Job Reviews: Cardiology as a Foundation Doctor

Everyone is expected to do a variety of medical, community and surgical rotations. I enjoyed cardiology throughout medical school and prioritised it as one of my top picks. I will discuss the kind of tasks involved, some of the good points about the job and some of the more challenging parts of it.

What will we cover?

So, what kind of things does a cardiology foundation job involve?

    • WARD ROUND: We always began the day with a board round, and we saw patients on ward rounds. I started to learn that different consultants run their ward rounds differently. Some wanted senior-led reviews on every ward round they run, whilst others wanted me to see patients independently. This was an excellent chance to gain skills in reviewing patients alone and gain some confidence in doing that (especially useful for my orthopaedic placement in my second year of foundation training). However, going on consultant-led ward rounds was very educational as you will learn from their decision making. 
    • INVESTIGATIONS: On any medical job, you will get lots of experience requesting and interpreting investigations, for example, blood tests, scans, and imaging. It is an excellent job to gain a basic understanding of  ECHO reports and chest x-rays. There are also no better physicians to learn about ECGs than cardiology registrars and consultants. 
    • REFERRALS: Again, this is true of most specialities. Cardiology patients are often independent but could also be complex and require input from many teams, including physiotherapists, occupational therapists, specialist nurses, pharmacists, dieticians, and many other specialities. You will work closely with heart failure nurses, pacemaker technicians, and cardiac physiologists. 
    • Cath Lab: Cardiology is a great job to gain experience going into the theatre and learning about PCIs and Pacemaker insertion. Although I was not interested in pursuing a career in cardiology, I found it very useful to learn more about the Selinger technique as it is widely used across both medical and surgical fields. It also enabled me to better answer patients’ questions in my  GP rotation, 
    • CCU days: My hospital had a Coronary Care Unit which was covered by cardiology juniors. It is an excellent opportunity to learn about a more acute side of cardiology, such as patients going into shockable rhythms. 

Positives of the job

Overall, this was an excellent job to have as a foundation doctor, and a rotation I recommend. My top reasons for this are: 

 

    1. Wide range of acute conditions like decompensated heart failure, arrhythmias and ACS which you will have to deal with in most other medical and surgical jobs.
    2. I got to work alongside a big team of other junior doctors and medical trainees, which made it so fun. Having juniors at the same grade or slightly higher was a great advantage. You can have a laugh with them, creating a friendly environment, but also having someone immediately available to ask your questions from. We always tried to take a lunch break together and help each other with the jobs in the afternoon. Not all jobs have a big team of juniors. 
    3. I got to leave on time most days. This was significantly different from some of my other colleagues on gastro or neuro. Although this is very department dependent and might differ at different hospitals.

Negatives of the job

As with all jobs, some things were challenging. These were:

    1. Cardiologists are sometimes referred to as the surgeons of the medical fields. This sometimes translates into having rapid ward rounds as they have to make it to the cath lab. This could leave you with some unanswered questions. The majority of the consultants will be performing procedures after the ward round making it hard to reach to ask a question. Having said that, I never struggled to find a consultant when I really needed them.
    2. Covering CCU could be scary as people would deteriorate rapidly. Although I did not have to do this independently as an F1, my F2 colleagues had to do that. Although interesting, they had some very stressful shifts. 
    3. You will most likely be part of the acute medical rota as a medical job. This is not a cardiology specific thing, but out of hours work and night shifts can be tiring and makes that work-life balance trickier. 

Final Word

Cardiology was my very first foundation job. It was a very steep learning curve as you could imagine but definitely made me feel more comfortable going forward in my future jobs. It was a good mix of medical  (you’d be surprised how high of a dose of furosemide you could give someone) and surgical procedures (like pacemaker insertion, cardioversion, PCI, etc). I definitely recommend doing this in your foundation years.

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