Cardiologist Career Guide,
Salary, Licence & Jobs 2026

Fourteen years minimum after high school: four of college, four of medical school, a three-year internal medicine residency and a three-year cardiovascular disease fellowship. Interventional cardiology adds a fourteenth-plus year and clinical cardiac electrophysiology adds two, so proceduralists commonly finish training in their mid-thirties. Each stage has its own board exam — ABIM internal medicine, then cardiovascular disease, then the subspecialty certificate.

BLS OEWS May 2025 puts the cardiologist (SOC 29-1212) median at $496,010 a year — $238.47 an hour — making it one of the highest-paid occupations in the federal wage data. The spread is enormous: $107,190 at the 10th percentile (which sweeps in fellows and part-time academic roles) to $610,060 at the 75th and $712,130 at the 90th, where high-volume interventionalists and EP physicians operate.

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The cardiologist is an internal medicine physician who diagnoses and manages heart disease and performs catheter-based procedures — angioplasty, stents, ablations, TAVR — through blood vessels rather than open incisions. The cardiac (cardiothoracic) surgeon trains through surgery, not internal medicine, and performs open operations like bypass grafting and valve replacement. They share patients constantly: the cardiologist typically diagnoses, the heart team decides together, and increasingly the catheter option wins.

Not open surgery, but interventional cardiologists and electrophysiologists perform invasive catheter procedures that have replaced many operations: coronary stenting, transcatheter aortic valve replacement, mitral clips, septal-defect closures, pacemaker and defibrillator implants and arrhythmia ablations. These happen in catheterization and EP labs under fluoroscopy, usually through a wrist or groin artery, with most patients home within a day — a major reason procedural cardiology volume keeps growing.

It is one of internal medicine's most competitive fellowships. Applicants typically need strong residency evaluations, research output and letters from cardiologists, applying through ERAS to a national pool where programs fill essentially every position. The bottleneck — roughly a decade of steady applicant excess over fellowship slots — is also why practicing cardiologists enjoy such leverage: BLS counts only about 600 openings a year against sustained demand from an aging population.

Call defines it. General non-invasive cardiologists keep clinic-and-lab schedules with moderate call, while interventionalists carry STEMI pagers requiring them to reach the hospital and open an occluded artery within tight door-to-balloon windows at any hour. Weeks of 55 to 60 hours are common in procedural practice. Many cardiologists shift toward imaging, clinic and administrative leadership in later career — one reason the earnings curve stays high but the workload profile changes.