Bridging the Gender Gap: The Urgent Need for Interventional Cardiology Training for Women – Perspectives from Latin America on Behalf of Mujeres Intervencionistas Latinoamericanas by SOLACI

INTRODUCTION. GENDER EQUITY AS A CATALYST FOR INNOVATION AND HEALTH EQUITY

Women have made remarkable progress across many medical specialties. Yet, interventional cardiology (IC) remains one of the most gender-segregated subspecialties in clinical practice worldwide.^[1] In Latin America, where cultural norms such as “machismo” persist, these disparities are not only present – they are deeply entrenched. This imbalance has far-reaching implications, affecting not only gender equity but also the quality of cardiovascular care, innovation, and leadership in a field critical to global health.

The persistent underrepresentation of women in IC reflects deeply ingrained cultural and institutional attitudes – an issue that goes beyond equity. As leadership theory and the lived experiences of women in high-stakes roles suggest,^[2] meaningful progress requires more than symbolic gestures. It demands comprehensive institutional change and a truly inclusive approach that values the full contributions of women in this vital specialty.

WHY PRIORITIZE WOMEN’S TRAINING IN IC?

Achieving a balanced workforce in IC, with equal representation of women and men, is essential for enhancing patient care and fostering a more equitable healthcare environment. Research indicates that female cardiologists are often more attuned to the unique presentations and treatment needs of cardiovascular disease in women.^[3] Their increased participation can lead to more inclusive and representative research, ultimately improving clinical practice.

Clinical excellence and diverse perspectives are key, as studies have shown that diverse care teams yield better patient outcomes, particularly in sex-specific disease presentations such as acute coronary syndromes in women.^[4] Moreover, increasing women’s presence in the field ensures more equitable participation in clinical trials, research authorship, and innovation pipelines. Female interventionalists also serve as catalysts for structural reform, reshaping hierarchical norms and promoting more collaborative, empathetic leadership styles.^[2,5]

LESSONS FROM LEADERSHIP LITERATURE: WHAT IC CAN LEARN

According to Naqbi,^[2] female leadership trajectories are shaped by a combination of personal traits, support networks, and institutional culture. Successful women leaders often exhibit emotional intelligence and resilience. Moreover, they show a collaborative, servant-leadership approach and strong engagement with mentorship and advocacy. Women exhibit a strategic vision tied to inclusive values and the lack of these conditions in many IC departments is a key reason why gender equity remains elusive.

SPECIFIC BARRIERS IN LATIN AMERICA

Women in cardiology in Latin America face greater obstacles than their counterparts in many high-income countries, due to deeply rooted cultural biases and a lack of resources to address workplace discrimination. This leads to the underrepresentation of women in specific areas such as IC. For example, in Brazil, women represent 31.1% of cardiologists but only 7.5% of interventional cardiologists.^[6] A regional cross-sectional survey of 240 Latin American cardiologists found that women comprised 41.7% of respondents, yet were underrepresented in leadership roles, earned less, and experienced higher rates of discrimination and limited opportunities for career development.^[7]

Regional initiatives like the Latin America IC Group (MIL Group), established in 2017, aim to build networks of support, advocacy, and professional development that promotes female participation through mentorship networks, webinars, and scholarships. Specifically in Brazil, the SBHCI MINT (Mulheres Intervencionistas) initiative supports female interventionalists through structured training programs and community-building activities. However, these efforts require strong institutional backing to create systemic change.

The underrepresentation of women in the IC field or leadership positions is not only a Latin American issue; similar trends are observed globally. For example, in Europe, only 18% of interventional cardiologists are women^[6] and in the USA, fewer than 5%. In Asia, women represent just 7.3% of interventionalists; and only 9.2% them are board-certified, compared to 28.3% of their male counterparts.^[8] However, compared to the U.S., Europe, or Asia, women in Latin America face amplified barriers due to several aspects, such as: (1) cultural constraints that define leadership and procedural specialties as male domains, (2) limited enforcement of anti-harassment and anti-discrimination policies, (3) societal expectations regarding women’s familial roles, limiting work-life balance, and (4) underfunding of initiatives aimed at professional development for women, among others.

These issues align with broader findings from healthcare, business, and academia^[2] where context-specific sociocultural norms often constrain women’s leadership.

ACTION AGENDA FOR GENDER-INCLUSIVE IC

To effectively advance gender equity in IC, a multifaceted and systemic approach is required. The following framework outlines four key pillars – Institutional Accountability, Training and Development, Mentorship and Sponsorship, and Support Networks and Visibility – that collectively address the structural, cultural, and professional barriers women face in the field. Each component is essential for creating a sustainable and inclusive environment that not only attracts but also retains and promotes female talent in IC [Figure 1].

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Figure 1:

Action agenda for gender-inclusive interventional cardiology.

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FINAL REFLECTIONS: EQUITY AS STRUCTURAL EXCELLENCE

Addressing the gender gap in IC is both a moral imperative and a strategic necessity for advancing cardiovascular health in Latin America. Through targeted training, mentorship, and institutional reform, the field can unlock the full potential of its workforce – improving outcomes and fostering a more just and innovative healthcare system.

As Naqbi^[2] notes, real progress requires more than individual resilience – it demands systemic change. The underrepresentation of women in IC is not about interest or ability, but about structural exclusion.

Promoting gender equity is not just about fairness; it is essential to clinical excellence, scientific advancement, and compassionate care. Closing this gap is not optional – it is vital to the future of cardiovascular medicine in Latin America and beyond.