From Representation to Reform: A Qualitative Study of Gender Equity in Interventional Cardiology

Women represent fewer than 5% of practicing interventional cardiologists in the United States (U.S.). The WECARE (WomEn in interventional Cardiology: A qualitative REsearch) study explored the career experiences, challenges, and support systems of women practicing interventional cardiology (IC) in the U.S. Semi-structured interviews were conducted with 18 women IC attendings and fellows representing diverse backgrounds. Interviews were analyzed using thematic content analysis. Five major themes emerged: (1) Career entry and negotiation: Participants described variable recruitment and promotion experiences, from early discouragement regarding lifestyle suitability for women to strong mentorship enabling advanced fellowships and leadership roles. Salary negotiation was often opaque and appeared inequitable, requiring persistent self-advocacy. (2) Motherhood and institutional gaps: Participants reported complex decisions about pregnancy timing, inconsistent maternity leave, and breastfeeding challenges requiring improvisation. Concerns about radiation safety persisted amid inconsistent institutional policies. (3) Bias and representation: Gender bias was acknowledged as being present but often manageable; women employed strategies such as humor, education, and assertiveness to mitigate impact. Some reported exclusion from informal networks and limited leadership opportunities. (4) Mentorship and Support systems: Mentorship was described as pivotal for training, negotiation, and resilience. Family support, childcare, and peer networks were crucial for work-life balance. (5) Resilience and advocacy: Despite persistent barriers, most participants expressed strong professional satisfaction and commitment to IC. Women in IC report high career fulfillment yet continue to face structural and cultural challenges. Mentorship, institutional transparency, fairness and standardized family-supportive policies are essential to sustain an equitable and diverse workforce.