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Cardiology in India is both historic and intriguing as the heart and circulation has been known and understood even before the Vedic period. One of the various therapeutic measures in curing cardiovascular disease has been in practising yoga or transcendental meditation and Ayurvedic treatment. Though only recently meditation has seen a resurgence globally in combating the disease, however, since then, there has been little to fewer innovations in cardiology in India.

The scarcity possibly lies in the limited resources and research efforts dedicated towards this niche field. Modern cardiology saw advanced outlook and progressed by the initiatives of Bharatratna recipient Dr. Bidhan Chandra Roy. Under his leadership and guidance, the Cardiology Society of India (CSI) was officially formed on April 4, 1948 – this is much earlier to the formation of the American College of Cardiology in 1949.

Demand and deficit

In India, with its vast and diverse demography, at least 50 million people suffer from type-2 diabetes, which happens to be a potential fatality for people affected by heart disease. With over 1.7 million lives lost each year – equating 28 percent of overall deaths in the country – the need for specialists in heart diseases has never been more pertinent. This is increasingly a growing concern due to the shortage of cardiologists and cardiovascular surgeons here. According to a study by The Indian Express, an Indian daily newspaper, that in 2017-  552 seats out of 1,907 super specialty medical seats, were vacant and only 104 were in cardiovascular and thoracic surgery – with just 55 amounting to cardiology. This despite government’s efforts to mobilize more students to pursue masters in surgery by appearing for their NEET examination, across the country. With 14 million urban and 16 million rural heart patients in India, the disparity in lack of cardiologists is appalling.

In the USA there are 31,890 cardiologists by comparison, India requires 88,000 but has only 4,000 specialists in the field. This downward trend might continue, as the specialization does not seem to attract a number of medical students pursuing a master’s degree. This could result in further shortages in the future.

Importance and responsibilities

Factors that contribute to the exponential rise in the number of people with heart disease include unhealthy diet, tobacco use and psychosocial stress. Public education and awareness surrounding the factors could limit the increase in heart diseases. However, without sufficient numbers of cardiologists, the situation will be increasingly difficult to control. As such, often patients will be left facing difficulty in availing vital and life-saving treatment. This shortage is not singular to India; the issue prevails even in nations with advanced technologies in healthcare developments. The Association of American Medical Colleges (AAMC) assessed a study on the ratio of physicians available for across the country and reported that nearly 60 percent of all cardiologists are 55 and above. While the number of people living who are 80 and above in age has steadily increased, the country could see a shortage of up to 120,000 physicians by the year 2030, AAMC projects.

Understanding the key features of becoming a cardiologist and skillset one requires would benefit why this profession is niche and high paying, comparatively with any other major in the medical field. The increased graduates going on to be a general practitioner has also led to a substantial number of medical students – in considering cardiovascular and cardiology as a good investment to their efforts in studying this alluring profession. 

Inherent skills of a heart doctor

Aspiring medical graduates require having completed 5 ½ years of MBBS, followed by an MD for 3 years and subsequently 3 years for DM (Cardiology) in order to become a cardiologist. The cardiologist needs to be a hard-worker, with dedication and above all else aptitude in science. With self-discipline, patience and commitment to excel, a cardiologist can be self-confident and succeed. The aspiring medical practitioners if they go by the present record of future requirements of cardiology-based professionals, young cardiologists will find themselves to have discovered not only a lucrative field to work but also a sense of fulfillment and compassion in their work.

A few of the steps to become a cardiologist, in India, mandates aspiring candidates appearing in Science majors in their higher secondary exams, followed by appearing in Medical Entrance Exams (MEE) conducted by various reputed institutes such as NEET, UG and AIIMS for MBBS Medical Exam. With the introduction of NEET, candidates across the country can appear and compete for seats to get admission in any part of the country. These exams are typically held between the months of May to June.

Admission into MBBS studies ideally takes four and a half years of the degree program and one year and six months of compulsory training. Subsequently, an MBBS graduate can opt for further studies in pursuing their Master’s degree in cardiology, if they intend to practice working as a specialist in Cardiology. Aspiring MBBS graduates are required to appear in Post Graduate Medical Entrance Test such as BHU M.D, NEET-PG, Jawaharlal Institute of Post-Graduate Medical Education and Research Entrance Exams and Delhi University Post Graduate Medical Entrance Test.

There are a few institutes, however, who provide admission to MBBS doctors on the criteria of their marks obtained in the MBBS program and work experience. Successful completion of the two to three years of Master degree in cardiology and receiving the requisite registration at Medical Council of India – sets the paths open for postgraduates in Cardiology to get jobs in public government hospitals like AIIMS, or private hospital centers like Apollo, Fortis and other corporate hospitals.

Types of cardiology

The study, diagnosis and care in the human cardiovascular system has three major classifications

 Invasive – Using minimal opening or invasive surgery to identify and treat electrical or structural abnormalities in the heart through angioplasty and stenting.

Non-invasive – identifying heart abnormalities without using needles or other medical equipment that are inserted into the body. i.e., Nuclear cardiology, Echocardiology, Cardiac electrophysiology, Stress test, CT scan and Heart monitors.

 Interventional cardiology – a non-surgical option where a small flexible tube is used to repair weakened or damaged vessels, other affected parts or narrowed arteries. i.e., Heart valve disease, Coronary artery disease, and Peripheral vascular disease.

Asides the aforementioned, some cardiologists specialize in children’s cardiology (pediatric) and others in adult cardiology. It is important to understand that a cardiologist is not a surgeon, but a different specialist performing heart surgery, mainly through tests and other procedures.

Salary prospects and career advancement

PYA Healthcare surveyed in various countries in different continents and aggregated that salaries rose for cardiologists and cardiovascular physicians, as well as non-physicians, between 2013 – 2017, with a total compensation for invasive/interventional and non-invasive cardiology professionals at 2 percent and 3 percent annual growth. In layman terms, median compensation inclusive of salary and bonuses for non-invasive doctors spiked from US$420,906 (2013) to US$467,941 (in 2017) and interventional cardiologists earned nearly 30 percent more than non-invasive professionals, with median compensation ranging from US$546,806 to US$595,157 in the same period. This aggregates similar to the salaries drawn in India by the specialists, with monthly salary averaging from anywhere of 1.5 lakh rupees and upwards in the private sector and 80,000 to 1 lakh rupees in government hospitals.

While the career and lucrative remuneration is alluring, aspiring MBBS doctors do not always find seats available to pursue their dreams and contribute to their society. With multiple destinations across several continents now offering bespoke courses to lure Indian students traveling abroad, finding the right course and institute has become pivotal.

Texila’s Fellowship in Non-Invasive Cardiology

This 2-year affordable program in non-invasive cardiology is designed to give a platform to doctors, who wish to build on their existing knowledge, skillset and experience, and to further in mastering the clinical and service part of Cardiology. The Fellowship Education Curriculum encompasses both theoretical and clinical components with emphasis on practical knowledge. This includes fellowship students in observing patients and learning and applying the aspects of patient care and their treatment.

With an international curriculum that suits students from all over the world, the fellowship programme provides attractive stipends during the study, exhaustive e-book access, and offers excellent exposure allowing the students to get hands-on practice in Premium hospitals specializing in Cardiology.

Dr. Lamidi Rasheed Emmanuel, a recent graduate of the fellowship at Texila, recalled her experience at Texila American University as, “It [Texila American University] has highly committed and efficient lecturers and staff in the Faculty. In fact, TAU is the best school to be.”

Once after the programme is complete, they will begin a long, but steady period in gaining experience under the guidance of experts in cardiology. Until fellowship, graduates reach a point where their own expertise becomes of the quality that countless people would depend on with their lives.

A profession as noble and charitable as the medical field might be, the higher purpose of serving patients and caring for them adequately is often – a knowledge acquired. At TAU, the faculty successfully imparts this wisdom to their diverse and thriving international student community.

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