Dr Iain Matthews
Brief ‘definition’ of specialty

Using your head and your hands to treat a single (very important) organ.

Overview of training programme 

A five-year programme (ST4-ST8). Training is split into two sections – two years general training and sub-specialty cardiology in the final two years. There are five distinct sub-specialty areas – adolescent and adult congenital heart disease, advanced rhythm training, heart failure, imaging and interventional cardiology. It is possible to combine some of the five areas but not all. There is a requirement in some areas for competitive recruitment to your chosen sub-specialty. General Internal Medicine (GIM) counts as a sub-specialty training area and is combined with another of the five areas - a significant proportion of trainees chose to drop GIM for this reason.

Exam requirements

Knowledge-based assessment (KBA) is a computer-based test of general cardiology knowledge that is sat at ST5 level and needs to be passed before the conclusion of ST7. Some sub-specialty areas have their own examinations e.g. British Society of Echocardiography, Heart Rhythm UK which, although not mandatory, are strongly recommended.

Other requirements

Logbook: There has been a move away from just using quantity as a means of assessing competency, however there is still a guide to the expected number of procedures at core and sub-specialty level.

Specialty Skills: Cardiology is a procedure-heavy specialty (most of which are taught on the job) and proficiency is assessed regularly. For those less ‘hands-positive’ there is a sizeable array of imaging modalities e.g. echo, cardiac magnetic resonance imaging (MRI), cardiac computed tomography (CT), and nuclear cardiology.

Mandatory Training: Advanced life support (ALS) course, ionising radiation (medical exposure) regulations course (to learn to stand further away from the X-rays and other very important information!).

Opportunities/expectations for out of programme/research

A culture of ensuring research exposure during your training exists within cardiology. Most trainees will have a further degree either before entry or will take time out of programme (OOP) to get one during training.

A day in the life of a Cardiology Registrar
0800 - 0900 Talk to patients prior to coronary angiography list
0900 - 1200 Coronary angiography list
1200 - 1230 Talk to patients about results of their coronary angiography
1230 - 1300 Reporting electrocardiography (ECG) results for GPs and 24-hour tapes for other specialties
1300 - 1700 Transthoracic echo list
1700 - 1730 Check on current inpatients on the ward
1730 - 1800 Paperwork and then home


Pros and Cons of working in this specialty


  • Lots of work.
  • Procedural skill is constantly tested.
  • Imaging systems generate interesting pictures.
  • There is a huge evidence base to underpin clinical decisions.


  • Lots of work.
  • Lots of phone calls for advice.
  • Potentially little GIM if any at all.
How this specialty differs from others and why I chose it

Cardiology is the most surgical (procedure-orientated) medical specialty. It focuses on a single organ and, although not as cerebral as some other medical specialties, requires focus and clarity of thought. Those less keen on performing angioplasties in the middle of the night or marathon atrial fibrillation (AF) ablation cases can get engrossed in the myriad imaging techniques available. I chose cardiology because it balances using your head and your hands.

Tips for success in applying for this specialty
  • Strengthen your CV with a cardiology focus to courses.
  • Undertake audits.
  • Write up case reports.
  • Do presentations etc.
  • Get as much exposure to medical procedures of all types as possible.
  • Try to get to the catheterisation lab, the echocardiogram lab, the magnetic resonance imaging suite etc. to see what goes on.
  • Although not mandatory, some research experience prior to applying is looked upon very favourably.
Further information