Building a leadership pipeline through professional development

The underrepresentation of women in cardiovascular leadership positions represents one of the most persistent challenges facing modern cardiology. In the USA, despite comprising nearly 30% of cardiology trainees, women hold only 5% of cardiology division chief positions—a stark disparity that reflects broader systemic barriers to advancement.1,2 This phenomenon extends globally, with some European countries having no female cardiology division leaders at all.3 Little has been written about the situation in low- and middle-income countries (LMICs) where challenges to career progression for women are additionally complex. The scope of this gender gap permeates every level of cardiovascular medicine leadership. Academic publishing reflects similar disparities, with women representing only 9.9% of editors-in-chief across 76 global cardiology journals.4 Conference programming continues to struggle with gender balance, as evidenced by the persistence of all-male panels (‘manels’) at nearly 40% of cardiovascular conferences.5 Perhaps most concerning is the absence of women in cardiovascular clinical trial leadership. More than half of trials published in high-impact journals between 2014 and 2018 lacked women investigators on their executive committees entirely, with lowest representation from LMICs.6 The gender-based leadership disparities that exist within cardiovascular medicine cannot be attributed to a lack of qualified candidates. Rather, they reflect complex, interconnected barriers including implicit bias, cultural factors, and structural obstacles that impede women’s advancement to leadership positions. The cardiovascular community has begun acknowledging these challenges, with professional societies and academic institutions implementing various initiatives to promote gender equity. Meaningful change requires deliberate, consistent, and evidence-based interventions that address both individual skill development and systemic barriers. Professional development programmes specifically designed for women physicians represent one promising approach to strengthening the leadership pipeline.7,8 Women As One, a non-profit organization dedicated to increasing gender equity in cardiovascular medicine by creating unique professional opportunities for women cardiologists, exemplifies this targeted approach through initiatives such as RISE @ ESC Congress 2025, scheduled for 28 August 2025. This third annual conference, presented in partnership with the European Society of Cardiology and the ESC Gender Task Force is themed Leadership on the Global Stage—Challenges and Opportunities. Provided in collaboration with the World Heart Federation’s World Congress of Cardiology, it will precede ESC Congress 2025. The programme emphasizes practical leadership skill development through didactic sessions, workshops, and case-based learning, while fostering mentorship relationships and professional networks that advance the career trajectories of women in cardiovascular medicine. Focused professional development initiatives serve multiple critical functions. They provide women with leadership competencies that may not be formally taught during traditional medical training, while creating networking opportunities that can be instrumental in career advancement. Additionally, these programmes offer role models and mentorship relationships that help women navigate the unique challenges they face as they rise to leadership positions. The success of targeted professional development programmes depends on several key factors. Programmes must address both technical leadership skills and the specific challenges women face in fields historically dominated by men. They should provide ongoing support rather than one-time interventions, recognizing that leadership development is a continuous process. Effective programmes also create sustainable professional networks that extend beyond the initial educational experience. The RISE Programme Directors carefully considered these factors, as well as participant feedback from previous RISE Programmes, as they crafted a timely and globally relevant agenda for the 2025 event. The goal of these programmes extends beyond achieving numerical parity. Diverse leadership brings varied perspectives, enhanced decision-making, and improved organizational performance—benefits that ultimately improve patient care.9 It also focuses attention on the importance of improving cardiovascular care for women, given the stark reality of less positive outcomes.10 As the cardiovascular field continues to evolve, ensuring that leadership reflects the diversity of both the profession and the patients we serve is not just an equity imperative, but a clinical one. Professional development initiatives like RISE represent important steps towards this goal, but sustained progress requires ongoing commitments from individuals, institutions, industry stakeholders, and professional organizations. By investing in the leadership development of women in cardiovascular medicine, we strengthen not only individual careers, but the entire field’s capacity to address the complex challenges of modern healthcare. The path forward requires both immediate action and long-term vision. Continued efforts to identify and dismantle barriers, coupled with proactive development of women leaders, will allow the cardiovascular community to build a more equitable and effective leadership structure that benefits all stakeholders—ultimately improving health outcomes. More information and registration for RISE @ ESC Congress 2025 can be found on the Women As One website and the ESC website. R.M. is the Founding Director and a Board Member of Women As One. M.R. and L.Z. serve as Program Directors of the RISE 2025 programme at Women As One. No other conflicts of interest are declared by the contributing authors.