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Cardiology vs. Anesthesiology: Which Specialty is Right for You?

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by Alec Palmerton, MD in Career

Cardiology vs. anesthesiology is one of the biggest debates among medical students interested in physiology. Both specialties allow you to explore the complex workings of the human body and use your skills to improve patient outcomes. However, they also have significant differences, such as the scope of practice, the work environment, and the training requirements.

How do you decide which one is right for you? I faced the same question as a medical student at Stanford, and I had to balance my personal and professional aspirations. I also had to consider practical factors such as job availability, salary, and training duration/path. In this article, I will provide helpful information and tips to help you make an intelligent decision on cardiology vs. anesthesiology and find a fulfilling career that matches your interests and abilities.

Cardiology vs. Anesthesiology: Salary and Job Security

Cardiology might be your specialty if you want to earn a lot of money and have a steady demand for your services. But be prepared for a competitive job market after fellowship, even if you graduate from a prestigious program. A Harvard-MGH fellow once told me, “I’ll consider myself lucky if I find a job in a city I recognize.”

Anesthesiology, meanwhile, offers more job openings. You can easily find a hospital that needs anesthesiologists, and the career outlook is positive, even if the salary is not as high as cardiology. But anesthesiology also comes with some challenges, such as higher burnout and less job security, which I will discuss later.

According to recent data, cardiologists earn an average annual salary of $507,000, while anesthesiologists have a slightly lower average salary of $448,000. Of all medical specialties, only orthopedists and plastic surgeons have higher average annual salaries than cardiologists, with orthopedists earning $573,000 and plastic surgeons earning $619,000.

Cardiologists earn $507,000 per year on average, while anesthesiologists earn slightly less with $448,000 annually

Cardiology vs. Anesthesiology: Competitiveness

Here we can assess the competitiveness of a specialty by looking at the unmatched rate – the % of people who apply and do not match into their preferred specialty. For anesthesiology, the unmatched percentage among US Seniors was 10.5%, making it moderately competitive among US residencies.

To pursue a career in cardiology, you must first match into an internal medicine residency. Among US Seniors, the unmatched percentage for internal medicine residency was only 2%, making it less competitive than other residencies. However, this does not necessarily mean that cardiology is less competitive than anesthesiology. After completing your internal medicine residency, you will still need to match into a cardiology fellowship, which is generally more competitive than an anesthesiology residency. 

Below is the unmatched percentage among non-pediatric fellowships with >100 applicants. The unmatched percentage of US Seniors applying to the cardiovascular diseases fellowship was 16.6%, making it more competitive compared to most fellowships with >100 applicants.


Training Path: Fellowship vs. Residency

The training pathways for cardiology vs. anesthesiology are not the same. Cardiology involves a three-year internal medicine residency and a cardiology fellowship. Anesthesiology involves a four-year anesthesiology residency.

An anesthesiology residency is generally less competitive than a cardiology fellowship. Your USMLE scores, med school, and research are the main things for residency applications. Research is also a big thing for fellowship applications, and your residency program counts more, but your USMLE scores matter much less.

Cardiology vs. Anesthesiology: Work-Life Balance

Work-life balance is a crucial factor for many medical professionals. Anesthesiologists often enjoy a better work-life balance due to the nature of their work. They have the ability to “clock out” at a designated time, leading to more predictable schedules. However, it’s worth mentioning that this also means anesthesiologists are thought to be more easily replaced, as they don’t typically maintain a panel of patients like their cardiology counterparts.

Cardiology, an often patient-centric specialty, requires building long-lasting patient relationships. While this can be rewarding, it also means carrying a patient panel and more administrative work.

That being said, cardiologists work an average of 56.2 hours/week, ranking third after general surgeons and intensivists who work 57.4 and 57.7 hours, respectively. Anesthesiology ranked in the middle of medical specialties, with an average of 51.8 weekly working hours.

Estimated Physician Average Yearly Salary by Medical Specialty in the US

Cardiologists work an average of 56.2 hours per week, while anesthesiologists work slightly fewer hours, at 51.8 per week.

Cardiologists require more documentation, such as referral letters and diagnostic tests, resulting in an estimated 16 hours of admin/paperwork per week, while anesthesiologists have only 9 hours, which is almost half the amount of time a cardiologist spends on paperwork.

Cardiologist works on admin/paperwork an average of 16 hours per week, while anesthesiologist works fewer hours, at 9 per week.

Training Duration and Subspecialties

The training duration is a key aspect to consider when choosing between cardiology vs. anesthesiology. Anesthesiology has a four-year training period, while cardiology has a minimum of six years, with three years of internal medicine residency.

In addition, cardiologists often pursue more subspecialty training in fields like echocardiography or electrophysiology because of the scarce job opportunities. This can increase the length of your cardiology training.

Cardiology vs. Anesthesiology: Job Satisfaction and Burnout Rates

Job satisfaction plays a significant role in career fulfillment. According to various studies, cardiology tends to have higher job satisfaction rates than anesthesiology. Many cardiologists express contentment with their career choice and would choose it again if given the chance. Additionally, cardiology has lower reported burnout rates than anesthesiology.

According to recent data, cardiology ranked near the upper end of all medical specialties with 93% of cardiologists stating that they would choose the same specialty again, while anesthesiology ranked slightly lower with 87% of anesthesiologists feeling the same way.

Cardiologists reported a 93% job satisfaction rate, while anesthesiologists reported slightly lower satisfaction with 87%

That being said, the burnout rates for cardiology were 43% which was near the lower end of all medical specialties. In comparison, anesthesiology’s burnout rates were 55% ranking above the middle of all medical specialties.

Cardiologists have a burnout rate of 43%, while anesthesiologists have a slightly higher burnout rate of 55%.

Cardiology vs. Anesthesiology Comparison

To provide a visual overview, here’s a table comparing cardiology and anesthesiology:

Average SalaryGenerally high income due to specialization, especially in interventional cardiologyCompetitive income influenced by the complexity and duration of surgeries
Job SecurityHigh demand due to an aging population and the prevalence of cardiovascular diseasesSteady demand, particularly in surgical and procedural settings
Training PathTypically involves 3 years of internal medicine residency followed by a 3-year cardiology fellowshipRequires 4 years of medical school, followed by a 4-year anesthesiology residency
LifestyleVaried; may involve on-call responsibilities, long working hours, and outpatient clinic dutiesVaried; potential for irregular hours, on-call duties, and a focus on perioperative care
Administrative PaperworkHigher documentation requirements such as notes, test orders, and referral lettersLess paperwork than cardiologist due to less direct patient management
Job SatisfactionGenerally high but can vary with the work environment and patient outcomesOften high due to the critical role in patient care, teamwork involvement
Burnout RatesRelatively higher due to long hours and acute patient care stressModerate, influenced by operational pressures and the nature of procedures
PersonalityStrong analytical skills, attention to detail, ability to handle stress and pressureAbility to stay calm under pressure, excellent communication skills, attention to detail, adaptability to dynamic situations

Please note that this table serves as a general comparison. To determine the most suitable career for you, consider your personal and career priorities and goals.

Concluding Thoughts

Choosing the right specialty between cardiology vs. anesthesiology depends heavily on your priorities. To determine this, try reverse engineering your ideal life and identify your top priority. A helpful exercise is to write down the top five things you want to achieve in your career and personal life. Knowing these priorities will make finding a career that aligns with them easier. Often, the biggest obstacle is not a lack of knowledge about different fields but a lack of self-awareness about our own preferences.

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Want FREE Cardiology Flashcards?

Cardiology is key for impressive USMLE scores. Master cardiology from a Harvard-trained anesthesiologist who scored USMLE 270 with these 130+ high-yield flash cards. You’ll be begging for cardio questions - even if vitals make you queasy.