Driven by a desire to contribute to science, improve patient care, and take the first step towards an academic career, Chiara studied for her PhD in Cardiovascular Imaging at Imperial from 2009 to 2012. “It was humbling to be part of one of the best programmes globally,” she explains. “Those were my first years in London and I've been here now for 15 years. I never planned to be in the UK for so long. It’s been a life-changing opportunity.”
She describes her supervisor, Dudley Pennell, Professor of Cardiology at Imperial’s National Heart & Lung Institute, as being influential during her studies. “He's an inspirational leader, a fantastic manager and very successful academic; I have so much to learn from him.” And in return Professor Pennell writes that “Her leadership style, determination and professional standing has been inspirational for so many young colleagues and certainly for women.”
While studying for her PhD in 2010, Chiara was offered a Senior Lecturer and Consultant Cardiologist role at the Bristol Heart Institute, University of Bristol. Here she was the clinical and academic lead of the cardiac magnetic resonance imaging (MRI) unit.
Spending 11 years in the city, she grew the Institute ten-fold, transforming it from a small regional centre into a nationally and internationally recognised clinical, academic and training hub. Now back in London, she’s continuing her clinical work alongside Professor Pennell again and a fantastic group of colleagues at the Royal Brompton and Harefield Hospitals.
First and youngest
Chiara has an impressive list of titles, award wins and nominations. Among them are Fellow recognition from the European Society of Cardiology in 2009, Fellow of the UK Royal College of Physicians in 2010, and Fellow of the American College of Cardiology in 2019. Many are accompanied by the words ‘first woman’ and ‘youngest’. “I'm seen in the cardiac imaging and cardiac MRI fields as a young(ish) key opinion leader among many male colleagues, and this has served as an inspiration to many female colleagues.”
But this gender imbalance has never represented a limitation for Chiara. “Mostly you hear women feel unheard or side-tracked when they sit on boards, surrounded by male colleagues," Chiara explains.
"Whilst this was certainly also my experience, particularly a few years back, I managed to turn this apparent disadvantage into an opportunity. I was able to leverage a different leadership and communication style (on occasion unconventional) than my male colleagues, which has resonated among colleagues and peers. As a result I was still seen as different, but my differences became assets."
"I also never hold myself back in aiming for the big positions. I just went for it, applying the driving principle that if you don't go for it, you will never get it."
Being a female leader can have many advantages.
Turning negatives into positives
"Challenges are always opportunities, but it requires the right attitude to see that and you need to be ready to invent a new world and new ways of doing things." It’s an approach Chiara illustrates well when remembering a student ski trip, where she broke her pelvis. Badly. “I had five fractures. I couldn’t have broken more. I was constrained in bed for a month and a half, because I needed time to heal and avoid a surgery.”
She saw two choices. “I could moan for six weeks and be upset. Or I could use this time as an opportunity to do something meaningful.” She picked the latter.
“I decided to write a paper that I never had time for. Now I magically did. So I wrote it, whilst supine in bed, and it would be one of the papers of my PhD. And then I applied for the American Heart Association Young Clinical Imaging Investigator Award, which is a major prize. And a few months later I was one of four finalists, I could not believe that.”
Attitude and aptitude
One of Chiara’s favourite quotes is: ‘Your attitude, not your aptitude, will determine your altitude,’ by US author and speaker Zig Ziglar, once mentioned to her by Professor Pennell. You’ll find it on the first page of her PhD. But she has her own twist on this saying.
I say ‘Your attitude together with aptitude, will determine your altitude.’ That's been a driving principle in my career, and in fact my life.
“If you’re very skilled but you're too shy to engage with the bigger world, you're not telling people what you do and who you are, you risk wasting your talent.”
“And if you're a social butterfly who’s very pleasant, chatty and charming, but you have no substance, then people will realise that and you'll go nowhere. With the right balance of both attitude and aptitude, you can fly.”
An extroverted mentor
Many people see Chiara as a mentor. And she has a good idea of why people are drawn to her. “I operate with an open-door policy. I am approachable and always available to help and give advice. And people know that.”
Not all mentors are like this. “I see people in leadership positions who have a top-down approach. They might look down on people, or be perceived as doing so. My approach is the opposite. It is bottom-up and I put myself at the same level as everyone else. I am one of them and this helps people to feel at ease, and empowered to engage with me.”
What should we be looking for in a mentor? “Someone who understands your field but who has the opposite qualities you have,” explains Chiara.
You want a mentor who will advise you, who can recognise your successes but also your shortfalls, and who could also give you a different perspective than the one you have.
“I think that’s why introverted colleagues and juniors come to me. I'm extroverted and they see me as a role model who is easily approachable. I want to show people a broader perspective than they have previously considered. People might feel less uncertain about the future and their aspirations and I want to show them that if I have done it, they can do it too!”
Leading by example
Chiara also tells her mentees to never be afraid to discover and admit to their own limitations. “Never hold yourself back. And believe in yourself. If you don't think you're good enough, let's discuss why and bring you to a place where you think you are good enough, either by working on your skills or boosting your confidence, or both. There are courses which are helpful to understand both our personalities and what our strengths and weaknesses are. We all have them, including me. The goal is to identify them and then learn to play by your strengths and work to improve your weaknesses.”
She recommends continuing professional development (CPD), having herself taken courses in Women Transforming Leadership at Said Business School, Oxford University and the National Institute of Health Research (NIHR) Future Leaders. “I was never told to learn more about myself. I enrolled on those courses out of interest, curiosity and initiative.”
“I encourage all my trainees and mentees to take the Myers Briggs Personality Test because it's a journey of self-discovery and introspection. Not everyone is initially keen to engage with this exercise, and I have to push them a bit outside their comfort zone, encouraging them to learn about themselves, by themselves. The test highlights some elements of your personality and makes you reflect and recognise some patterns of behaviours and feelings, which could potentially hold you back. It buys you time and space to think about who you are and where you're going.”
This self-introspection has given Chiara an opportunity to show juniors and peers she’s not as perfect as they might perceive her to be.
It’s never an easy conversation, to talk about your weaknesses or failures. But I speak about mine as I want to show people that I do have them too, thus leading by example.
A fearless CEO
Of all her achievements, it’s her role as CEO of the Society for Cardiovascular Magnetic Resonance (SCMR) that Chiara’s most proud of. “It’s the one that’s the most out of place for me. I don't know any other cardiologist that’s in a CEO position, doing two jobs. It’s a completely different beast in this role and I’m setting different standards for the CEO position. Usually, you’d have an MBA for this role, and I’m showing you don’t necessarily need to have that.”
"In my two years in this post, I have taken unconventional and counter-intuitive decisions that have paid positive dividends in the Society, which has historically been quite conservative in their decision making. I was very pleased when my President thanked me for my work in front of all our membership saying 'SCMR is proud to have a fearless CEO.'"
"Indeed, finding myself as a UK-based CEO of a US-based association a few months before the outbreak of the COVID-19 pandemic meant I had to reinvent a new way of working and a new way to run the Society and the business of professional associations. I have done this using intuition and common sense, and I am proud to have successfully sailed the ship during these stormy two years. SCMR is more successful than it has ever been, including financially."
But Chiara is proud of each and every accolade she has received over the years. “There’s a story behind each of them. They're in different domains, some are teaching, some are professional, some are about women in medicine, but they all have a lot in common. It’s a multifaceted set of awards, telling the story that I’m also multifaceted. It is all about trying to do and achieve things that were never done before."
"It always seems impossible until it's done" is one of Chiara's favourite mottos, borrowed from Nelson Mandela. In 2013 and 2015, while she was in Bristol, her cardiac MRI Unit was the runner-up and highly commended for the local NHS Recognising Success Awards in Research and Education and in Best Service Improvement. She reflects that "Sometimes it is just about being the right person in the right place at the right time."
The NHS recognising I do good clinical work meant a lot to me. The teaching award with the students enriches me, as does the mentorship and all the other professional recognitions. It’s all part of me.
An entrepreneurial spirit
After accomplishing so much, Chiara’s considering entrepreneurial activities. “That could be in digital health or digital cardiology, I still have to find my niche. I'm looking at the challenges facing the NHS and challenges post-COVID-19 pandemic. Every challenge presents an opportunity, so I am trying to scope my next venture.”
She also sees herself having a more global influence. “I’ve had some impact in Europe and in the US cardiology/imaging fields, but hopefully I can go even further to help and contribute to making the world a more positive place.”
Ten years from now, we may see Chiara’s name on ballot papers. “I'm giving politics serious thought. Whether I will achieve that, I don't know. But politics needs people who want to drive agendas, who are competent, honest and have the courage to be disruptive in a positive way. And I’ve certainly been quite positively disruptive throughout my career.”
I've been rethinking how to do things, and that's been a winner for me. I often didn't go with the flow; I often made unconventional decisions and I was never afraid to go in a different direction than most people would have taken. I've achieved more as a result. It's that disruption and the confidence in my abilities that energises me. My grandpa was a prominent politician in Italy, so I may have the genes!
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