Sometimes finding the right career can be difficult, but if you have an interest in something specific, like medicine, then it's worth exploring, and a career in cardiology can be incredibly rewarding. This sought-after and important area of medicine is concerned with the cardiovascular system, including the heart and blood vessels.
As such, cardiologists are highly skilled members of the medical community. This article takes you through how to become a cardiologist, from reviewing the role, its responsibilities and requirements, the job market and salary information, to the steps you need to take to enter this career.
Just one of many specialists and types of doctors, cardiologists are professional medical practitioners who specialize in matters relating to the heart and blood vessels, collectively known as the “cardiovascular system”. As a result, cardiologists are often known as heart specialists. Given the critical nature of this system, cardiologists are highly sought-after.
Cardiologists don't just reactively handle cardiovascular diseases or problems, such as angina, heart attacks, high or low blood pressure, heart murmurs or congenital heart disease. They will also work on advising patients worried about cardiovascular diseases or those who are at particular risk of developing one. Cardiologists might also be involved in medical research relating to this area.
Here is a list of the typical duties of a cardiologist:
- Examining patients exhibiting symptoms relating to cardiovascular conditions
- Diagnosing and treating cardiovascular conditions
- Talking to patients and their relatives/companions about these diseases, including treatments and prognosis
- Coaching patients on mitigating cardiovascular risk (such as dietary control or exercise)
- Prescribing medication and coordinating patient referrals where needed
- Regularly meeting and testing patients with a risk of cardiovascular disease
- Communicating with surgery or hospital staff regarding patients and processes
- Training nurses, fellow doctors and support staff on cardiovascular processes and knowledge
- Maintaining accurate records and medical administration duties
- Leading or supporting in urgent care or emergency surgery relating to cardiovascular disease
Cardiologists have very similar working conditions to many other roles in the medical industry. This section discusses the work environment, hours and job satisfaction for cardiologists.
Given the complexities in their line of work, cardiologists enjoy a modern and technologically advanced working environment. Hospitals and clinics with cardiology divisions are typically well-funded and will rank very high in local and national healthcare systems. Therefore, cardiologists will be able to work with the very best equipment and highly competent support staff.
The flip side to this is that expectations and demands are high. Cardiology divisions operate in a literal life-and-death environment, and cardiologists will be subject to high levels of stress and significant workloads, discussed below. They will need to spend time with upset, scared, frustrated, or grieving relatives and will need to control their emotions and rationalize complicated decisions.
This stress and pressure will not just come from patients and their families. Cardiologists will often be in charge of department budgets. Clinical directors will want to see this money used in the best ways possible, and therefore there will be a large amount of bureaucracy and politics involved in the role.
Cardiologist working hours are very long. They might exceed sixty or seventy hours a week. The working pattern will be extremely agile and intense, with shift coverage requiring a mixture of early starts, late finishes, weekend work and many consecutive days without time off. Like in many areas of medicine, cardiologists might also have to work night shifts. They will have to spend days and nights on call, where they will stay and sleep in the hospital, being called up for emergencies or last-minute work wherever needed.
Cardiologists typically enjoy high levels of job satisfaction, driven by a fair workplace and the rewarding nature of what can be accomplished in the role. One recent US survey indicated that male cardiologists are moderately satisfied in their role, with 88% of female cardiologists feeling the same. The report indicated that there is still a gender pay gap in the role, with salaries higher for male cardiologists and the career path being a little harder to access for women.
Despite these high levels of satisfaction, there is room for improvement. A survey by the American Heart Association indicates that 27% of cardiologists suffer from career burnout, and a recent report has stated that many cardiologists are dissatisfied with their pay, especially in regards to their high levels of responsibility.
Like many areas of healthcare, cardiologist roles are expected to increase significantly over the coming years as an ageing population and tighter labor market increase the need for skilled doctors. The Bureau of Labor Statistics predicts that the projected employment levels for cardiologists will increase by 5% from 2020 to 2030. Furthermore, the American College of Cardiology writes of a real shortage in qualified cardiologists, meaning that those who are trained and ready to get going in this field will be able to choose their role, and can “shop around” for a position which truly fits their values and other motivational or career aspirations.
The states with the highest number of cardiologists (per 1000 jobs) are New Jersey, New Hampshire, Delaware, California and Colorado.
The average salary for a cardiologist in the US is $300,589. The entry-level wage, on average, is $250,000, with junior level being approximately $282,000, mid-level being around $307,000, and those at a senior level earning around $315,000. This is because of their knowledge and the scope of their role.
The states offering the highest average salaries for cardiologists are Arizona, Arkansas, Hawaii, Colorado and Delaware. If you’re looking at an international career as a cardiologist, then the top-paying countries outside the US for this role are Belgium, Finland, The Netherlands, Norway and Iceland.
So, if you have reached this far and still think that cardiology is the right job for you, then take some time to consider the skills and attributes needed for success in this role. Although individual medical institutions might ask for different levels of experience and skill profiles, cardiologists will typically need to be strong in the following areas:
- Dexterity and manual coordination skills
- Problem-solving and critical diagnosis skills
- Decision-making capabilities
- Communication skills that can be adapted to a wide audience (patients, colleagues, clinical directors, and relatives)
- Emotional intelligence
- Resilience skills and being able to remain calm under intense pressure
- Reliability and time management skills
- Teamwork and the ability to manage people across various areas and teams
- Training and mentoring abilities
- Attention to detail
Becoming a cardiologist takes a great amount of planning, preparation, education requirements, and training. This section takes you through steps on how to become a cardiologist and the professional skills you need to get started.
Step 1: Determine if it’s the right job for you
Based on the skills and attributes needed for success in cardiology, you should consider these and think about whether they align with who you are. For example, if you are naturally detail-oriented, communicative, and calm, then this could be a good alignment to the role.
Similarly, in order to consider what career might be right for you, think about your values and what makes you tick. Caring and nurturing people, for example, could be a good fit for cardiology. Another thing to consider is taking a career test to see how your skills and values align with various professions. One example is CareerHunter's six-stage assessment. These six tests, mapped out by psychologists, provide you with a career profile that sets out training and possible career pathways based on your results.
Step 2: Focus on the right subjects at school
Cardiology will require a strong base set of subjects at school. These will certainly include English, mathematics and sciences (such as physics, biology, and chemistry). Other useful subjects could be Business Studies, and even Latin or other languages, to support with medical terminology at a later stage in your career.
Step 3: Earn a bachelor’s degree
In order to progress to medical school and earn your Doctor of Medicine (MD) qualification, three years of undergraduate study is required. There are many medical-related bachelor’s degrees you can study, depending on the area of medicine you wish to explore. Undergraduate qualifications in sciences (especially Biology of Life Sciences) are also widely accepted.
Step 4: Attend medical school
To become a medical doctor in the US, you will need to complete an MD program, which is a four-year doctorate with practical training, alongside exams and theory. The course becomes more practical and clinical in the final two years. Entry into a medical school where you can work on your MD will require a passing grade in the Medical College Admission Test (MCAT), provisioned by the Association of American Medical Colleges (AAMC).
Step 5: Take the United States Medical Licensing Examination
Next up, you will need to take your United States Medical Licensing Examination (USMLE), which allows you to practise medicine in the US. The USMLE is a three-step examination process designed to assess your understanding of medical concepts and science, the application of this knowledge, and independent assessments testing your competence in performing medical procedures unsupervised.
Step 6: Complete a residency program
A residency program will allow you to practise medicine in a healthcare setting, complete with training, coaching, mentoring and other support. You might complete a residency while you are getting qualified, but more commonly it will be for a period of three years after you attain your MD. Residencies are a prerequisite for cardiology licensing and will help you understand the differences between clinical theory and putting your knowledge into practice.
Step 7: Get licensed
Whereas licensing for cardiologists will vary from state to state, you will always need to be a graduate of an accredited MD program and pass a criminal background check. Once you have attained your USMLE, you will be able to get a licence to practise cardiology in all US states, with the key variances being in the state’s individual application process more than differences in what is required. A state medical licence is needed for board certification.
Step 8: Get board-certified in internal medicine
The next step is to get board-certified in internal medicine. This certification is conducted through the American Board of Internal Medicine (ABIM). This is an examination taken to ensure you are fit to practise medicine. When you have passed this demanding exam, it is time to revisit the ABIM and look at fellowships.
Step 9: Complete a fellowship program
Cardiology fellowships last three years following the completion of your residency and are run via the ABIM. Fellowships allow you to focus on specialisms and provide you with a wealth of in-depth knowledge about cardiology. The other important aspect to a fellowship is ensuring that you are provided with up-to-date knowledge regarding cardiology. The ABIM will also ensure you remain qualified in these areas through seminars, continuous learning, and mandatory recertification.
Step 10: Get board-certified in cardiovascular disease
Following the completion of your fellowship, you will complete the fourteen-hour Cardiovascular Disease Certification Exam. These exams are mapped out using ‘blueprints’ that tell you what to expect, as well as pass marks and award criteria. Once you pass this exam, you are released into the big wide world of cardiology practice!
Cardiology is an immensely demanding but equally rewarding role. Those in the role are paid well and enjoy high career satisfaction. If you have read through this article and have decided that you want in, then you really need to start planning the long road to getting qualified as a cardiologist. This takes time and a fair amount of effort but can be facilitated with a detailed career plan.
Another good idea to help you kick start your cardiology career is to network with cardiologists, for example, through LinkedIn. These individuals might be able to give you personal advice about navigating the qualification and licensing routes in order to expedite your development into this incredible industry. Good luck!
Are you interested in cardiology? What are your next steps to becoming a cardiologist? Let us know in the comments below!
This is an updated version of an article originally published on 11 December 2014.