08 FYi • Career


OF MEDICINE


HEART AT THE


The dynamic specialty of cardiology offers a broad range of career opportunities at the cutting edge of medicine


C


ORONARY heart disease is the leading cause of death in the UK, claiming more than 73,000 lives every year. These stark figures are among the key factors driving efforts to more effectively prevent, diagnose and treat this condition, helping to make cardiology one of the most innovative and dynamic medical fields.


Managing coronary heart disease patients forms only part of a


cardiologist’s role. They also treat those with heart failure, arrhythmias, cardiomyopathy and more, undertaking invasive procedures such as catheterisations and fitting pacemakers, along with non-invasive imaging and cardiovascular clinical pharmacology. There is a strong focus on working within multidisciplinary teams and


a wide range of sub-specialty areas to pursue, as well as varied research opportunities.


Entry and training Doctors looking to enter the specialty must successfully complete both foundation and core training programmes. For the latter, there are two available routes: core medical training (CMT) or acute care common stem - acute medicine (ACCS-AM). Trainees are also expected to achieve full membership of the Royal College of Physicians (MRCP(UK)) before progressing to the next level of training (ST3 – ST7). They will also have to register with (and pay the relevant fees to) the Joint Royal Colleges of Physicians Training Board (JRCPTB) at the start of specialty training. Cardiology specialty training (beginning at ST3) takes five years. The


first part consists of three years of core cardiology training, including training in general internal medicine. This is followed by two years of advanced modular training in either (or with combinations of): interventional cardiology; electrophysiology and devices; imaging (echo, MR,CT and nuclear); adult congenital heart disease; heart failure; academic cardiology or inherited cardiovascular conditions. For trainees who wish to dual certify with general internal medicine


(GIM), up to one extra year is usually required, the total time being dependent on previous GIM training within the core years. Dr Ian Wilson, consultant cardiologist, VP of training for the British


Cardiovascular Society and Chair of the RCP specialist advisory committee, said: “Upon completion of this programme, we have a general cardiologist (or cardiologist/general physician) trained to deal with all acute cardiological emergencies presenting to the ‘front door’, but with advanced skills in a cardiology subspecialty. “The modern trend is for teams of cardiologists with different subspecialty interests to work together, providing front door emergency care along with a variety of local subspecialty services.” Cardiology is a very competitive specialty and trainees are advised to plan ahead to seek out ways to improve prospects and prepare thoroughly for interviews. It can be useful to carefully read the person specification, talk to the cardiology training programme directors, take every opportunity to publish (case reports, reviews, audits, etc), consider taking a higher degree (e.g. MD or PhD), and do what you can to “tick” the necessary boxes. Where appropriate, consider applying to less competitive deaneries to improve your chances of success. The British Cardiovascular Society (BCS) runs an annual, one-day


course for core and foundation level doctors who are considering specialty cardiology training, with the next event taking place on 23 October, 2015 at the RCP, London. A Career in Cardiology aims to improve delegates’ chances of securing a cardiology training post and includes specific sessions on the ST3 application process and mock interviews. Advice can also be sought from the British Junior Cardiovascular


Society (BJCA) who have recently established a free ‘Starter BJCA’ membership for foundation programme and core trainees interested in undertaking higher specialty training in cardiovascular medicine.


The job Cardiologists are largely hospital-based, working closely with both community-based primary care doctors and other hospital specialists including diabetologists, nephrologists and cardiothoracic surgeons, as well as anaesthetists and the imaging specialties (e.g. radiology and nuclear medicine). Key members of the cardiology care team also include specialist nurses, cardiac physiologists and cardiac surgeons. Consultants generally divide their time between inpatient and


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