Introduction

Cardiology is one of the most popular and varied medical specialities. It is a field that combines acute care with long-term patient management, offering a diverse range of subspecialties, including interventional cardiology, adult congenital heart disease, electrophysiology, imaging, and specialist heart failure management. Whether you enjoy working in the high-stakes setting of a cath lab or improving patient outcomes through prevention and rehabilitation, cardiology offers something that aligns with your interests and career aspirations. There are a range of skills to develop with cardiology. This includes practical and analytical skills that you will develop during training. Research remains encouraged within cardiology, and there will be an opportunity to develop a range of academic interests.

Cardiovascular conditions are very common and make up a significant proportion of co-morbidities for a range of medical patients. Cardiology as a field is continually developing to meet such demands. This allows you to apply the latest evidence-based practices to make a difference in the healthcare of many patients, making cardiology a very fulfilling and enriching career.

Cardiological input is required at both district general hospitals and tertiary centres; therefore, as a consultant, you can choose where you would like to work. There are opportunities to take up sessions at DGH and tertiary centres in a range of appointments.

Eligibility

To apply to Cardiology, one should have full MRCP, evidence of achieving core competencies or equivalent and a full registration with a license to practice with GMC. Cardiology is a Group 1 speciality, meaning it requires completion of IMT 3 or equivalent.

When and where to apply?

Cardiology applications typically open around November, and since 2012, there has been no Round 2 for Cardiology. All applications to Cardiology are made nationally via the Oriel Application System. Late applications are not accepted, so checking the dates for the application year and applying well in advance is essential.

Once you submit your application on Oriel, it goes through longlisting, where your application is assessed to ensure you meet the eligibility criteria for applying to the speciality. The scoring system does occasionally change, and it is worth reviewing this before application.  This is followed by application shortlisting, which is based on application self-assessment and verification of your self-assessment score. A limited number of applicants who score the highest mark are invited to the interview. Later, you must upload the evidence for the score you assigned while applying, which is reviewed and assessed.  

Please note that there are two marks for thorough evidence organisation, so it is crucial to ensure you upload the correct evidence for each domain.

Detailed guidance on scoring applications can be found under the Application scoring section on the PHST website. Your achievements should be related to cardiology to show your commitment to the specialty.

Interview

The Cardiology interview lasts about 50-55 minutes and is split across two stations, each lasting about 22 minutes.

The first station involves the following questions.

• Suitability and commitment to the specialty

This is an opportunity to talk about all your achievements and how they make you a suitable candidate for Cardiology.

• Medical registrar suitability

This discussion will be driven by a short verbal question provided by the interviewers that assesses your ability to manage an acute unselected medical take and manage a multi-disciplinary team.

• Professionalism and governance

This section is based on your understanding of GMC Good Medical Practice and must demonstrate that you are able to apply the GMP principles in your practice.

The second station comprises two clinical scenarios, each followed by a discussion based on the scenario. In this section, you are also assessed on your communication while discussing the two clinical scenarios. Typically, there are long and short cases. A range of interview courses are available, which can be helpful for practice. It is often helpful to obtain advice and guidance from cardiology consultants and registrars.

Ranking

Based on the scores of the two stations, you are assigned an interview score (out of 80). Your interview score is added to the application score (out of 20) to form a total score (out of 100). The total score ranks you in the national recruitment to the specialty.

Further information on the interview and scoring can be found here – https://www.phstrecruitment.org.uk/specialties/cardiology

You can find more information about the application numbers, post numbers and competition rations under the data section of the Cardiology page on the PHST website.

Interview advice from a Cardiology registrar

Interviews can be difficult; however, by being prepared, you can optimise your chances of success. The first element is being prepared for the structure of the interviews. This can be done by looking at the cardiology interview section on the application process. Next will be to speak to previous registrars and consultants about the interview process. Similar themes and questions will be asked every year, and by gaining this experience, you can be as prepared as possible. Obtaining practical experiences, such as being in the cath lab, attending echo sessions and gaining on-call experience even in a shadowing role, may help you understand the practical elements of clinical scenarios. Lastly, practice is a crucial element of the interview technique. Being able to deliver answers confidently will improve your score. Practising with colleagues and obtaining feedback will hopefully help you develop your answers to a suitable level.

A week in the life of a Cardiology registrar

A week in the life of a cardiology registrar is varied. You will often be involved in a range of inpatient and outpatient work. This will consist of clinics providing care to various patients and also allow for the management of chronic conditions. There are often outpatient echo lists to scan a variety of patients from a range of specialities; from pre-operative patients, pre-chemotherapy patients to chronic cardiology conditions. There are many academic opportunities, including the opportunity to attend multi-disciplinary meetings in a range of subspecialties. In cardiology, the MDT is essential, and regularly, we work with nurses, specialist nurses, surgeons, physiologists, radiographers and radiologists.

Inpatient work is often varied. This can involve the cath lab, in which you will undertake and learn how to pace, complete angiograms and other procedures. You will see referrals from a range of medical and surgical specialities. You are often available to advise colleagues in A&E, theatres or other parts of the hospital to manage acutely unwell patients. There is an emphasis on continuous professional development, and you will be encouraged to attend courses and deanery teaching days to improve your skills. Cardiology is a busy, multifaceted and highly rewarding specialty, with lots of room to develop as you train.

Written by Dr Kaustubh Patil (IMT1) and Dr David Saliu (Cardiology Registrar ST 5)