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Q&A – Dr Waqar Aziz, Cardiology SpR, St Thomas’ Hospital, London


What first attracted you to cardiology? I remember the first organ I learned about in school biology was the heart. In medical school I found myself drawn to everything related to the cardiovascular system and loved to work out ECGs. Working in cardiology I realised the range of treatments that patients can be offered and how the specialty is always on the cutting edge of biomedical technology. I loved the ability of cardiologists to save patients’ lives – for example in acute MI – and the potential to very quickly improve a patient’s quality of life whilst reassuring others about their cardiovascular health.


What do you enjoy most about the job? I love using the latest cutting edge technology (i.e. fancy gadgets!) to benefit patients every day. I also enjoy learning skills that can potentially save a patient’s life instantly such as percutaneous coronary intervention or emergency pericardiocentesis. Cardiology provides a great balance between clinical medicine and the use of the latest technology and procedure-based care.


outpatient clinical duties – including coronary care, investigation and interventional procedures – with some time in theatre or on the ward. Cardiologists may work some of their time as part of acute medical admissions teams looking after emergency medical admissions to acute medicine units. Sub-specialisation within cardiovascular medicine has become


commonplace with individuals focussing the development of their expertise in areas such as cardiac imaging, coronary intervention, heart rhythm disorders, adult congenital heart disease or heart failure. RCP London figures show there are currently more than 700 people


training in cardiology in the UK – a quarter of whom are based in London – with the vast majority (77 per cent) male. Specialists in this field are often categorised as the most high profile and practical-skill based of the medical specialties, with RCP London identifying the three key personality traits as: committed, dynamic and level-headed. It is a field that is constantly changing and innovating. Looking to the


future, the NHS Careers website predicts: “New imaging modalities such as magnetic resonance and CT scanning are likely to complement and challenge the invasive investigations performed in the cardiac catheter laboratory,” adding: “The specialty is determined to evolve in a way which continues to make it attractive to the brightest medical graduates, irrespective of gender.” Cardiology may be a highly competitive and demanding specialty but


treatment can make a real and immediate difference to both quality of life and life expectancy, making it a challenging but very rewarding field.


Sources • NHS Medical Careers – www.medicalcareers.nhs.uk


• Joint Royal Colleges of Physicians Training Board (JRCPTB) - http:// www.jrcptb.org.uk/specialties/cardiology


• The British Cardiovascular Society – www.bcs.com • British Junior Cardiovascular Society - tinyurl.com/oxkqgau


Joanne Curran is an associate editor of FYi


What do you find most challenging? Working in a busy specialty with a fast turnover of patients can make it difficult to keep abreast of the many developments whilst at the same time learning new procedural skills and having a personal life. However, this is not impossible. To survive in cardiology you must show dedication and hard work but at the same time have patience and learn to appreciate the road.


Has anything surprised you about the specialty? The ability and willingness to incorporate new innovations into the care provided to patients is something that surprised me and continues to feed my unquenchable interest in the field. The multidisciplinary aspect, interacting with cardiac echocardiographers, physiologists, cath lab staff, CCU and ward staff and other specialties like cardiothoracics to provide essential care to patients was something that I only realised once I started working in cardiology.


What do you consider the most important attributes of a good cardiologist? As with any medical specialty, attributes like empathy, kindness, team work, a strong work ethic, enthusiasm, perseverance and leadership are essential. As too are being willing to work outside of your comfort zone, being decisive, anticipating potential complications and knowing your limitations. Working with often critically ill patients and performing delicate procedures, you must be prepared for inevitable complications. Being able to enjoy the highs whilst persevering through these lows and supporting each other through these is what also makes a good cardiologist.


Is there any advice you could give to a final year or FY trainee considering cardiology? Knowing which specialty you want to do is the most important first step, enabling you to set out the goals to achieve before joining higher specialist training. I would recommend pursuing the membership exams first and then try to obtain presentations/ publications in your chosen specialty. Sub-specialties cater for a range of tastes. Invasive ones include interventional cardiology, and devices and electrophysiology. Non-invasive ones include heart failure/ imaging and also adult congenital heart disease and inherited cardiac conditions. Remember this is a lifelong process of learning and you must enjoy the road whilst progressing towards your chosen destination.


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