Cardiology vs. critical care 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? In this article, we will provide helpful information and tips to help you make an intelligent decision on cardiology vs. critical care and find a fulfilling career that matches your interests and abilities. We will also help you evaluate practical factors such as job availability, salary, and training duration.
Cardiology vs. Critical Care: 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.”
Critical care, meanwhile, offers more job openings. You can easily find a hospital that needs intensivists, and the career outlook is positive, even if the salary is not as high as cardiology. But critical care also comes with some challenges, such as higher burnout and less job security, which we will discuss later.
According to recent data, cardiologists earn an average annual salary of $507,000, while intensivists have a lower average salary of $406,000. 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 intensivists earn less with $406,000 annually
Cardiology vs. Critical Care: 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.
To pursue a career in cardiology or critical care, 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 mean that critical care or cardiology are less competitive. After completing your internal medicine residency, you will still need to match into a fellowship, which is generally more competitive than matching into a residency.
The unmatched percentage of US Seniors applying to the cardiovascular diseases fellowship was 16.6%, making it highly competitive compared to most fellowships with >100 applicants. In comparison, only 85 US seniors applied to the critical care medicine fellowship, with a 35.3% unmatched percentage.
Below is the unmatched percentage among non-pediatric fellowships with >100 applicants.
Training Path: Fellowship
The training pathways for cardiology and critical care are quite similar. To become a cardiologist, you must complete a three-year residency in internal medicine, followed by a cardiology fellowship. Similarly, to become an intensivist, you must complete a two-year fellowship in critical care after completing an internal medicine residency.
A critical care fellowship 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. Critical Care: Work-Life Balance
Work-life balance is a crucial factor for many medical professionals. Both cardiologists and intensivists have demanding schedules and on-call duties due to the nature of their work. However, it’s worth mentioning that intensivists 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.
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. Intensivists ranked at the top of medical specialties, averaging 57.7 weekly working hours.
Cardiologists work an average of 56.2 hours per week, while intensivists work slightly more hours, at 57.7 per week.
Both cardiologists and intensivists have to deal with long hours of documentation. Intensivists spend slightly more hours, approximately 18 hours per week, due to extensive documentation requirements related to ICU admissions, daily progress notes, discharge summaries, and care coordination. Meanwhile, cardiologists spend around 16 hours per week on admin/paperwork.
Cardiologists work on admin/paperwork an average of 16 hours per week, while intensivists work more hours, at 18 per week.
Training Duration and Subspecialties
The training duration is a key aspect to consider when choosing between cardiology vs. critical care. Critical care has a five-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. Critical Care: 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 critical care. 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 critical care.
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 critical care ranked near the lower end with 78% of intensivists feeling the same way.
Cardiologists reported a 93% job satisfaction rate, while intensivists reported lower satisfaction with 78%
That being said, the burnout rates for cardiology were 43% which was near the lower end of all medical specialties. In comparison, critical care had a burnout rate of 55%, which ranked near the upper end of all medical specialties.
Cardiologists have a burnout rate of 43%, while intensivists have a higher burnout rate of 55%.
Cardiology vs. Critical Care Comparison
To provide a visual overview, here’s a table comparing cardiology and critical care:
| Aspect | Cardiology | Critical Care |
|---|---|---|
| Average Salary | Generally high income due to specialization, especially in interventional cardiology | Lower than cardiology |
| Job Security | High demand due to an aging population and the prevalence of cardiovascular diseases | High demand due to the need for specialized care in critical care units |
| Training Path | Typically involves 3 years of internal medicine residency followed by a 3-year cardiology fellowship | Typically involves 3 years of internal medicine residency followed by a 2-3 year critical care fellowship |
| Lifestyle | Varied; may involve on-call responsibilities, long working hours, and outpatient clinic duties | Demanding; involves long and irregular hours, including nights and weekends |
| Administrative Paperwork | High documentation requirements such as notes, test orders, and referral letters | Higher documentation requirements due to extensive documentation requirements related to ICU admissions, daily progress notes |
| Job Satisfaction | Generally high but can vary with the work environment and patient outcomes | Lower |
| Burnout Rates | Lower | Moderate to High |
| Personality | Strong analytical skills, attention to detail, ability to handle stress and pressure | Strong decision-making skills, ability to handle stress and pressure, good communication skills |
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. critical care 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.
