Focus on Internal Medicine Careers: Cardiology/Electrophysiology.
Following is an interview of Mark Haigney, MD, a practicing electrophysiologist and Associate Professor of Medicine and Pharmacology at the Uniformed Services University of the Health Sciences (USUHS). Dr. Haigney is also the Director the Cardiology. 2Lt. Javed Nasir, a fourth-year medical student at USUHS and the Military Liaison to the ACP Council of Student Members, conducted the interview.
IMpact: Thank you for taking the time for this interview. Many of our readers may be unfamiliar with the field of electrophysiology. Could you briefly describe the field of electrophysiology and the training necessary to become an electrophysiologist?
Dr. Haigney: An electrophysiologist is like an electrician for the heart. Electrophysiologists are specialists in abnormalities of the heart’s conduction system. To become an electrophysiologist, you must complete a three year internal medicine residency, a three to four year fellowship in cardiology, and an additional one to two years of training in electrophysiology. Electrophysiologists typically work at large medical centers and many spend the majority of their time working in an electrophysiology lab. Some of the more common procedures done in the lab include invasive testing of the electrical conduction in the heart, implantation of pacemakers and defibrillators, and ablation of cardiac tissue that may be causing arrhythmias.
IMpact: Electrophysiology seems like a highly technical and specialized career field. Do you still use your internal medicine training?
Dr. Haigney: Absolutely, I use my internal medicine training daily. Earlier today I evaluated a patient who was thought to have hypertrophic cardiomyopathy. However, after taking a careful history, I learned that this patient also had bilateral carpal tunnel syndrome and several other peripheral neuropathies. Since I have a strong foundation in internal medicine, I was able to consider options other than cardiac disease, and eventually found that this patient’s symptoms were attributable to amyloidosis.
IMpact: Where do you see the field of electrophysiology going in the next ten years?
Dr. Haigney: Currently, there is an acute shortage of trained electrophysiologists, partly due to the recent increases in the use of devices for patients with ischemic heart disease and heart failure. In the future, I hope this shortage will be ameliorated by decreases in atherosclerotic heart disease and possibly novel therapies for heart failure.
IMpact: Do you have any advice for medical students who may be interested in becoming a cardiologist and/or electrophysiologist?
Dr. Haigney: Both general cardiology and electrophysiology are terrific fields to work in. In addition to dealing with acute care, you also get to participate in longitudinal care. If a student is interested in these fields, I would highly recommend rotating through a cardiac care unit (CCU). Participating in a research project is another great way to learn about these fields. A research project allows to you work much closer with a staff cardiologist than a typical CCU rotation does. Also, as I mentioned earlier, it is very important to have a strong foundation in internal medicine, and students interested in cardiology should seek a strong internal medicine training program.
IMpact: What is the lifestyle like for a cardiologist?
Dr. Haigney: There was a time when cardiologists did not have much time for activities outside of the hospital. However, medicine has changed a lot and now most cardiologists I know have a good balance between work and other activities. Most have weekends off and typically take one or two months of vacation every year.
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