Cardiology vs. internal medicine 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. internal medicine 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. Internal Medicine: 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.”
Internal medicine, meanwhile, offers more job openings. You can easily find a hospital that needs internists, and the career outlook is positive, even if the salary is not as high as cardiology. But internal medicine 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 internists have a considerably lower average salary of $273,000. 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 internists earn less with $273,000 annually
Cardiology vs. Internal Medicine: 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 internal medicine, the unmatched percentage among US Seniors was 2.0%, making it the 2nd least competitive residency among US residencies in the 2022 Match.
To pursue a career in cardiology, you must first match into an internal medicine residency. However, this does not necessarily mean that cardiology is less competitive. After completing your internal medicine residency, you will still need to match into a cardiology fellowship, which is generally highly competitive.
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. internal medicine are not the same. Internal medicine involves a three-year internal medicine residency. Cardiology involves a three-year internal medicine residency and 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. Internal Medicine: Work-Life Balance
Work-life balance is a crucial factor for many medical professionals. Internists often enjoy a better work-life balance due to the nature of their work. They usually have predetermined working hours, leading to more predictable schedules. However, it’s worth mentioning that this also means internists 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. Internal medicine ranked near the middle of medical specialties, with an average of 51 weekly working hours.
Cardiologists work approximately 56.2 hours per week, compared to internists who average 51 hours per week
Both cardiologists and internists have to deal with long hours of documentation. Internists spend slightly more hours, approximately 18 hours per week, due to extensive diagnostic tests. Meanwhile, cardiologists spend around 16 hours per week on admin/paperwork.
Cardiologists work on admin/paperwork an average of 16 hours per week, while internists 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. internal medicine. Internal medicine has a three-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. Internal Medicine: 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 internal medicine. 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 internal medicine.
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 internal medicine ranked at the lower end with 61% of internists feeling the same way.
Cardiologists reported a 93% job satisfaction rate, while internists reported considerably lower satisfaction with 61%
That being said, cardiology has a burnout rate of 43%, ranking near the lower end of all medical specialties. In comparison, internal medicine has a burnout rate of 60%, ranking near the upper end of all medical specialties.
Cardiologists have a burnout rate of 43%, while internists have a higher burnout rate of 60%.
Cardiology vs. Internal Medicine Comparison
To provide a visual overview, here’s a table comparing cardiology and internal medicine:
| Aspect | Cardiology | Internal Medicine |
|---|---|---|
| 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 | Stable role for primary healthcare and managing various medical conditions |
| 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. |
| Lifestyle | Varied; may involve on-call responsibilities, long working hours, and outpatient clinic duties | Varied; may involve on-call responsibilities, long working hours, and outpatient clinic duties |
| Administrative Paperwork | High documentation requirements such as notes, test orders, and referral letters | Higher administrative requirements. |
| Job Satisfaction | Generally high but can vary with the work environment and patient outcomes | Lower |
| Burnout Rates | Relatively low | Higher |
| Personality | Strong analytical skills, attention to detail, ability to handle stress and pressure | Strong communication and problem-solving skills, ability to handle diverse patient needs. |
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. internal medicine 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 preferences.
