13 to 15 percent of cardiologists in the UK, Australia, and the USA being female. How important do you think it is to have a representation within the specialty of other women doing well and showing you that it is possible to do? Do you think gender plays a role in it?

SPEAKER_01 5:30

I think it's definitely important to have role models within cardiology. I don't think female role models are really important, and I hope that I've been able to be a role model for some cardiology trainees in Yorkshire who I know. I actually think role models, whether they're male or female, are important. There are definitely differences, and I think it's probably more related to being a woman who works full-time and has a family. How different that is in cardiology as opposed to any other medical specialty, I think that's really difficult because I've never really done another medical specialty. I think it's a say it's a difficult question to answer. I definitely think role models are important, but I don't necessarily think that they need to be female role models. I think it can be, you know, you can have a portfolio of role models, some people who you want to emulate, some people who you respect, some people who you want to behave like when you're a consultant, some people who you love and adore, but know you don't want to work in that way. So I think it's probably important to take lots of bits of experience and look at lots of different people.

SPEAKER_00 6:41

Yeah, yeah. Yeah, and I think there's always that balance of trying to, you know, help other women alongside you, but at the same time not making it so obvious that there is a big gender gap because I think we are all trying to move forward and minimize these gender differences. And certainly, probably what we're seeing today is nothing like what it was like 30, 50 years ago.

SPEAKER_01 7:04

I mean, I certainly don't want to be treated any differently because I'm a woman. I don't think I was throughout my training. There were some times when I wish that people had been a tiny little bit more sympathetic to the situation that I was in. So, for example, doing night shifts and being in the lab, I found quite difficult. And there was a bit of a pressure for me to stay in the lab. And I don't feel like I had any support at that stage, and that's much, much better than it is, you know, now than it used to be. I think, probably just because there are more women that are training. But you're absolutely right. I don't think the standard, you know, I I want to be an exceptional cardiologist. I don't want to be an exceptional woman cardiologist because I think that in some respects belittles the training and belittles the experience that we have. That's not to say that there's not differences. And some of the things that I think make me really good at my job, being a heart failure doctor, for example, are very, well, they're very me characteristics. Some of them, some people might say they're quite female characteristics, emotional, emotional intelligence, I think is probably something that is a little bit more prevalent in women. But even talking about this makes me a bit uncomfortable because actually I think these are personal characteristics rather than them necessarily being related to a gender.

SPEAKER_00 8:20

Yeah. Yeah. Do you, I mean, there still appears to be quite a big difference in the number of women that we have in certain subspecialties. So, for example, electrophysiology, intervention, and even within research, where the numbers are tiny compared to, you know, our our male counterparts. What's your take on that? Do you think that it's that we can't do it, or that we just don't want to, or that it's just not as accessible for us?

SPEAKER_01 8:52

I certainly didn't want to do it. I would like to think I would have been able to. And I don't think that women can't do these things at all. In fact, there are some really excellent examples of women who are doing these jobs. So, Jennifer Rossington, who's one of my colleagues in Leeds, is an exceptional interventional cardiologist. There are many women throughout the country who are exceptional interventional cardiologists and electrophysiologists, but it's something that I just didn't want to do. We also have excellent researchers in Leeds who are who are women. Um, Elam Levitt in the MRI department at the university is a great role model and a fabulous cardiologist. So there are definitely women around who do these things. I think actually it's really powerful that I can choose not to do these things as well. So it's just something that I didn't want to do. As to why it is, I don't know. The training is different. I think there are some things about, particularly with interventional cardiology and electrophysiology, the need to do fellowships, which by the time you get to the end of your training, you're likely to be deep into your 30s. You may well have family. And the idea of taking your family and looking after family abroad as a woman, I think would be quite challenging. I am struggling to think of anybody that I know who is a woman who's taken a family abroad to do a fellowship. Whereas I know plenty of men who have had small children who have taken their family with their partners who then stay with the children and look after them. So I wonder whether that might be something. I don't have any data to tell me otherwise or to say that that's the right thing, but I do wonder whether that might be part of it.

SPEAKER_00 10:33

Yeah, I think it certainly contributes in that paper that I referred to before, the numbers of males that are the sole carer for family or that have the main responsibilities are minuscule compared in their female counterparts. So I mean that will make a massive difference.

SPEAKER_01 10:53

I think for things, I think for the, like you say, that that extra experience where you are making a decision to take everyone abroad and especially if maybe you're working less than full-time, which we know that women are more likely to do, and your partner is potentially the bigger earner in a family, then that would probably have a bearing on your decision to go abroad for a year to do a fellowship. That's not to say there aren't excellent fellowships, of course, in the UK, but even moving away from your family, your support network would be very difficult, I think.

SPEAKER_00 11:22

Yeah. And can I ask for me, and I guess for everyone else that who's listening, as a registrar now, I sometimes struggle to look after myself, let alone a family. How do you manage work-life balance and raising your family and having your patients and having your clinics and doing everything? Because I honestly can't even begin to imagine what it must be like.

SPEAKER_01 11:52

That's a really good question. And I felt exactly the same as a registrar, actually. I felt exactly the same. I was the type of registrar who stayed until I'd finished doing things. I remember working in York and starting at seven o'clock in the morning to do primary care ward rounds and finishing at seven o'clock at night and being really proud of the job I was doing and feeling really satisfied by that work. And you just can't do that when you've got a family, or at least I can't do it. What makes a difference? So I'm very lucky that I live near my parents, which means that they are backup for me. So I do have, I do have a fallback. And I think one piece of advice that I would give to people is to try and find a community. It doesn't have to be mums, it can be neighbours, it can be family and friends, but there are going to have to be times in the job that we do that you have to make decisions either between work or family, and you have to you have to feel comfortable doing that. So you have to have some good childcare. My husband's a GP, which means he works very regular hours. We have combined diaries, so we know what we're doing-ish, sort of. And I am increasingly aware of the fact that I am not perfect, and that means that I have a really messy house, but you try and concentrate on the important things. So I try and get to work on time, I try and leave on time, I try and plan my extra childcare when I'm on call. And I try really hard not to work at weekends unless I'm on call. I try hard not to work during nights unless I'm on call so that I can spend time with my kids. Yeah. So not sweating the little things as well. But I think that's a good piece of advice generally for life, whether you have children or not.

SPEAKER_00 13:39

Yeah. So do you think it was the children that kind of made that shift in your priorities, or did was it just that you realize that I actually can't keep doing this?

SPEAKER_01 13:51

No, it was definitely children. It was definitely children. Absolutely. Um, and um, I did plan things a little bit in that when I went back to work after having my daughter, I fairly quickly did a PhD, which was a science-based PhD, which meant that I didn't have to be there for research patients. I could look after my daughter if she was unwell. It was very flexible, and I'm extremely grateful to the team that I was working with at the time who allowed me to work flexibly. So I think a little bit of planning in that respect was helpful as well. That the three years that I did my PhD over, it really did allow me to be really flexible and to feel like I was a mum for quite a lot of the time, which was very important to me.

SPEAKER_00 14:40

Yeah, yeah. And obviously, we're seeing lots of networks coming around, not just in the UK, but across the globe, really. The American College, the British Cardiology Society, the European Society of Cardiology all have networks supporting women. Uh, do you think that these are important? What do you think we can gain from these?

SPEAKER_01 15:01

So I think they are important. As you know, we've got a Women in Cardiology Society in Yorkshire, which was set up by my colleague Jennifer Rossington. Every year we do an outreach session for medical students who are interested in cardiology, and we are all available as mentors. Doesn't just include myself and Jen. There's Catherine Dickinson, Kate English, Helen Parry are all cardiology consultants at Leeds. We have some locums who may well join us as substantive consultants. And we have two excellent female cardiothoracic surgeons in Leeds as well. So being able to advertise ourselves. Throughout West Yorkshire, there are a number of other women cardiologists, and just being able to name everybody and have telephone numbers is a useful thing, although it isn't really a very formalised structure. Obviously, there's a much more uh formalised structure within the British Society of Cardiology. Being on Twitter pages, sharing stories about women who've done amazing things, sharing research publications, I think is all part of the really great work that the Women in Cardiology Society, the British Cardiac Society, do. I think you introduced me as a member, and I certainly am an enthusiastic member, but I'm not on the board or really have any role in running that, but very much in support of things.

SPEAKER_00 16:16

And I know we've briefly touched on this, but what's your take on having a mentor as a woman going forward? I know that you said that it doesn't really make a difference as to whether your mentor is female or male, but do you think it's something that we should all be striving towards having in terms of progressing in our careers?

SPEAKER_01 16:36

I think mentors, I don't think you have to have a mentor. I think if you can find a mentor organically, then that's really useful. I think talking to lots of different people is useful. Having someone that you sit down and talk with and can talk about your problems and can talk about solutions is important, whether it's a professional mentor or even actually just a really good friend, I think. The other thing I want to say about support, you've mentioned mentors, is coaching. And I I've recently had some coaching through one of the organizations at the trust. And coaching is a really well, it's different from mentorship, but I've found coaching really very useful as well in terms of being able to organize priorities and change the way that you do things.

SPEAKER_00 17:20

And if you don't mind me asking, do you mind just explaining the difference between having a mentor and taking coaching?

SPEAKER_01 17:28

So coaches don't, so mentors and coaches, neither of them should tell you what to do, but coaching is a lot more about space to talk about things. Coaches ask an awful lot of questions and they won't give you advice. Mentors may ask those questions, so mentors can definitely be coaches, but mentors will usually stay with you for a longer period of time. They might give you advice, they might put you in contact with other people. They may well do coaching with you and ask you difficult questions and make you think about things. But a coach really isn't someone who would take interest in your career. It's a bit more of a, oh, I'm gonna sound really uh head in the clouds. It's it's a bit more of a discovery, a bit about yourself and a bit about why you feel the way you feel about things. So why you struggle to balance your work life, how you can let go of things, which which is helpful in trying to maintain a work-life balance, how you can manage dealing with mistakes, things like that.

SPEAKER_00 18:25

Right. Okay.

SPEAKER_01 18:26

So it is a bit different.

SPEAKER_00 18:28

Yeah. And I never really thought about the the differences between the two of them. I guess from a professional point of view, I always thought if you needed to get somewhere or have that external person helping you, a mentor was probably the thing that was the best thing to try and get. Although I appreciate that there's no good and bad. But it's always good to know that there are other options out there depending on what you really need at that time.

SPEAKER_01 18:54

And I think the other thing, there's no right or wrong approach to that. And um say some people find mentors by looking on Twitter, looking on places like the British Uh Women in Cardiac Society, talking to people within their trust. I've had a few mentors over my career. I'm lucky enough to work with most of them as consultant colleagues, and they're now friends. And I think you do have that change, you it is possible to have that changing relationship. And over time, so you that relationship can change between being mentors to being friends and colleagues, but still I they're still the same people that I would go to for advice or advice about my career, definitely.

SPEAKER_00 19:37

And if I can just ask you, I know you've already given us a lot of advice as to how we can go forward, but if we could maybe end with you uh telling us to any listener who perhaps hasn't done a cardiology job and is thinking about it or is thinking about pursuing career in cardiology in general, what would your advice to them be?

SPEAKER_01 20:03

So the first thing I would say is not to be frightened of it. The the cardiologists that I work with are the friendliest, most fabulous bunch of people that I work with. And in addition to all of my consultant colleagues, I work within an amazing team of nurses, cardiac physiologists, many of whom are incredible women. I say some of my very favourite people are the cardiac physiologists and the heart failure nurses that I work with. So being in cardiology is not just about looking at ECGs, sorry, electrophysiologists, it's being part of a really great multidisciplinary team. So that's the first thing that I would say. I would say contact cardiologists and go and ask for experience, ask about their job, ask to see what they do, ask to spend some time with cardiology registrars on the shop floor, particularly when they're on call. I still think being a cardiology registrar is the coolest job in the hospital. And have a good think about how you would get to where you want to be in terms of using your time properly. So doing projects that are a little bit cardiology-based is a good way of getting into things. And there are always cardiologists who are really happy to help you with audits and projects and things like that.

SPEAKER_00 21:22

Thank you. So I think we'll leave it there. Thank you so much for your time today and for all your advice, both personal and professional and everything in between. And thank you everyone for taking the time to listen to us. Thank you.