I work as a Cardiologist in a busy tertiary university hospital, where I treat patients medically or with life saving cardiac procedures. Cardiologists are specialist doctors who diagnose, treat and help prevent diseases that can affect the heart and blood vessels. A wide range of patients are treated from babies through to adults. The work can involve treating patients with on-going and long-term illnesses. However my work also entails responding to emergency and potentially life threatening scenarios. It is important to be emotionally resilient when working in these challenging situations and be comfortable working in a fast-paced and pressurised environment. Diseases encountered are arrhythmias, coronary artery disease, valve disease, heart failure, inherited heart conditions and congenital heart disease.
I work in the cardiac catheter lab, which I really enjoy. Patients can be local or transferred from another hospital for complex device implantation. A typical patient is a 68-year-old gentleman who has had previous cardiac bypass grafts for ischaemic heart disease. He now has heart failure and has had previous hospital admissions with this condition. A cardiac resynchronisation therapy implantation is carried out with the assistance of a specialist registrar. The specialist registrar is a electrophysiology and devices trainee and has 1 year remaining prior to the completion of cardiology specialist training. The trainee is taught how to implant complex devices. The case usually takes about 90 minutes to perform but can be longer depending on the complexity of the case. It is essential to be focused on attention to detail in mentally complex situations. Working as a cardiologist requires high levels of confidence in skill, knowledge and flexibility. It is important to make quick decisions and remain calm in stressful situations. The job can be extremely pressurised and time critical. An example is carrying out emergency procedures such as coronary intervention. It is important to be an excellent team worker as you are working besides colleagues who are trained to support cardiology work. The work can involve long hours and it can become extremely busy.
Within cardiology there are many sub-specialities, which make this career very interesting and you can offer a lot to cardiology patients. The sub-specialties comprise of interventional and structural cardiology, imaging, heart failure and transplantation, adult congenital heart disease, electrophysiology and devices and inherited cardiac diseases. In interventional cardiology percutaneous coronary intervention is carried out and stents are deployed in the coronary arteries for an acute myocardial infarction or angina. Structural intervention usually involves implanting a valve via blood vessels. One common structural intervention is TAVI (transcatheter aortic valve implantation). Cardiac imaging involves interpreting a range of tests and images that are carried out on the heart which include echocardiograms, cardiac MRI and CT scans. A cardiac electrophysiologist identifies and treats heart rhythm disorders through medication and invasive procedures such as ablation or device implantation. A heart failure and transplant cardiologist maintains and treats patients with heart failure and works with patients with heart transplants.
I regularly review my emails and address any queries. I then catch up with my administration work. This is associated with patients’ treatment. Paperwork can take a lot of your time.
The following day I spend time doing my academic work. Academic cardiology enables the development of both my research and teaching skills, this is a great opportunity to balance academia and education. Cardiology is one of the most evidence-based specialities and has many research opportunities in academia. As an academic cardiologist, I have the opportunity to take part in ground-breaking research. This can have a significant impact in leading to new knowledge. This can be presented in leading international journals and conferences to benefit patients worldwide. I also enjoy teaching medical students and trainee doctors.
On other days I have an outpatient clinic where I review patients referred from colleagues from primary care. I help identify their problem and instigate tests and offer treatment. It is an important attribute to be a good problem solver with an analytical mind. Patients can be from young adults to elderly and it is essential to be an excellent communicator and be able to understand and empathise with your patients.
I review patients on the ward who attend acutely in hospital with their cardiology problem. I am faced with many of their acute problems. It is important to be assertive in certain situations and have the ability to make good decisions. You work as a team and it is an important attribute to be a good leader in the face of persistent challenges. The hours of work can be 40-50 hours a week and the frequency of on-call can be high. It is important to strike the right balance with work and life.
I enjoy cardiology as it provides me with a career wherein I can offer a lot to my patients from medical therapies through to life saving procedures.