INSIDE INFORMATION

"Cardiology is a fabulous combination of clinical medicine, imaging and procedural intervention. It is possible to make huge a difference in people's lives. I wouldn’t have done anything else even if it meant leaving my home and training in another part of the world."

Dr Srija Bhattacharyya, Cardiology Registrar, Auckland District Health Board

Click on the questions below to view comments from more clinicians.

Why did you choose this specialty, and what do you most like about it?

 

	Contributors all chose this field because of the nature and variety of work. Cardiology is said to combine the intellectual aspects of a medical specialty with considerable opportunity for procedural work. Practice may include angioplasty, radiofrequency ablation, pacing and cardiac biopsy. The specialty is a particularly rewarding area of work since you are able to make dramatic improvements to a patient’s symptomatic and functional state. In most cases it is possible to return the patient to a normal life.

 

	You should possess good medical knowledge and aptitude for technical procedures: one contributor commented that it is necessary to have a ‘physicianly attitude’ with slight surgical tendencies. Specific abilities vary depending on the particular area of interest.

 

	Much cardiology work is procedure-based so set lists, catheter laboratories and clinics occupy a large proportion of the working week. You would also expect to care for patients on the ward. There can be a moderately high rate of call-in, depending on your particular area of interest and expertise. Most consultants work more than 50 hours per week.

 

	As technological advances are made and the cost of interventions increases, the most significant issue facing cardiology in New Zealand will be the appropriate use of new technology. It will be a challenge to retain good levels of clinical care given the constraints imposed by restrictions on health spending. Cardiologists currently have to cope with the demands of patients who are increasingly aware of treatment options (because of information available on the internet) in the context of rationing. Developments in gene therapy and molecular cardiology will also challenge the specialty.

 

	Contributors advise that you should talk to trainees and consultants and that you should not be put off by the on-call commitments if you are attracted to the specialty. Within cardiology there are areas of interest to suit everyone. Although the advanced training programme is three years in duration, it is recommended that you should spend four years in training. It is also advisable to spend a period of time (one to three years) completing post-Fellowship training overseas, and it would be worthwhile studying towards an MD or PhD.

 

	Prospects in cardiology are seen as being reasonable. Contributors commented that although it may appear at times that openings are scarce, there is growing demand for the specialist services of cardiologists because the prevalence of heart disease in the population is increasing. Opportunities for employment do continually arise.

 

	As in any profession it is difficult to take time out from training to start and raise a family, although this is becoming easier with increasing opportunity for part time appointment. Travel as part of training is encouraged: an overseas cardiology fellowship is a near requirement if you wish to develop a particular area of interest or expertise. Once you are established in a permanent position, leave for travel will depend on the size of the department and the availability of locum and cross-cover.

 

	Support from home is important since cardiology is not seen as being especially ‘family-friendly.’ Long hours of work and on-call and call-back commitments inevitably have an impact on family life, and even once you are a consultant you might still expect to be called during the night. Contributors commented that the demands of the job are comparable with those in other professional careers.

 

	The call frequency could be considered a disadvantage, although the extent of this commitment varies between the different areas of the specialty. Cardiology is increasingly technically oriented and resource limitations from capped funding may prove a source of professional frustration

 

	The training programme in New Zealand is well regarded and there is much enthusiasm at present for continuing to make improvements.