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Cardiology vs. Physical Medicine and Rehabilitation: Which Specialty is Right for You?

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by Yousmle Staff in Career

Cardiology vs. physical medicine and rehabilitation 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. physical medicine and rehabilitation 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. Physical Medicine and Rehabilitation: 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.”

Physical medicine and rehabilitation, meanwhile, offers more job openings. You can easily find a hospital that needs a physiatrist, and the career outlook is positive, even if the salary is not as high as cardiology. But physical medicine and rehabilitation 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 physiatrists have a lower average salary of $306,000. 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.

Estimated Physician Average Yearly Salary by Medical Specialty in the US

Cardiologists earn $507,000 per year on average, while physiatrists earn less with $306,000 annually

Cardiology vs. Physical Medicine and Rehabilitation: 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 physical medicine and rehabilitation, the unmatched percentage among US Seniors was 13.9%, 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 physical medicine and rehabilitation. After completing your internal medicine residency, you will still need to match into a cardiology fellowship, which is generally more competitive than physical medicine and rehabilitation. 

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. physical medicine and rehabilitation are not the same. Cardiology involves a three-year internal medicine residency and a cardiology fellowship. Physical medicine and rehabilitation involves a four-year rehabilitation residency.

A physical medicine and rehabilitation 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. Physical Medicine and Rehabilitation: Work-Life Balance

Work-life balance is a crucial factor for many medical professionals. Physiatrists 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.

Both cardiology and physical medical and rehabilitation are patient-centric specialties that require building long-lasting relationships with patients. While this can be rewarding, it also means carrying a patient panel and more administrative work.

That 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. Rehabilitation ranked in the middle of medical specialties, with an average of 49.9 weekly working hours.

Estimated Physician Weekly Working Hours by Medical Specialty in the US

Cardiologists work an average of 56.2 hours per week, while physiatrists work fewer hours, at 49.9 per week.

Both cardiologists and physiatrists have to deal with long hours of documentation. This is due to the increased number of referral letters and diagnostic tests. Physiatrists spend an estimated 19 hours on admin and paperwork per week, while cardiologists spend slightly less with 15 hours per week.

Estimated Physician Admin/Paperwork Hours by Medical Specialty in the US

Cardiologists work on admin/paperwork an average of 16 hours per week, while physiatrists work more hours at 19 per week.

Training Duration and Subspecialties

The training duration is a key aspect to consider when choosing between cardiology and. physical medicine and rehabilitation. Physical medicine and rehabilitation 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. Physical Medicine and Rehabilitation: 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 rehabilitation. 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 rehabilitation.

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. In comparison, physical medicine and rehabilitation ranked slightly lower with 85% of physiatrists feeling the same way.

Job Satisfaction Rate By Medical Specialty in the US

Cardiologists reported a 93% job satisfaction rate, while physiatrists reported slightly lower satisfaction with 85%

That being said, the burnout rates for cardiology were 43% which was near the lower end of all medical specialties, while physical medicine and rehabilitation burnout rates were 47%.

Burnout Rate By Medical Specialty in the US

Cardiologists have a burnout rate of 43%, while physiatrists have a slightly higher burnout rate of 47%.

Cardiology vs. Physical Medicine and Rehabilitation Comparison

To provide a visual overview, here’s a table comparing cardiology and physical medicine and rehabilitation:

AspectCardiologyPhysical Medicine and Rehabilitation
Average SalaryGenerally high income due to specialization, especially in interventional cardiologyLower than cardiology
Job SecurityHigh demand due to an aging population and the prevalence of cardiovascular diseasesStable demand with aging populations and focus on non-life-threatening conditions
Training PathTypically involves 3 years of internal medicine residency followed by a 3-year cardiology fellowshipInvolves four years of physical medicine and rehabilitation residency
LifestyleVaried; may involve on-call responsibilities, long working hours, and outpatient clinic dutiesPredictable hours without on-call duties
Administrative PaperworkHigh documentation requirements such as notes, test orders, and referral lettersSlightly higher documentation requirements such as notes and referral letters
Job SatisfactionGenerally high but can vary with the work environment and patient outcomesLower
Burnout RatesRelatively lower Moderate
PersonalityStrong analytical skills, attention to detail, ability to handle stress and pressureEmpathetic, strong intercommunication 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. physical medicine and rehabilitation 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.

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.

Subscribe