HERZMEDIZIN: Looking back on your career, what factors, opportunities, or turning points have most strongly shaped your path in cardiology?
El Sayed: Looking back on my career, one of the most defining opportunities was receiving a scholarship to train and complete my MD thesis at the Royal Brompton Hospital in London, UK. I began my journey as an adult cardiology resident, a field close to my heart since my father was a pioneering cardiac surgeon in my country and an enduring source of inspiration. During my time at the Brompton, I specialized in pediatric and congenital cardiology, which opened a new dimension in my professional path. Upon returning home, I established a dedicated unit for congenital heart disease, which has since grown into a thriving center with ten highly skilled interventionalists—most of them women—who continue to advance the field with passion and expertise.
HERZMEDIZIN: How would you describe the current status of women in cardiology in your country regarding career progression, leadership positions, and academic opportunities?
El Sayed: When I first entered the field, women in cardiology were few and far between. Today, the landscape has changed dramatically, with more and more women choosing cardiology as their career path. In my own department, for example, we now have an equal number of female and male residents. I believe our country stands out for the strong presence of female cardiologists, and opportunities are largely determined by expertise rather than gender. Leadership roles are equally attainable— I myself served as Head of the Cardiology Department for six years, and our current head is also a woman. That said, I feel women often still need to work twice as hard as men to prove themselves, but the progress we’ve made is undeniable and inspiring.
HERZMEDIZIN: What structural, institutional, or cultural barriers continue to limit the advancement of women in cardiology?
El Sayed: The greatest cultural barrier is probably the multiple roles expected of a woman. Above all, a woman is expected, at a relatively early stage of life, to start a family and have children. Women who have children are also, culturally, expected to carry the greatest share of responsibility toward those children – and toward the family more broadly, as a parent. Institutionally, men are still perceived as easier to reach agreements with, as people who do not ask too many questions. There is a cultural perception that women’s wish to be thorough – to ask questions, to prepare every detail adequately, and to be properly informed before deciding – is not recognized as a strength but is instead perceived as a kind of weakness.
HERZMEDIZIN: How well are women represented in procedural subspecialties such as interventional or structural cardiology, and what factors influence their participation in these fields?
El Sayed: Representation across subspecialties reflects these dynamics. Women are strongly present in congenital and structural interventions, imaging, and electrophysiology—fields that demand patience, precision, and a keen eye for detail. Many pioneers in these areas have been women, creating role models who inspire younger colleagues. By contrast, coronary interventions remain largely male‑dominated, shaped by historical trends and perceptions of the field as more physically demanding and are only gradually opening up to greater female representation.
HERZMEDIZIN: How supportive are cardiology institutions in your country regarding pregnancy, parenthood, work-life integration, and flexible career pathways?
El Sayed: Institutional support for parenthood and work–life integration is significant but imperfect. Women in government institutions such as university hospitals are entitled up to four months of paid maternity leave, which can begin either on the day of delivery or up to one month before. They may also take unpaid leave of up to two years per child, with a lifetime maximum of six years. These policies provide flexibility, but extended unpaid leave can affect financial stability and slow career progression in such a competitive field. The challenge remains in balancing professional growth with family responsibilities, and ensuring that women who take time away are not disadvantaged in the long term.
HERZMEDIZIN: What role have mentors, sponsors, professional societies, and Women in Cardiology initiatives played – or are still playing – in advancing women’s careers?
El Sayed: Mentors, sponsors, and professional societies have played a crucial role in advancing women’s careers. Guidance from mentors, opportunities opened by sponsors, and visibility through societies and Women in Cardiology initiatives have all helped women gain confidence and recognition. These networks continue to provide solidarity and inspiration for younger colleagues.
HERZMEDIZIN: Looking ahead, what changes do you believe are most important to achieve greater gender equity in cardiology, and what advice would you give to the next generation of women entering the field?
El Sayed: Looking ahead, achieving greater gender equity will require both cultural and institutional change. More flexible career pathways, stronger support for work–life balance, and proactive promotion of women into leadership roles are essential. My advice to the next generation is simple: seek out mentors, believe in your expertise, and claim your place with confidence. Cardiology is demanding, but deeply rewarding—and women have already shown they can shape its future with resilience and vision.
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