Well, #EACTS2021 may be over...but I'm not done! 😆
One of the most important sessions was on Women In Cardiothoracic Surgery
I suppose I should clarify - not writing a 🧵on this for likes or 'virtue signalling' - my wife's journey through her training gave me some insights...
#EACTS2021
Opening talk on why @EACTS needs a womne's committee from @JolandaKluin - this was a great talk to set the tone for the session
#EACTS2021
Prof Kluin discussed the many challenges that can face women in medicine, in academic medicine, in surgery and in cardiac surgery
#EACTS2021
Cannot tell you how much I loved this point. Prof Kluin explained how she could have used either of these title slides - both are true, one more modest than the other, one more likely to be used by women than men. When one takes a step back & thinks about it...so true
#EACTS2021
Prof Kluin also alluded to constant challenges women face in all walks of life - even the President of the EC, Ursula von der Leyen, and the now infamous #sofagate episode - worth watching the video if you missed this
I think unsurprisingly, yet sadly, women much more likely to have considered leaving due to gender bias, or to have felt discriminated against at work on the basis of simply being a woman ☹️
Some important lessons here for those planning and in charge of surgical training. Women don't feel supported at work - don't complain we don't have enough surgeons, yet fail to stop behaviours that can trigger the loss of trainees!
#EACTS2021
Next talk from Dr Jasmine Hanke reporting results of the German survey on Women in Cardiac Surgery
I liked this summary slide of the multiple - really, it's *multiple* - challenges and career-limiting factors for women as a whole, not just in surgery
So...this is what they did...all centres responded. Dr Hanke was pleasantly surprised to learn that 24.7% of trainees were female, much higher than she expected / perceived
Started off by showing % of people in different countries that would be comfortable with a woman as a leader...why is this not 100%? Surely you want the best person, irespective of gender?
And look at Jacinda Ardern! Has there been a better leader in past 2 years?
I am sure this slide was depressing for women - only 74% of women perceive other women as equally suited for leadership roles as men - love the Madeleine A quote!
#EACTS2021
So...why do I feel this resonates so much? Well, apart from the fact that it is an obvious and big inequality - and most of us don't like inequalities - as I said above my wife - an anaesthetist - had a lot of nonsense from men in her training too
#EACTS2021
Decided on a career in anaesthetics, well on the way through training yet the frequent uninvited 'advice':
"Have you not thought above GP?"
"You know it's hard with children and the early starts"
"Do you need to work if your husband is a Dr too?"
etc ad infinitum
#EACTS2021
Tip to my fellow men - even though you may think this 'advice' is helpful, in almost all situations it isn't!
If your advice on a woman's career isn't sought...don't give it! Seriously, learn when to stfu!
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It takes time to read the paper, read the supplementary appendix, analyse the results, think about them etc!
Some thoughts...🧵
On Sunday I wrote a thread about asymptomatic severe AS and what we knew already from RECOVERY & AVATAR RCTs and what the guidelines currently advocate
Transthoracic echocardiography (TTE), when performed with care and diligence, can reveal a lot about the valve. TOE isn't necessary in all cases to determine leaflet pathology.
A worked example below:
In the PLAX view, you can assess the scallops of the leaflets
In a true PLAX view with aortic valve clearly visible, you mostly see the A2-P2 interface. Here, you can see a clear & large prolapse of the posterior leaflet
If you tilt upwards towards the PLAX RV outflow (pulmonary valve) view you see mostly the A1-P1 interface
Here, you can see the valve looks slightly different & no prolapse is seen
PE has garnered a reputation for huge profits as they typically buy into a company, aggressively ⬇️ costs whilst ⬆️ profit margins, leverage debt if needed, and then sell, often at a large profit
Does this matter when it comes to delivering healthcare services?
Sixty years ago this month - October 1963 - US cardiologist Dr Robert Bruce published a paper detailing his efforts to devise a multi-stage treadmill test
Little did he know this would go on to become the Bruce protocol the most widely used for exercise testing
A thread...
Prior to this, 'stress testing' to evaluate cardiac function was performed using the Masters 2-step technique, first described in 1935. This crude but simple test involved repeated steps up & down over 90 seconds
Bruce, amongst others, recognized the limitations of this test & set about developing an exercise treadmill test
His initial work focused upon a single stage protocol, but he soon realized this wasn't stressing fitter patients enough & the test was taking too long!