If you'd like to make a positive impact on the health and wellbeing of people whose lives are affected by illness of the cardiovascular system a career in cardiology may suit you

Cardiologists are doctors who specialise in diagnosing, treating and preventing diseases that mainly affect the heart and blood vessels.

You'll work with adult patients to treat ongoing, long-term illnesses or will respond to emergency, potentially life-threatening situations.

Conditions you will encounter include:

  • angina
  • arrhythmias
  • cardiomyopathy
  • congenital heart disease
  • disease of the arteries
  • heart attacks
  • heart murmurs
  • oedema.

As well as working to improve survival rates and quality of life, you'll also be involved with disease prevention.

Paediatric cardiologists work with children and this is a separate specialty.

Types of cardiology

You have the opportunity to become a general cardiologist or to specialise in a specific area. General cardiologists diagnose and treat diseases of the blood vessels and heart and also have an interest in the prevention of disease.

The cardiology sub-specialty is stroke medicine but many cardiologists choose to develop their role in areas of sub-speciality interest, such as:

  • adult congenital heart disease - a heart condition or defect you're born with
  • cardiac electronic device therapy - uses devices such as implantable cardioverter-defibrillators to treat patients with heart failure or arrhythmias
  • cardiac imaging - reads and interprets a range of tests and images that can be run on the heart, including echocardiograms, MRI scans and cardiac CT scans
  • electrophysiology - works with the bio-electric impulses of the heart to help identify and treat problems, such as irregular heartbeats, through medication and invasive procedures
  • heart failure - supports and treats patients with heart failure, including cardiac transplants
  • interventional - performs advanced cardiac procedures such as stent placements in closed or diseased arteries, atherectomy and balloon angioplasty.

New areas of sub-specialisation include inherited cardiac conditions.

If you're more interested in the science behind cardiology, you could pursue academic opportunities in the field of research.

Responsibilities

As a cardiologist you can expect to:

  • treat patients by reviewing and understanding their medical backgrounds and examining them to assess their current condition and health
  • look at and employ ways of preventing, diagnosing and treating a range of heart-related problems
  • carry out tests such as echocardiograms and interpret test results to measure how effectively the heart is working, which will help you to decide on the best method of treatment
  • perform specialist procedures, such as cardiac catheterisation, to help diagnose and guide treatment of a variety of heart conditions
  • carry out a range of advanced interventional or surgical cardiac procedures, such as coronary artery bypass surgery, stenting or coronary angioplasty
  • prescribe medication to patients to help treat a range of cardiac illnesses
  • provide ongoing support and advice to patients under long-term care
  • work effectively in a multidisciplinary team, collaborating and liaising closely with colleagues
  • provide support and advice to colleagues working in other specialities
  • practise governance and audits within your department
  • complete administration, which can include anything from accurately recording patient interventions and referrals to overseeing budgetary information
  • teach and provide educational support and training for junior staff
  • carry out clinical research in your area of interest
  • be at the forefront of trialling breakthrough treatments and medication developed by pioneering research.

Salary

  • Junior hospital trainees can expect to earn £28,243 (Foundation year 1), rising to £32,691 (Foundation year 2). As a trainee doctor you'll receive a basic salary, plus salary enhancements for any hours which can be classed as unsocial.
  • Salaries for qualified doctors starting specialist training (early career cardiologist) are between £38,694 and £49,036.
  • A speciality doctor (senior cardiologist) can expect to earn a basic salary of £41,158 to £76,751.
  • As a consultant cardiologist your basic annual salary will range from £82,096 to £110,683, with the opportunity to earn more if you have additional managerial or educational responsibilities. You can also add to your basic salary by taking on work in private practice in addition to your NHS contracted hours.

Figures relate to the pay and conditions of medical doctors within the NHS - the largest employer of cardiologists in the UK.

Income data from NHS Health Careers. For salary figures in Scotland, Wales and Northern Ireland, see the BMA website.

Figures are intended as a guide only.

Working hours

Cardiologists often work irregular hours and are frequently on call at the weekend. You need to be flexible as hours can be long.

Cardiologists typically spend around 75% of their time per week on direct clinical care. The rest of the time is spent on support activities such as meetings, providing advice to colleagues in other areas of specialism, clinical research and teaching.

There are some part-time cardiology opportunities are available.

What to expect

  • Working as a cardiologist requires high levels of skill, knowledge and resilience. The work can be pressurised and time-critical in some instances (for example, carrying out surgery or emergency situations), and you'll often work long hours in a busy environment.
  • As a practitioner, you'll usually be based in a hospital. Cardiologists following an academic or research career are more likely to be based in a lab environment.
  • You'll work as part of a team including cardiac surgeons, cardiac physiologists and specialist nurses.
  • Women are currently under-represented at consultant level. Organisations such as the British Cardiovascular Society are actively looking to increase the numbers of women training in cardiology.
  • Cardiology is likely to take you to some emotional highs and lows. On the one hand, you can be working with patients in some very difficult medical situations such as end-of-life care, but on the other, you can save lives and help people recover from potentially life-threatening illnesses.

Qualifications

To qualify as a cardiologist, you'll first need to complete a degree in medicine recognised by the General Medical Council (GMC). This usually takes five years to complete, although if you've already got a degree in a subject other than medicine (normally a 2:1 or above in a science-related subject), you can apply for a four-year accelerated medical graduate trainee programme (also known as the Graduate Entry Programme).

You'll then go on to complete the two-year UK Foundation Programme, common to all medical graduates. During this time, you'll work in hospitals as a junior doctor on a rotational basis in different departments. Try, if possible, to do rotations in areas relevant to cardiology such as diabetes and endocrinology. On successful completion, you'll be awarded a Foundation Programme Certificate of Completion (FPCC).

At this stage you must complete general medical training, which consists of either a three-year internal medicine stage 1 programme or a four-year acute care common stem (ACCS) programme.

To progress on to higher specialty training in cardiology (ST3 to ST7), you'll need to achieve MRCP from the Royal College of Physicians (or equivalent) to show you have the required knowledge and skills.

Speciality training is competitive and there may not be enough posts for all applicants, even if they've met the required standards. This training usually takes five years, although a large number of trainees also choose to undertake research, which adds on a further two years' minimum. Information and advice on medical specialty training, including competition ratios, are available on the Health Education England website.

At the end of this training you'll receive a Certificate of Completion of Training (CCT) and will be eligible for entry on to the GMC specialist register in cardiovascular medicine. You can apply for consultant positions six months prior to gaining your CCT.

See hospital doctor for full details on the qualifications and training required to be a doctor.

Skills

You'll need to be:

  • able to make quick decisions and remain calm in stressful situations
  • focused on attention to detail in mentally complex situations
  • comfortable working in a fast-paced and pressurised environment
  • a good problem solver with an analytical mind
  • an excellent communicator who is able to understand and empathise with your patients and colleagues
  • confident in your skills, knowledge and ability
  • assertive and a good motivator and leader
  • an excellent teamworker
  • persistent in the face of challenges
  • emotionally resilient when working in challenging situations.

Work experience

Before applying to do a medical degree you're expected to undertake work experience, either paid or voluntary, in areas relevant to medicine. This could be through work experience at your local hospital, doctor's surgery, mental health trust or nursing home, or through work shadowing a doctor. This experience shows your commitment to becoming a cardiologist and provides insight into the physical and emotional demands of working in medicine.

Consider joining your university's cardiovascular student society to keep informed about developments in the field. You could also take a student-selected module, project and elective in cardiology as part of your undergraduate medical degree.

During your two-year Foundation Training as a junior doctor, you should choose a cardiology placement to gain an insight into the work.

Find out more about the different kinds of work experience and internships that are available.

Employers

The largest employer of cardiologists is the NHS, although there are also opportunities in private clinics, universities and academic institutions, the armed forces and national governing bodies.

Academic cardiologists can also expect to find positions within the NHS, universities, academic institutions and the private sector (such as large medical health and pharmaceutical companies.)

As a cardiologist you'll also have excellent opportunities to work abroad.

Look for job vacancies at:

Specialist recruitment agencies also handle vacancies for doctors.

Professional development

As a junior cardiologist, you will have an educational supervisor and may find it helpful to work with them to create your own specific professional development plan. The onus is very much on you to progress your career around areas of particular interest that you develop through your training.

You'll be expected to continue learning and developing throughout your career. This is essential given the rate at which medical developments and scientific research lead to changes in all aspects of medicine, and is essential for remaining on the GMC register.

This learning can take many different forms, including undertaking a piece of relevant research or attending developmental activities such as conferences, exchange events, workshops or training courses. Further information on professional training and development is available from the British Cardiovascular Society.

Career prospects

As a recently qualified junior cardiologist, you'll continue to grow and develop into your role with help from your supporting educational supervisor. Your experience will build as you take on more duties and you'll begin to understand more about which area, or which combination of areas, you would like to work across more specifically.

After a few years, as you progress to become a senior cardiologist, you will continue to develop your chosen areas of specialty, and will also have the opportunity to develop your leadership and management skills.

Cardiologist consultants generally choose to continue training in additional specialities, which means that as you progress to this position you can expect to receive high salaries and have more opportunity to take on senior-level management roles within hospitals.

Management roles include clinical lead, clinical director and medical director. You will also usually be involved in the supervision of junior doctors.

As an academic cardiologist, you'll have the opportunity to engage with pioneering research, which can have a significant impact in the field (this could be prevention, intervention, medical or surgical). You will develop both your research and teaching skills, with the opportunity to blend academia and education within your portfolio.

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