Subspecialty and Combined Training Careers

Although this section of IMpact explores the subspecialty and combined training careers of internal medicine, it's worth emphasizing what makes internal medicine unique. Internal medicine physicians see things differently. Holistically. And in a unique way that allows them to analyze, lead, and humanize health care in a variety of different settings and roles. See all the career opportunities internal medicine can provide.

Cardiac Electrophysiology

The Discipline

Clinical cardiac electrophysiology represents advanced training in cardiovascular disease and focuses on management of complex cardiac electrophysiologic disease of the heart. Often called “electrophysiologists,” these internal medicine physicians are trained in the mechanism, function, and performance of the electrical activities of the heart. Electrophysiologists evaluate and assist with management of patients with significant heart rhythm disturbances (arrhythmias). They are trained to perform noninvasive and invasive diagnostic procedures (such as tilt-table testing and electrophysiologic studies) and to treat arrhythmias with medication, devices (pacemakers, cardioverters), and interventional methods (such as catheter ablation).

Cardiac electrophysiologists typically practice in cardiology group practices and in medical institutions in which these types of disorders are diagnosed and managed.


Cardiac electrophysiologists must complete an additional year of training beyond a general internal medicine residency and fellowship in cardiovascular disease; this training is most commonly done immediately following a cardiovascular disease fellowship. Following completion, cardiac electrophysiologists are eligible for board certification by the American Board of Internal Medicine.

Training Positions

In the 2022-2023 academic year, there were 116 Accreditation Council for Graduate Medical Education (ACGME)-accredited training programs in clinical cardiac electrophysiology with 333 trainees.

Major Professional Society

  • Heart Rhythm Society

See all the career pathways open to internal medicine physicians.

Back to the March 2023 issue of ACP IMpact