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Men rule hearts
When you think of a cardiologist, the image that comes to mind is that of a balding man with a moustache and a belly. It is difficult to imagine a female cardiologist simply because there are so few around.
A random internet search of websites of India's top hospitals and heart institutes reveals just a handful of women cardiologists and cardiac surgeons. India's premier medical establishment, the All India Institute of Medical Sciences (AIIMS), has just one female professor of cardiology. Allied branches, such as paediatric cardiology, cardiac anaesthesia and cardiac pathology, do enjoy a healthy presence of female faculty though. The Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, has no women cardiologists or cardiac surgeons. It's the same story at the Asian Heart Institute in Mumbai, where Dr Ramakant Panda is vice-chairman and managing director. The iconic Narayana Hrudalaya is a step ahead with one woman cardiologist who is a consultant with them. And the combined faculty of Apollo heart institutes in Chennai, Hyderabad, Bangalore and Ahmedabad has just two female heart doctors.
Cardiology has always been a boys' club. While in India there aren't statistics to substantiate this, there are enough figures from the US and the UK to prove it. According to 2010 figures from the American College of Cardiology, "women still account for less than 20 per cent of all cardiologists in the US. " About 39 per cent of internal medicine residents in the US are female;only 10 per cent of them are cardiology trainees, and just 6 per cent of American College of Cardiology (ACC) Fellows are women.
A 2009 census carried out by the Royal College of Physicians in the UK in three territories revealed that a mere 90 of the 766 cardiologists were females or in other words no more than 11. 75 per cent. In the case of cardio-thoracic surgery, the percentage was only 4. 66.
Things are not very different in India's cardiology departments. Says reputed cardiologist Dr Subhash Manchanda, who has dedicated 36 years of professional life at AIIMS and is now a consultant cardiologist with Sir Ganga Ram Hospital in Delhi: "I've taught the subject at AIIMS for almost 40 years. I must have seen 100-odd cardiologists graduate from the institute, but the number of women out of this bunch would be just about 10. " He, too, blames the demanding nature of the job and the level of commitment required for this anomaly. "In India, women are also focussed on their family life. Therefore, it possibly becomes difficult for them to manage a high-stress job and home, " he adds.
India's first woman cardiologist, Dr S Padmavati, is a living proof of the gender gap in this field. She is one of the few women cardiologists who have managed to rise through the ranks and today she heads the cardiology department at the National Heart Institute in Delhi. "Women studying cardiology do very well in their exams but then when they get married and have children, they take a break from work. Later, no one wants to hire them as they don't have enough experience, " says 92-year-old Padmavati who has remained single all her life. She started her career in 1953 at the Lady Hardinge Medical College in Delhi. She established the first cardiology clinic and cath lab in north India. Creating more part-time consultancy posts for women would correct the skewed sex ratio in her profession, feels Padmavati.
Dr Aparna Jaswal, electrophysiologist (who tests electrical conduction of the heart) with Fortis Escorts Heart Institute in Delhi, agrees with Manchanda and adds that to be a good cardiologist you have to be wedded to the profession. "You need at least 15 to 16 years of hard study. Then, once you start practising you have to give a lot of time and mind to your patients. That's why managing a family alongside becomes very difficult, " she says. In fact, a female cardiologist TOI-Crest spoke to on condition of anonymity went on to say that "you can either be married or be a cardiologist. "
All through the years of her super specialisation in cardiology and later super sub-specialisation in electrophysiology, Jaswal recalls being the only woman in the class. However, she admits she was never judged on the basis of her gender.
Interestingly, her colleague and senior at Escorts, Dr Savitri Shrivastava, who is also director, paediatric cardiology, reveals sexual discrimination is common in her field. "It is a mindset problem. Patients expect cardiologists to be male. If I have a male colleague who is much junior and less competent than I am, he still manages to attract more patients, " says Shrivastava, who did her specialisation from AIIMS in 1969. She says women interested in taking up cardiac surgery are often told by their male seniors that this is not a line for women. "The field is dominated by men, " says Shrivastava.
Another leading paediatric cardiologist, who wished to speak off the record to TOI-Crest, says cardiology is such a tough branch of medicine that many men also shy away from it. "We have four resident seats in cardiology vacant in our institute. Many male students too don't want to take up this specialisation. So it's just not about women, " she says.
WITH INPUTS FROM ASHIS RAY
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