The heart is a fascinating organ -- 60 to 100 beats a minute, 24 hours a day, for decades and decades. It’s also a very complex muscle, so when it doesn’t work properly, there are many possibilities as to why. That’s when you call in a cardiologist. Cardiologists specialize in heart disease and conditions. Some of them, called electrophysiologists, or EPs, specialize even further into heart rhythms.
Education, Licensing and Certification
Cardiologists and EPs are physicians. Like all physicians, they must spend a long time in school. You should plan on four years of undergraduate school and four more of medical school. Cardiologists begin in internal medicine. Cardiology is a sub-specialty of internal medicine, and electrophysiology is a sub-specialty of cardiology. Your residency will be in internal medicine -- another four years. After you pass the internal medicine board exams, you go back to school for a cardiology fellowship, which takes another three to five years. The EP also does still another fellowship of one or two years that is specific to her practice. You’ll need a license to practice in all states, and you’ll probably want to become board certified in cardiology -- and then take a vacation.
In addition to general cardiologists and EPs, there’s another sub-specialty of this discipline, called interventional cardiology. Interventional cardiology and electrophysiology have some shared characteristics. Interventional cardiologists don’t just treat you with medication. They might also perform procedures such as heart catheterizations or put in small tubes called stents to help keep arteries open. EPs insert cardiac devices such as pacemakers, which correct heart rhythm problems. The procedures are performed under general or local anesthesia in a sterile suite, much the same as an operating room. EPs also use an invasive procedure called ablation, which uses an electromagnetic device to correct the heart rhythm.
Because they start as internists, all cardiologists and EPs understand how the whole body works, not just the heart. They know, for example, that one of the complications of diabetes is heart disease, so they will either help their patients manage their diabetes or send them to another specialist. Some patients with heart disease will have both an internist and a cardiologist co-managing their care. Or, a cardiologist will manage a patient’s care until an interventional procedure becomes necessary, and then call in an interventional cardiologist to consult. All three specialists work together for the patient’s benefit.
Because these careers are so similar, it’s really a matter of personal preference which you choose. You’ll need most of the same skills for cardiology or electrophysiology. A steady hand and manual dexterity, however, are more critical for an EP or invasive cardiologist. Empathy and good communication skills are important, according to the U.S. Bureau of Labor Statistics, as well as the ability to organize and sort through lots of information to make an accurate diagnosis. In addition, the BLS notes you’ll need patience, physical stamina and problem-solving skills. You might also like to know that the American College of Cardiology has a special member section just for women, so you can find support and networking opportunities with other women in the field.
- MayoClinic.com: What’s a Normal Resting Heart Rate?
- American Board of Medical Specialties: Specialties and Subspecialties
- Dr. John M: What’s Electrophysiology?
- American College of Physicians: Cardiology
- University of California, San Francisco: Interventional Cardiology
- Cleveland Clinic: Invasive and Interventional Cardiology
- Cleveland Clinic: Cardiac Electrophysiology and Pacing
- U.S. Bureau of Labor Statistics: Physicians and Surgeons
Beth Greenwood is an RN and has been a writer since 2010. She specializes in medical and health topics, as well as career articles about health care professions. Greenwood holds an Associate of Science in nursing from Shasta College.