Dr Tony Hermuzi, ST6
Brief ‘definition’ of specialty

Congenital and acquired heart disease from fetus to adulthood and everything in between.

Brief run-down of training programme content and duration

The first three years focus on general paediatric cardiology, acquiring knowledge and basic skills e.g. echocardiography involving the diagnosis, investigation and management of all forms of congenital heart disease. The final two years involve special interest training in one or two areas: advanced echocardiography, intervention, adult congenital, electrophysiology and pacing, pulmonary hypertension, transplant/heart failure or imaging.

Exam requirements

Trainees can come from a paediatric background or from adult Core Medical Training (CMT) with nationally based selection after 36 months experience.

Paediatric: Complete paediatric ST1-3 with satisfactory competencies and obtain the MRCPCH.

Adult: Complete CMT 1-2 with satisfactory competencies, 12 months of paediatric experience (inclusive of six months Neonatal medicine) and obtain the MRCP(UK).

Other requirements

Yearly annual review of competence progression (ARCP) with blueprint of assessments required at each level using a mix of workplace-based assessments (WPBA), mandatory courses e.g. morphology, basic echocardiography, advanced paediatric life support, teaching, audit and research with an overall supervisor’s report.

Opportunities/expectations for out of programme/research

As there are relatively few paediatric cardiology centres in the country, most trainees (excluding London) are attached to only one centre during their training. As a result most trainees seek out of programme time (OOPT) for special interest training in addition to post-Certificate of Completion of Training (CCT) fellowships. Research is looked on favourably as there is a general lack of high-powered, randomised studies in this area. The ‘safe and sustainable’ children’s and adult’s congenital cardiac services reviews are likely to change working patterns significantly across the UK in the next few years and we await the outcomes from this.

A day in the life of a Registrar/Consultant

Based on ‘hot’ on-call weeks with a mix of clinic, cardiac catheter lab sessions, education, teaching and research.

08:00 am: Meeting (departmental teaching/A=adult congenital/S=surgical referral).

08:30 am: Paediatric Intensive Care Unit (PICU) multi-disciplinary ward round.

09:00 am: Paediatric/adult congenital ward round.

11:00 am: Perform/review echocardiograms for PICU/ward patients as required.

1:00 pm: Clinic/catheter lab session.

5:00 pm: Evening ward round/review post-catheter patients.

6:00 pm: Admin – home.

Pros and Cons of working in this specialty


  • Huge variety from fetal to adult life and everything in between
  • Variety not just in ages and cases but physiology and how that applies to current condition and procedures which may affect this
  • Potentially very practical and procedure-based
  • Massive emphasis on team-based working and close working relationship with surgeons


  • Very hands-on senior-led specialty
  • Huge commitment to work needed in order to achieve all required and seize training opportunities
  • Large team-based working can be challenging at times
How this specialty differs to others and what made me choose it

Paediatric cardiology involves structural and functional heart disease from the fetus to adulthood and requires the application of knowledge regarding changing physiology to specific conditions and interventions. It is very interventional (particularly in the context of paediatrics) in terms of both surgical and medical therapies.

I enjoy working with acutely unwell children and adults on a daily basis and in particular the procedures involved in confirming diagnosis and treatment (e.g. ranging from echo to septostomy, to perioperative imaging, to follow-up) which require focus and clear understanding. The range of work is wide and involvement in every aspect of patient care can be extremely rewarding.

Tips for success in applying for this specialty
  • Attend basic courses that will improve understanding and demonstrate commitment e.g. morphology/basic echo courses.
  • Audit and research projects are always running and Consultants usually need help with them.
  • Time spent in fellowship posts can provide very useful experience, although they are not always necessary.
For more information

The Joint Royal College of Physicians Training Board (JRCPTB)

Paediatric Cardiology UK Trainees Wikispace

British Congenital Cardiac Association