Dr Iain Simpson discusses cardiology, the diversity of the specialty, the importance of teamwork, and what it is that makes him happiest.
Introduction to cardiology
Cardiology is a unique, all-encompassing specialty covering primary/secondary prevention and acute/chronic conditions with medical, percutaneous and surgical management options. The specialty has a solid evidence-base and a plethora of research opportunities from bench to bedside.
Cardiology offers a vast array of career opportunities. Cardiologists can specialise as general cardiologists with an interest or develop a subspeciality interest such as imaging, coronary intervention, structural heart disease and intervention, electrophysiology and devices, and GUCH amongst others. Each subspecialty increasingly involves a multidisciplinary team of general cardiologists, imagers (cardiologists, radiologists), interventionists, electrophysiologists and cardiac surgeons for evidence-based decision-making. Interactions with other specialties are frequent to address risk factors, comorbidities and rehabilitation.
Cardiologists specialising in imaging use simple or complex echocardiography, CT, MRI and nuclear medicine often in conjunction with radiologists to aid diagnosis. Coronary intervention involves assessment (non-invasive, angiography, intravascular ultrasound (IVUS), optical coherence tomography (OCT), pressure wire, (FFR)) and management (medical, coronary stenting or bypass surgery) of elective and acute coronary syndrome patients with contribution to 24/7 on-call primary angioplasty, PPCI, and rotas for heart attack patients.
Why did I choose cardiology and why I would recommend it to others?
Cardiology is a broad speciality offering many different career opportunities and interaction with a wide multidisciplinary team and other specialties. It is not surprising that cardiology remains a popular and competitive speciality!
Dr Sarah Clarke, consultant interventional cardiologist and president elect of the British Cardiovascular Society
What is unique about cardiology?
The specialty of cardiology combines physicianly, radiological and surgical skills all in one specialty. It is a specialty which makes a real difference to both quality of life and life expectancy and this is extremely rewarding.
Dr John Ian Wilson, consultant cardiologist, Mid Yorkshire Hospitals NHS Trust, Wakefield. SAC chair in cardiology
Training and working in cardiology
Five key facts about training in cardiology from the Specialty Advisory Committee (SAC) for cardiology chair Dr Ian Wilson:
- This is a 5-year programme consisting of 3 years of core cardiology training which includes training in general internal medicine followed by 2 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, inherited cardiovascular conditions or further internal medicine.
- There is opportunity to spend time out of programme in order to engage in research (usually for the purposes of obtaining a higher degree) or to further to one’s experience during Advanced Modular Training, time which is frequently spent abroad.
- The curriculum is fully flexible and able to be modified to accommodate part time training (LTFT and academia). Currently, just over 20% of cardiology trainees are female and it is important to increase this number. The flexibility within the programme and the large choice of subspecialty with varying on-call commitments makes this possible.
- The end product is a general cardiologist trained to deal with all acute cardiological emergencies presenting at 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 so providing front door emergency care along with a variety of local subspecialty services.
- Entry to the training programme remains highly competitive, and potential trainees often go the 'extra mile' to make themselves competitive. Success however leads to a most fulfilling career.
Visit the Joint Royal College of Physicians Training Board (JRCPTB) for further information on training in cardiology. Learn more about the recruitment and interview process by visiting the ST3 recruitment page.
- British Cariovascular Society
- BCS/Mayo Clinic Cardiology Review Course (5 days) - update across the speciality in preparation for the knowledge based assessment, KBA, examination
- Heart Journal - Heart, the official journal of the BCS, is an international peer reviewed journal.
- OpenHeart - Open Heart is an online-only, open access cardiology journal published jointly by BMJ and BCS.
- BMJ articles related to cardiology
- Stroke prevention by percutaneous closure of patent foramen ovale: a systematic review and meta-analysis ( Heart / 10.1136/heartjnl-2013-304394)
- The clinical value of serial measurement of high-sensitivity cardiac troponin T in acute exacerbations of chronic obstructive pulmonary disease ( Open Heart )
- Electrocardiographic interpretation in athletes: the 'Seattle Criteria' ( British Journal of Sports Medicine / 10.1136/bjsports-2012-092067)
- Left ventricular thrombus formation after acute myocardial infarction (Ronak Delewi1, Felix Zijlstra2, Jan J Piek1 / Heart )
- Medical Care: Cardiology section
- Clinical Medicine CME (December 2013 issue)
- Census of consultant physicians 2012 - cardiology
- Future Hospital Programme Case Studies:
- RCP projects relating to cardiology:
Historical highlights from the library, archive and museum collections
Probably the most famous fellow in RCP history is William Harvey (1578–1657). His major contribution to medicine was his research into the circulation of blood around the body. This discovery was published in De motu cordis et circulatione sanguinis in 1628. The RCP library has a first edition of this book, including its famous illustrations of blood flow in the arm.
A wealth of resources on the history of the specialty were collected by the esteemed cardiologist and RCP fellow Evan Bedford (1898–1978). From the time of this training onwards he collected books concerning the history and development of field. By the time of his death he had amassed over 1,000 books dating from 1514 to the 1960s. The Evan Bedford Collection represents a major feat of book collecting and scholarship; it was given to the RCP, and now forms part of our library .
One of the treasures of the RCP museum is set a set of six anatomical tables displaying human veins, arteries and nerves. The circulatory and nervous systems were dissected at Padua’s famous anatomy theatre in the 17th century, and then skilfully arranged on varnished wooden panels. The tables were long thought to have belonged to William Harvey, but are now known to have been owned by Sir John Finch (1626–82). The tables are displayed publicly on the top floor of the RCP building in London.