Age Question for Practicing Cardiology

[Studebug]

I am leaving a chemical engineering job to start med school in the fall. I have two great interest with cardiology being one of them. If I went through the cardiology route, I will be 48 when I complete the program with no specialty fellowship.

Do you think 48 will be a negative when looking for job opportunities?

What age do cardiologist normally work until? Do some typically go part-time closer to retirement?

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[Myostatin]

Many cardiologists have a background in physical sciences or engineering -> given your background you will probably continue to like cardiology throughout your training. Being 48 will not adversely affect your ability to get a job (there are far, far more cardiology jobs than applicants). Its also a flexible field with regard to retirement age. In interventional/EP long hours and wearing lead most of the day takes its toll, and people tend to retire earlier as they do in the surgical specialties - though I have seen interventionalists who are at least into their late 60s and going strong. On the non-invasive side I have seen people practicing into their 70s. The beauty of cardiology is also that you're board certified in IM, and on top of that you can always practice non-invasive even if you're trained as an interventionalist. Bottom line is that you can practice for as long as you desire. modifying your scope if you decide you no longer want to be highly procedural.

 

[Studebug]

Many cardiologists have a background in physical sciences or engineering -> given your background you will probably continue to like cardiology throughout your training. Being 48 will not adversely affect your ability to get a job (there are far, far more cardiology jobs than applicants). Its also a flexible field with regard to retirement age. In interventional/EP long hours and wearing lead most of the day takes its toll, and people tend to retire earlier as they do in the surgical specialties - though I have seen interventionalists who are at least into their late 60s and going strong. On the non-invasive side I have seen people practicing into their 70s. The beauty of cardiology is also that you're board certified in IM, and on top of that you can always practice non-invasive even if you're trained as an interventionalist. Bottom line is that you can practice for as long as you desire. modifying your scope if you decide you no longer want to be highly procedural.

Thank you for your response. I want to elaborate on one point. After 3 years of IM, you do become a board certified Internal Medicine doctor, correct? So you are saying that if one needed a change you can practice as an IM instead of a Cardiologist- not that I would ever do that but I am trying to understand.


Plus, one of the reasons for leaving engineering is I want to be able to help people in need. If I am a board certified IM doc then hopefully I would be able to contribute to free clinics extra when time allowed???

I just didn't know if you didn't practice IM directly because you were a practicing Cardiologist, do you loose that Board Certified capability?

 

[howelljolly]

Thank you for your response. I want to elaborate on one point. After 3 years of IM, you do become a board certified Internal Medicine doctor, correct? So you are saying that if one needed a change you can practice as an IM instead of a Cardiologist- not that I would ever do that but I am trying to understand.


Plus, one of the reasons for leaving engineering is I want to be able to help people in need. If I am a board certified IM doc then hopefully I would be able to contribute to free clinics extra when time allowed???

I just didn't know if you didn't practice IM directly because you were a practicing Cardiologist, do you loose that Board Certified capability?

yes yes and no, i think.

After med school, you would complete an internal medicine residency (3 years) , and do a three year fellowship in Cardiovascular Disease. At this point you'd be a cardiologist. You could then do a year (?) of subspecialization in interventional, EP, or nuclear... and some other non-boarded fields. It seems that the most common or prototypical path is to do the interventional fellowship (total 7 years post-graduate training).

Now back to the front.... you're a specialist in cardiology, but you are a generalist in internal medicine. So, yes you can still practice in that capacity. Many cardiologists who havent done a subspecialty fellowship after cardiovascular disease find themselves doing a great deal of internal medicine. After all, the vascular system does traverse the whole body.

 

[Myostatin]

What HowellJolley said - You won't lose the capacity to practice IM once you're a cardiologist. In fact IM board certification is a requirement for cardiology board certification. General cardiologists often do some amount of general medicine.

 

[dragonfly99]

You can technically still practice general IM once you become a cardiologist. People generally take the IM board certification exam after finishing IM residency, and when you pass it is good for 10 years. However, even someone who never passed the board certification exam for IM (or who let it expire after the 10 years were up) could practice general IM legally. Most cardiologists don't practice general IM just becaue they prefer to do cardiology alone, and cardiology is more lucrative than IM. Also, after not doing general IM for a while, most cardiologists don't feel comfortable taking care of stuff like pneumonia, cellulitis, rheumatoid arthritis, etc. because they may not have the most current knowledge. However, nothing would stop you from doing that if you had done an IM residency, and wanted to go back to doing that. Certainly free clinics will love to have you volunteer. I volunteer at one and take care of dermatology and other stuff (as best I can) in addition to hypertension and diabetes.

What most cardiologists would do if they wanted to cut back hours was what the posters above have described. They'd stop doing heart caths/angiography, etc. but keep seeing their clinic patients, reading echocardiograms, etc.

 

[Larry Renal]

I always heard that practicing as a generalist when you have specialist certification was dicey, mainly for billing issues. The reason being that when you're a cardiologist and you evaluate someone for hypertension, are you billing as a cardiologist or internist? Then, when you are seeing someone with an ambiguous complaint but want to work up a cardiac issue. It's "unethical" to self-refer, right? It's hard to switch hats. Is anyone actually doing this?

 

[dragonfly99]

Well, you can definitely moonlight as a generalist if you are a subspecialty fellow in IM, and there appears to be nothing illegal or unethical about this. Our entire VA emergency room and hospitalist overflow service at my teaching hospital is totally staffed by subspecialty IM fellows. I don't know how the billing would work in outpatient private practice, but I'm sure there are ways to legally code for things. I recently met a GI doc who also does some general medicine...she's a FMG who practices in a small rural town without many doctors and one of the few female docs in town, so women started coming to her for general medical things, like to ask about having their BP and lipids checked.