Cardiology vs. Interventional Cardiology vs. Cardiovascular Medicine....need help

[carpe diem]

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Can anyone out there help me distinguish between these three, particularly with regards to training and scope of practice????

thanks

carpe

 

[AJM]

Well, Cardiology and Cardiovascular medicine are one and the same. The training is the basic 3 years of internal medicine residency plus 3 years of cardiology fellowship. Interventional cardiology is simply a further subspecialization of cardiology -- I believe it's 2 extra years of fellowship, but I don't remember offhand. Interventional cardiologists do most of the procedures in the field of cardiology -- all the caths, angioplasties/stents, etc. The cardiologists do the rest (well, for the most part). There's not a very clear line separating their job descriptions, because interventional cardiologists are still cardiologists (so will often see patients who don't need invasive procedures), and "general" cardiologists get some interventional experience in their training (although I'm unsure how much).

 

[Goofy]

Interventional Cardiology is generally a one year fellowship beyond a 3 year cardiology fellowship. Interventionalists do just that, they intervene. They do all the plumbing work in the cath lab including stents, balloons, Vgrams, etc...

General cardiologists practices primarily office based medicine, although variations exist. Depending on what type of fellowship he/she has trained in, a general cardiologist can do tons of invsaive caths (diagnostic), but they are not licensed to fix the problem. General cards permits you to run echo and stress labs among other things.

 

[Goofy]

AJM,

Cardiogy fellows spend an innordinate amount of time the cath lab. This is the core of their trainin.

Additionally, the difference between a general cardiologist and interventionalist is actually quite clear in the medical community. The function in overlapping but largely seperate capacities.

 

[Whisker Barrel Cortex]

I agree with the information above. Just wanted to add that general caridiologists diagnose conditions through EKGs, stress tests, echocardiography (I believe there is a fellowship for this, but general cards can do it), and physical exam. They also treat conditions such as congestive heart failure, angina, non-Q wave (means mild) heart attack, arrythmias, etc with medication.

 

[AJM]

Okay, so I was kind of unclear when I said that there's not a definite line between those specialties. While I agree that most interventionalists are almost always in the cath lab, my point was that if an interventionalist does not want to only do caths, they can also do general cards as well. I've worked with a few interventionalists who only do caths 1 or 2 days a week, and the rest of the time they attend on the wards and have their own non-interventional practice. I also know a non-interventionalist who does caths once in a while (although I didn't realize that he only does diagnostic caths). 🙂

 

[Goofy]

AJM,

I agree that the line can sometimes be confusing. Think of an interventionalist as a cardiologist with extra training. They are fully trained to do everything a conventional cardiologist does and more, they can do interventional procedures. Many interventionalists do balance most aspects of their practice, and some have given it up entirely. But in the strictes of senses, an interventionalist has unique capabilities. It's sort of like a cardiologist practicing internal medicine. Although he/she has advanced training in cardiology, he/she can still function as a internist.

 

[NuMD97]

One other point: Cardiology can be "fast-tracked", if you're lucky, and you are able to combine Internal Medicine and a Cardiology Fellowship into a five year combined program instead of six years - three Medicine and three Cardiology Fellowship.

 

[carpe diem]

Thanks for all the great info everyone....

Here's another thought..... Why is Psychiatry considered "primary care" by some scholarship programs (namely, NHSC) and can get funded but a fast track IM/cardiology candidate (as NuMed97 alluded to) would not receive funding????

......seems to me that a government program promoting general public health and wise use of resources would want to place physicians who have a desire to practice primary care (with an emphasis on cardiovascular disease) in the "field" to help prevent morbidity and mortality in the area of medicine that drains most of the country's healthcare dollars...

I mean, I know psychiatric care is important, but let's focus on the things which can effect the most good for the most people (i.e. CV disease) if our (NHSC's) focus is going to be primary care.....

am I missing something here, or is the Psychiatry primary care designation purely a political one??

....please sound off

p.s. I propose someone develop some combination residencies/fellowships such as "Internal Medicine/Preventive Cardiology" and place these physicians among underserved areas (especially urban) which are hit even more by CV disease ....

 

[Neville Sarkari]

Carpe--

There are Cardiologists who primarily do prevention work (mostly lipid clinics and academic centers etc). But let's face it, cardiology and primary care are very different. You don't need a cardiologist or 3+ years of cardiology training to do cardiac prevention. As general internists we do it all day long.

Interventional cardiology is changing, and quick. The new coated stents are going to revolutionize the field (again) and some of the busiest cardiologists are now doing a lot of "peripheral vascular" type work. For example opening up leg arteries etc. Also, many "General Cardiologists" do diagnostic caths, float swans, place permanent pacemakers etc.

Neville

 

[carpe diem]

Neville,

good points....... I suppose I just want my cake (scholarship) and eat it too ( eventually be a cardiologist).......unfortunately, I am realizing quickly that I may be too old for most scholarships.....I'll be 39 in May and just starting med school

I assume you practice general internal medicine....my practice decision is a little ways off and I'm interested in "primary care" ( FP or IM or some of the combo residencies)...but I don't know enough about the real practice of internal medicine....are there days when you treat only URI's patient after patient???? and is it possible to focus (at least in your practice) on particular areas within IM without having done a fellowship in the area???

thanks....