An important part of medical school is choosing a specialization. Some medical students decide to stay in internal medicine, while others choose to specialize in specific diseases or parts of the body. If you’ve ever considered the specialization of cardiology and wondered “What is a cardiologist, anyway?”, read on to learn more about this exciting field and uncover the opportunities available for cardiologists after medical school.
A cardiologist is a doctor with specialized knowledge in treating the heart and other parts of the circulatory system, including the blood vessels. Cardiologists work with patients directly, but they also work with other doctors in a consultative role to help treat heart-related conditions or prepare patients for major procedures that could affect the heart.
Cardiologists must go through the same training as other doctors – four years of medical school and three years of residency in general internal medicine. Additionally, they must also complete three to five years of specialized training in the field of cardiology, typically through a fellowship program. Since the heart is such a vital organ, cardiologists must be extremely well trained before working on live patients without guidance.
In order to practice medicine, all physicians must become licensed through their state licensing boards. This is typically accomplished by taking and passing the United States Medical Licensing Examination (USMLE). Once a doctor has become certified in general internal medicine through the state licensing board, he or she can then take additional licensure examinations to become certified in specific specialty areas, such as cardiovascular disease.
Cardiologists can also earn the professional designation of Fellow of the American College of Cardiology (FACC). This designation is earned through an election process by the American College of Cardiology (ACC) and is based on academic achievement, peer review, contributions to the field of cardiology, and demonstrated commitment to uphold the ideals of the ACC. Earning the FACC designation is a high honor in the field of cardiology and is strong evidence of a physician’s ability to perform in the field.
Cardiologists care for patients with heart diseases or heart-related issues. They perform many of the same diagnostic procedures as other physicians – checking a patient’s height, weight, blood pressure, medical history, etc – but they also may use some additional tests designed to specifically check heart function. Once a diagnosis has been made, the cardiologist will recommend a course of treatment that could include lifestyle changes, medicine, additional testing, and even surgery.
Open-heart surgery is typically reserved for those physicians who specialize in cardiothoracic surgery, but cardiologists may still perform other less-invasive procedures, such installing a pacemaker or cardiac catheterization.
Since the hearts of adults and children are very different, cardiologists typically choose to work with one age group or the other while still in training. Pediatric cardiologists learn about heart diseases that are specific to children, and they know how to care for the unique needs of a child. Adult cardiologists are often referred to as simply “cardiologists”, and they will usually only treat adult patients.
After completing medical school and three years of a general internal medicine residency, aspiring cardiologists can choose to complete a general cardiology fellowship, or they can specialize in a specific area of cardiology. Cardiac doctors can specialize in any of the following areas
This sub-specialty focuses on diagnosing and treating heart conditions in children. Patients of a pediatric cardiologist can be infants through young adults, so pediatric cardiologists should be comfortable working with small children and also explaining conditions to concerned family members.
This sub-specialty focuses on treating heart conditions with minimally invasive procedures, such as angioplasties or stents. Doctors specializing in interventional cardiology work to identify and correct heart problems early in an effort to avoid more serious, invasive procedures, such as open-heart surgery.
In this sub-specialty, doctors train for all standard cardiac care, but they also learn to perform cardiac catheterizations, which evaluate proper heart valve function and potential artery blockage. If these issues are identified, an invasive cardiologist may refer the patient to an interventional cardiologist or cardiothoracic surgeon for treatment.
This sub-specialty focuses on using non-invasive tests, or tests that can diagnose heart conditions without requiring any kind of surgery. Noninvasive cardiologists learn to conduct, read, and interpret echocardiograms and stress tests.
This sub-specialty focuses on the electrical activities in the heart. These doctors treat heart arrhythmias, palpitations, and flutters by using electrical pulses to regulate a patient’s heartbeat.
Doctors who choose this sub-specialty train to be surgeons of the arteries and veins, with special focus on those closest to the heart and brain. Vascular surgeons treat minor conditions, such as varicose veins, and major conditions, such as clogged arteries that require stents or surgery.
Doctors who choose this sub-specialty train to become open-heart surgeons. They may perform coronary bypass procedures, valve replacements, or even full heart transplants.
Depending on their specialty, cardiologists may use a variety of tests and procedures to diagnose a heart-related condition or illness. Some tests and procedures are less invasive, but not as accurate at pinpointing a condition. Other tests will show a cardiologist exactly how a patient’s heart is functioning, but these can be quite invasive and very costly. Depending on the patient’s symptoms, current health, and prior medical history, a cardiologist may perform any of the following tests and procedures:
• Electrocardiogram (ECG) – During this test, a patient is hooked up to multiple electrodes that monitor the heart’s electrical activity.
• Stress test – During this test, a patient’s heart is monitored at rest, then again under stress-induced conditions to evaluate the heart’s performance when stressed. A stress test can be physical, when a patient walks on a treadmill to induce stress, or nuclear, when a patient is injected with a chemical to induce stress.
• Cardiac catheterization – During this test, a long, thin tube is inserted in an artery or vein and threaded up to the patient’s heart. Through the catheter, the cardiologist can then perform diagnostic tests to evaluate heart function or combine this test with other treatments, such as an angioplasty or stent, to immediately treat the problem area.
• Angioplasty – In this procedure, the cardiologist will thread a thin tube with a small balloon on the end through the arteries to an area with an identified blockage. The doctor will then inflate the balloon, pushing the blockage against the outer walls of the artery and opening it up for increased blood flow.
• Stent – A cardiac stent is usually placed in conjunction with an angioplasty or catheterization. Using a catheter, the cardiologist will place a thin mesh coil into a blocked artery to help keep the artery open and improve blood flow.
While these are not the only tests and procedures used by cardiologists, these are some of the most common treatments performed. Depending on the severity of the patient’s condition, a cardiac doctor may decide to perform multiple tests or procedures for the best overall care plan.
A big part of a cardiologist’s job description is cooperating with other doctors to provide well-rounded patient care. Patients will not usually visit a cardiologist directly; instead, they will share symptoms to a primary care doctor, who will then make a cardiology referral based on those symptoms and the patient’s medical history.
Once the cardiologist has seen a patient, he or she will then need to keep in regular contact with the patient’s primary care doctor to share progress and updates, including test results and recommended procedures. If the cardiologist works in a hospital, he or she may be coordinating with several other doctors and nurses throughout the patient’s hospital stay.
According to the U.S. Bureau of Labor and Statistics, the demand for cardiologists is projected to grow at 18% through 2022, which is significantly faster than the average career field. Due in part to an aging population and higher incidence of heart disease and other heart-related illnesses, more cardiologists are needed to properly care for patients across the United States.
Those who choose to enter the field of cardiology can expect a rewarding career with a lucrative salary. According to Salary.com, non-invasive cardiologists can expect to earn a median salary of $389,200, while invasive cardiologists can earn $423,500 annually on average. Salary will vary by specialization, location, and type of practice, but wages for cardiologists are higher than many other physician salaries.
Cardiologists can also shape their careers in many different work environments. Cardiac doctors are most in demand in large cities and major metropolitan areas, although they can likely find work in private practices and smaller local hospitals in more rural areas as well. Cardiologists working in hospitals will likely earn more money than those with private practices, but they should also expect to work longer, more unpredictable hours in a hospital setting.
While working in the field of cardiology may require additional years of training and a more rigorous work environment, the extra effort is rewarded in higher salary potential and a worthwhile career helping patients to care for one of their most vital organs.