"I always felt most 'at home' in the cath lab" - An interview with Nicola Ryan
How does Dr Ryan view her role as an interventional cardiologist? The answer is in this interview she has kindly given us.
It’s a great speciality; I would not let other people’s preconceptions dissuade young women fellows.
Why are there still so relatively few women interventional cardiologists? Do you think that working conditions (e.g. exposure to radiation) may be an impediment on women embarking on this career path?
I think it’s a combination of factors, however, being traditionally seen as a male-dominated field with relatively few role models may mean that female trainees are more drawn to other subspecialties.
Historically, concerns with regard to radiation exposure may have played a role, however, nowadays, radiation protection equipment is better and doses are very low, even in long cases.
In some institutions, I suspect the perceived intensity of the on-call rota may also have played a role in discouraging female trainees.
Nicola Ryan
What made you choose this specialty?
I really enjoyed most aspects of cardiology during my training, however, I always felt most “at home” in the cath lab.
I enjoy the variety of procedures from the immediate satisfaction of primary PCI, the symptomatic relief that patients who have had angina for longer than I’ve been a doctor, were told they have a blocked artery and it’ll do them no harm, get from intervention.
What is the main obstacle you have encountered to become an interventional cardiologist? How did you manage to overcome this?
Thankfully, despite Ireland having no female interventional cardiologists when I was a trainee, I never really felt I encountered many major obstacles during my training.
I, unlike others, have only been directly told that I shouldn’t pursue interventional cardiology by one person, but it was at a time when I had already decided my career pathway, and this person was not someone whose opinion I particularly valued.
The main obstacle I see is finding time to provide high-level patient care as well as pursue research.
From your point of view, what are the main assets you may have as a woman, compared with your male colleagues?
I think every cardiologist has different skills and does things in a slightly different manner.
I like to think that I spend quite a bit of time with my patients going through their images after their procedures to try to ensure they understand what has happened and why the follow-up medication, rehab, etc., is important.
Equally explaining pressure wire assessments, etc., and the rationale for it and the outcome rather than simply “you don’t need a stent”.
Do you feel your patients have a different attitude to you because you are a woman? Do you feel your colleagues treat you differently because you are a woman?
I think the majority of patients want to be treated well and want a good doctor and are not concerned whether their doctor is a man or a woman.
I like to think the majority of my patients think I’m a good doctor and I don’t think I’ve ever had a patient being surprised they have a female doctor when they come for PPCI.
Some patients have more old-fashioned views and expect a man to be “fitting their stent”. I have had comments such as “I thought Dr Ryan was a man” or “the wee lassie did my stents”, however, they’re in the minority.
I don’t believe that the majority of my colleagues treat me differently.
What advice can you provide to young women fellows wishing to pursue a career in interventional cardiology?
It’s a great speciality; I would not let other people’s preconceptions dissuade you.
Any hospital that does not welcome female trainees is not a hospital I would consider working or training in. There are plenty of hospitals where all trainees are welcome and valued.
