Cardiology is a sub-specialty of internal medicine. Therefore, a physician who plans to practice cardiology first goes through the internal medicine residency program, and then attends fellowships to obtain the more specialized training and practice in the type of cardiology one wants to practice.
Cardiologists provide health care to prevent, diagnose and treat diseases and conditions of the heart and cardiovascular system, including the arteries. Because the field of cardiology encompasses so many different types of diseases and procedures, there are many different types of cardiology one may choose to practice depending on his or her interests and skill sets, and the type of work they’d like to do. A cardiologist is not a surgeon. The physicians who do open heart surgery are cardio-thoracic surgeons, and they complete a surgical residency program, not an internal medicine residency as cardiologists do.
Training and Education for Cardiologists:
Again, cardiologists start by training as internists
, including 4 years of medical school, plus three years of residency training. After completing the internal medicine residency, a prospective cardiologist may enter one of many different types of cardiology fellowships. Cardiology fellowships are 2-3 years depending on the type of fellowship.
A non-invasive cardiologist primarily runs an office-based practice, seeing patients to prevent and manage potential heart problems. The average non-invasive cardiologist sees about 25-30 patients per day in the office. Non-invasive cardiologists do not do procedures; they mainly perform diagnostic tests to identify heart problems. If the problem is treatable with diet or medication, the physician will prescribe the appropriate drug therapy or dietary regimen. However, if the heart problem requires any type of surgical procedure, the non-invasive cardiologist will then refer the patient to another physician.
Non-invasive cardiologists perform tests such as ECHO’s, stress tests, and EKG’s (electrocardiograms). Another more recent development for non-invasive cardiologists, which has been a lucrative advancement for them, is nuclear cardiology. Nuclear cardiology involves a high-tech special “nuclear camera” which is used to take images of the heart after the patient is injected with radioactive dye. These nuclear images are much more effective than other tests for diagnosing a number of heart issues.
Compensation for Non-Invasive Cardiologists: Approximately $400,000 per year, according to the MGMA.
Invasive, Non-Interventional Cardiologists:
Invasive cardiologists do all the things non-invasive cardiologists can do, plus a bit more. Invasive cardiologists are trained in a diagnostic procedure called cardiac catheterization, which is used to find blockages of the arteries. Therefore, the non-invasive cardiologist’s time is split between office visits and time in the “cath lab” doing these catheterizations. If a blockage is found, and an additional procedure is needed, a non-interventional cardiologist can't intervene to fix the problem.
Therefore, the non-interventional cardiologist would refer the patient to an interventional cardiologist for the angioplasty or whatever procedure is needed.
Compenation for Invasive, Non-interventional Cardiologists: The average invasive, non-interventional cardiologist earns about $454,000, according to the MGMA.
This type of cardiology requires additional fellowship training, of 1-2 years in addition to the 3-year cardiology fellowship. The interventional cardiologist is able to perform more advanced procedures than the invasive and non-invasive cardiologist.
Interventional cardiologists will spend most of their time in a hospital performing procedures such as balloon angioplasty to open blocked arteries, or placing tiny mesh stents into narrowing arteries. Most interventional cardiologists also spend some time weekly in an office, following up with patients after procedures, or consulting with them prior to the procedures. Interventional cardiologists typically complete hundreds of procedures per year, including up to 300 catheterizations and up to 100 angioplasties.
Interventional Cardiologist Compensation: Averages about $545,000 per year, according to the MGMA.
Yet another option for cardiologists is to complete an additional 1 to 2-year fellowship in electrophysiology, which is the study of the bio-electrical impulses of the heart which control the pace of one’s heartbeat. When the electrical impulses are not functioning properly, this can cause a heart arrhythmia which can be fatal if left untreated. Not long ago, the only remedy to correct irregular heartbeats was to insert a pacemaker. Now, although that is part of what EP’s do, there are also a variety of other surgical procedures such as ablation which essentially disables the part of the heart which is malfunctioning, and drug therapy to manage complex arrhythmias.
Electrophysiologists compenstion: EP's earn about $480,000 annually, according to the MGMA.
If You are Considering a Career in Cardiology:
Because it takes so many years of training to become a cardiologist, and because the field is so dependent on technology and pharmaceutical advancements, one should be cognizant of the future trends of cardiology. You may not necessarily want to go with “what’s hot now”, but do some research on what may be in demand 10 years from now.
One example is cardiac surgery. Fifteen or twenty years ago, bypass surgery was experiencing a surge in popularity as one of the only ways to treat a blockage. Therefore, many physicians who entered surgery tracks decided to pursue cardio-thoracic surgery. However, now that so many other procedures are available to preclude cardiac bypass surgery such as stents and balloons inserted by non-surgeon cardiologists, there are now many cardiac surgeons fighting for the best jobs. Although there are still jobs out there for cardiac surgeons, the best jobs are highly competitive, where as cardiologists can pretty much hand-pick their jobs, because supply and demand favors cardiologists, unlike cardiac surgeons right now.