How to Become a Cardiologist

April 25, 2024
7 min read


Reviewed by:

Luke Hartstein

Former Admissions Committee Member, NYU Grossman School of Medicine

Reviewed: 4/25/24

If you want to become a cardiologist, we’ll outline all the information you need to help you achieve your goal. Read on to learn about cardiology requirements, if this career path is right for you, and more! 

Cardiologists are experts in the cardiovascular system, making them experts when dealing with cardiovascular conditions and diseases. Without them, critical conditions such as heart failure, cardiac arrest, and stroke would be much more challenging to treat and rectify. 

Cardiologists are essential doctors with the power to save many lives using their knowledge and skills. Does a cardiologist’s path intrigue you? If so, we’ll outline how to become a cardiologist, starting from high school graduation to your first day of work as a cardiovascular expert! 

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What Does a Cardiologist Do? 

Cardiology is a specialization that focuses on the health conditions of the cardiovascular system. This system is responsible for the circulation and supply of blood to all different parts of the body and includes the heart and blood vessels.

A cardiologist’s job is to find, treat, and prevent cardiovascular problems or conditions using close inspection, communication, and performing examinations or diagnostic tests on patients.

It might sound simple, but the cardiovascular system is essential to maintain many bodily functions. If something wrong happens within this system, the consequences are often life-threatening, with only a small window to deliver treatment. Common cardiovascular diseases include: 

  • Heart Attack: The heart not receiving enough blood, usually due to blood vessel problems
  • Stroke: Brain damage caused when blood stops flowing to the brain
  • Heart Failure: The inability of the heart to pump sufficient blood
  • Arrhythmia: Abnormal heart rhythm
  • Hypotension/Hypertension: Blood pressure being too low/high

Even if you’re unfamiliar with cardiology, you’ve probably heard these terms. Unfortunately, these diseases and conditions listed are not just deadly but also common. 

According to the Centers for Disease Control and Prevention, heart failure is the number 1 leading cause of death for people in the U.S, totaling 696,962 deaths. Also, stroke is the 5th leading cause of death. 

Cardiovascular health is paramount, and cardiologists play a significant role in people's health. Their ability to diagnose, treat and prevent cardiovascular diseases is necessary for public health. 

How Hard Is It to Become a Cardiologist?

Cardiology is one of the more difficult medical specializations; the path to becoming a cardiologist is long and challenging. It requires many years of: 

  • Studying
  • Training
  • Consistent academic excellence
  • Hands-on experience
  • Persistent dedication to become a cardiologist

A cardiologist often makes critical decisions. The cardiovascular system is very complex, and cardiologists often must deal with situations where someone’s life is on the line. One small mistake can cause severe health problems or even death. Due to such high responsibilities, the requirements to become a cardiologist are lofty. 

You should expect challenging, in-depth coursework, a heavy study load, and assignments and examinations during your studies. However, academics are merely the foundation. You must also master the ability to apply what you’ve learned, as you must pass examinations, certifications, and countless years of hands-on training.

Furthermore, in addition to excellence in cardiology, being a successful cardiologist requires competence in a wide array of skills, such as:

  • Dexterity
  • Attention to detail
  • Ability to handle physical/psychological stress 
  • Organizational skills
  • Communication skills
  • Decision-making skills (especially when a patient’s life is at risk)

You’ll need to develop these skills during your training years after medical school. 

What Are the Subspecialties in Cardiology?

Because cardiology is a complex field of medicine it has many subspecialties. These subspecialties include:

  • Interventional Cardiology: This focuses on procedures to treat heart problems, like inserting stents to open blocked arteries.
  • Electrophysiology: This is about studying and treating heart rhythm problems, like arrhythmias.
  • Heart Failure and Transplant Cardiology: This deals with patients whose hearts aren't working properly and might need a heart transplant.
  • Adult Congenital Heart Disease: This is about heart problems that people are born with but continue into adulthood.
  • Cardiac Imaging: This involves different methods to take pictures of the heart, like echocardiograms and MRIs, to diagnose heart conditions.
  • Preventive Cardiology: This focuses on helping people lower their risk of heart disease through lifestyle changes and medication.

These are just some examples, but there are other subspecialties too. Each one deals with different aspects of heart health and treatment.

How Much Does a Cardiologist Make? 

According to the Bureau of Labor Statistics, a cardiologist’s average annual salary is approximately $354,000. You will receive high compensation for your knowledge and skill while having the opportunity to improve or save the lives of countless individuals.

How Much Cardiologists Make in Different States?

Below is a table of how much cardiologists make in each state. 

State Average Cardiologist Salary
Oregon $412,567
Alaska $410,538
North Dakota $410,474
Massachusetts $405,573
Hawaii $401,804
Washington $392,573
Nevada $388,165
South Dakota $387,942
Colorado $383,077
Rhode Island $382,133
New York $364,121
Delaware $360,108
Vermont $355,569
Virginia $354,898
Illinois $354,791

State Average Cardiologist Salary
Maryland $348,752
Nebraska $341,307
Missouri $339,194
California $338,254
South Carolina $336,266
Pennsylvania $333,562
New Jersey $332,879
Oklahoma $330,531
Maine $330,358
Wisconsin $329,663
North Carolina $329,326
New Hampshire $324,379
Idaho $323,579
Texas $321,402
Kentucky $320,362

State Average Cardiologist Salary
Wyoming $319,233
Minnesota $318,411
Michigan $317,130
New Mexico $316,617
Indiana $315,015
Ohio $309,503
Arizona $308,501
Connecticut $306,933
Mississippi $304,778
Iowa $304,398
Montana $303,853
Arkansas $302,744
Alabama $300,060
Utah $295,698
Tennessee $295,485
Kansas $286,974
Georgia $279,530
Louisiana $278,002
West Virginia $257,616
Florida $247,386

Source: ZipRecruiter

Is Cardiology Right for You? How to Decide

Deciding to pursue this career path is one that requires lots of careful consideration. The best way to confirm whether or not cardiology is meant for you is whether or not you’re truly interested. Interest in cardiology creates motivation and passion, and both can effectively fuel you to move forward, improve your performance, and you’ll be able to handle hardships better.

Are you interested in studying cardiology? Does the cardiovascular system evoke curiosity and make you want to learn more about it? Are you passionate about taking care of patients, curing fatal diseases, and saving countless lives? If you answered yes to the above questions, cardiology is right for you. 

Many cardiologist duties and tasks involve interacting and communicating with patients to diagnose and evaluate their conditions. If you’re someone who enjoys caretaking, being a good listener, and paying attention to people’s health and needs, this job can be very fun for you. 

Due to the long and extensive process of studying, training, and on-the-site work that cardiologists need to go through, cardiology is a very respected and high-paying field. Skilled cardiologists are also heavily appreciated for treating conditions and illnesses of patients, restoring their health, improving their quality of life, and most of all, saving their lives in the process. 

A job as a cardiologist is very financially rewarding. According to Cardiovascular Business, the average base annual salary for a cardiologist in the USA is $212,401 which is the 7th highest amongst medical specialties. 

Another benefit of this specialization is that many cardiologists consider their jobs to be less stressful compared to other medical professions. This is because, as a cardiologist, most of your tasks are non-surgical procedures involving conducting tests, evaluating patients, and interpreting data. These are considered “non-invasive” tasks, meaning you don’t need to do any incisions on the patient’s body. Cardiovascular surgeries are done by cardiac surgeons instead of cardiologists. 

In essence, becoming a cardiologist is certainly not for the faint of heart, but once you do reach that goal, the rewards are plentiful. At the end of the day, you must consider the following questions: 

  • Can you take all the challenges involved? 
  • Are the rewards and benefits of being a cardiologist intriguing enough for you to consider it worth all the trouble? 
  • Does the job of a cardiologist actually interest or motivate you?

Becoming a Cardiologist: Step-by-Step

After confirming your genuine interest in cardiology, here is a list of steps you’ll need to follow to become a cardiologist:

  1. Get a bachelor’s degree
  2. Complete the MCAT
  3. Enter medical school
  4. Pass the United States Medical Licensing Examination (USMLE) 
  5. Complete your residency
  6. Enter a fellowship program
  7. Acquire licensure
  8. Become certified

Let's break this down step-by-step to give you the best chance of success.

Step 1: Getting a Bachelor’s Degree

Like any medical specialization, education is of utmost importance when pursuing cardiology. To start, you must complete your undergraduate education and get a bachelor’s degree to be eligible for the next steps. 

A bachelor’s degree usually takes four years to complete, and it’s four years well spent. It’ll give you an invaluable opportunity to lay your career’s foundation. Take this time to develop your profile and prepare as much as possible for the future. 

Performing well in your courses is essential to build up your knowledge and skills and increase your chances of getting into medical school. Medical schools are quite competitive. Therefore, you must achieve academic excellence and a top-tier GPA to maximize your chances of getting accepted to medical school.

Once you’ve acquired your bachelor’s degree, you’ll need to continue your education in medical school. To be eligible for that, you’ll need to complete the Medical College Admission Test (MCAT) first.

Step 2: Pass the Medical College Admission Test 

The (MCAT) is a standardized test required by almost every medical school for admission. The test is composed entirely of multiple-choice questions, and the scores are calculated based on the number of correct answers. MCAT test scores usually need to be less than three years old to be valid for medical school applications. 

Curious about what’s on the MCAT? The exam covers the following four main topics:

  • Biological and Biochemical Foundations of Living Systems
  • Chemical and Physical Foundations of Biological Systems
  • Psychological, Social, and Biological Foundations of Behavior
  • Critical Analysis and Reasoning Skills

The MCAT is a challenging test that requires a healthy amount of preparation. Achieving a high score helps you become a more competitive applicant. 

Step 3: Complete a Medical School Degree Program 

A bachelor’s degree isn’t enough to become a cardiologist; you must also complete a degree in medical school, which will take another four years to complete in most cases. This is where the bulk of your cardiology education begins. 

In a traditional med school model, the first two years are entirely classroom-based. You’ll take advanced medical and health-related courses such as: 

  • Anatomy
  • Physiology
  • Biochemistry
  • Pathology
  • Pharmacology

You will also learn medical terminology, make effective medical decisions, and conduct various standard procedures, such as communicating with patients, reviewing medical history, and performing diagnostic tests.

You’ll partake in supervised training in a real hospital in your last two years. This is where you’ll apply what you’ve learned and gain hands-on experience. You’ll participate in a rotation of different medical specialty areas, such as internal medicine, obstetrics, and gynecology.

Once you’ve finished that, you’ll get your Doctor of Medicine (MD) degree (or an equivalent). But before you graduate, you should complete the USMLE exam and apply for a residency program, as residency will be your next stop. 

Step 4: Pass the United States Medical Licensing Examination

During your time in medical school, it is strongly advised to pass the United States Medical Licensing Examination (USMLE). This is a three-step examination for medical licensure in the U.S, and each of these steps is taken at different points during your medical school education. 

USMLE Step 1

Step 1 of the USMLE is usually taken after your second year. The full testing session lasts eight hours and is divided into seven 60-minute blocks. The amount of questions per block is different but will never exceed 40 questions. 

Step 1 examines your understanding and ability to apply basic scientific concepts of medical practices. You must have a solid foundation in up-to-date medical procedures and medical and scientific principles learned in the classroom to perform well.

USMLE Step 2

Step 2 is usually taken during your last year of medical school before graduating. It lasts nine hours and is divided into eight different 60-minute blocks. Similar to Step 1, the number of questions in each block is inconsistent but never exceeds 40. 

Step 2 examines your ability to apply your medical knowledge, skills, and understanding of basic clinical concepts and practices to provide supervised patient care, emphasizing disease prevention and health improvement. The content of Step 2 covers many different body systems, tasks, and competencies for physicians.

USMLE Step 3

Step 3 is the final part of the USMLE exam. You must hold an MD and pass Step 1 and Step 2 to qualify for Step 3. Step 3 is longer than the previous two steps; it contains multiple-choice questions and computer-based simulations and takes two days to complete.

Step 3 is almost entirely about your ability to apply your medical knowledge and clinical concepts and procedures essential for the unsupervised practice of medicine. To perform well in this section, you must deliver medical care independently and responsibly in a real, professional setting.

Once you pass this final step, you’re eligible to get a license needed to practice medicine unsupervised. 

Step 5: Undertake a Cardiologist Residency

After medical school, you must complete a cardiologist residency. A residency is essentially postgraduate supervised training to let medical school graduates gain experience in their chosen specialty. 

Prospective cardiologists must complete a residency program in internal medicine, which lasts for three years. You will practice many internal medicine specialties, such as oncology, respiratory medicine, and gastroenterology. You’ll learn cardiology techniques during residency, such as: 

  • How to interact with and prepare patients
  • Cardiac catheterization
  • Hemodynamic studies
  • Stress tests 
  • Echocardiograms
  • Radiographic imaging and fluoroscopy

During your residency, you’ll build your experience, skills, knowledge, portfolio, and connections, which will be very important in the future.

Step 6: Enter a Fellowship Program

After you complete your residency, a cardiology fellowship program is the next step. This hands-on training session is more advanced, with an in-depth focus on cardiology, and takes another three years to finish. You’ve almost made it, so hang on!

During a cardiology fellowship program, you’ll work with physicians and learn about specific concepts, practices, and procedures through on-the-job training. Some of these procedures include:

  • Heart catheterization
  • Clinical research
  • Echocardiography
  • Intervention

You will also learn about the diagnosis, treatment, and prevention of various cardiac conditions, such as:

  • Heart failure
  • Heart attack
  • Arrhythmia
  • Hypertension/Hypotension
  • Coronary artery disease 
  • Valvular heart disease

Your fellowship program is possibly the most important part of preparing to become a cardiologist. You’ll build upon your knowledge and previous general training to gain an in-depth understanding of cardiology. By the end of your fellowship, you should have learned everything you need to become a cardiologist.

There are still a few more things to do before you begin your long-awaited career. Don’t worry though, because they won’t be too difficult.

Step 7: Get a License 

According to many health organizations, including the American Board of Internal Medicine (ABIM), you must acquire a license to practice medicine without supervision in the U.S. 

Fortunately, to get a license, you must pass the USMLE, which is done while you’re in medical school. Nonetheless, you’re still eligible to take and pass this exam after you’ve graduated. You’re eligible to take the exam if you are enrolled in or a graduate of a U.S. or Canadian medical school leading to an MD degree. 

However, if you’re dismissed or have withdrawn from medical school, you’re no longer eligible for the USMLE.

Step 8: Acquire Certification

After completing all your training, cardiologists must be certified by taking an exam administered by ABIM. This exam tests your skills, knowledge, and understanding of cardiology and standard practices, procedures, and techniques.

The exam has two components: the multiple-choice part and the ECG and imaging studies. The multiple-choice component examines your knowledge, identification skills, diagnostic reasoning, and judgment skills of many types of cardiovascular diseases. Most of these questions describe realistic scenarios involving patients. 

The ECG and imaging studies component has you interpreting and analyzing data and your ability to make decisions. Such data and material include:

  • Electrocardiograms
  • Intracardiac electrograms
  • Hemodynamic recordings
  • Chest radiographs

Once you’ve been certified and gained both your licensure and doctoral degree, you’re finished all needed education and training. Now you can start your career as a cardiologist!

Other Considerations

We’ve covered the challenges and the benefits of the process of becoming a cardiologist, but there are still more factors you should consider.

Costs of Becoming a Cardiologist

It takes a long time to become a cardiologist, and there are many costs to be covered.

First is your tuition. In most cases, you’ll need four years of undergraduate education and four more years of medical school education. The tuition varies depending on which school you go to. 

For reference, here is the median annual tuition for undergraduate biology and health studies programs as of 2022:

Biology Health Studies
In-State Public Tuition 8,883 USD 7,070 USD
Out-of-State Private Tuition 40,140 USD 32,976 USD


Additionally, according to the Tuition and Student Fees Reports done by the AAMC, the median annual tuition for medical school programs was 36,075 USD for residential students of public medical schools and 61,990 USD for residential students of private medical schools.

Another thing you should pay attention to is living expenses. This could include groceries, gas (if you have a car), rent, phone bills, health insurance, and more. How much you spend in your daily life depends on where you will finish your studies and training. 

Additionally, being a cardiologist requires you to pass at least two standardized extracurricular exams: the USMLE and the American Board of Internal Medicine’s certification exam. Both require a fee for every registration. As of 2023 October, for the USMLE fee, Step 1 and Step 2 both cost 975 USD for registration, while Step 3 costs 895 USD. Additionally, the Internal Medicine Certification Exam held by the American Board of Internal Medicine costs 1,430 USD. 

The above shows a rough scheme of all the fees you should consider. You should look into the details of your situation and always prepare for any additional spending that may occur. Fortunately, once you begin your training in residency and fellowship programs, you will start to get paid, so costs will be less of a concern when that time comes.

Work Environment

Adapting to the work environment of cardiologists is crucial. Cardiologists mostly work in physician’s offices, clinics, or hospitals. Most of their work can be done independently, but they frequently work with patients, physicians, and other medical professionals. 

Many cardiologists work full-time schedules and may participate in on-call rotations. The work schedule for cardiologists is fairly stable, although the workload may fluctuate. 

Specializations and Advancements

During your cardiology education, training, or even work, you can think about what you wish to specialize in. Some popular specializations include pediatrics, interventional cardiology, or cardiac imaging, but you can even become a cardiology educator at a university or academic hospital. 

Your specialization can affect your career path and how you advance. 

FAQs: Becoming a Cardiologist

Do you still have questions about how to become a cardiologist? We’ve outlined several questions and answers below to help you pursue cardiology. 

1. How Long Does It Take to Become a Cardiologist? 

It takes about 14 years from start to finish to become a cardiologist from the time you enter an undergraduate program. 

2. At What Age Do You Become a Cardiologist? 

Assuming you enrolled in college right after high school with no gap years, you can expect to be in your early 30s when you become a cardiologist. 

3. How Long Is a Cardiology Residency? 

You must complete a three-year internal medicine residency to become a cardiologist, plus a fellowship program. 

4. What Is the Career Outlook of Cardiologists?

According to the U.S. Bureau of Labor Statistics, the overall employment of physicians and surgeons is projected to grow by 3% in the next decade. Approximately 22,700 new openings for physicians and surgeons are projected each year, on average. The “physicians and surgeons” here include cardiologists.

5. What Are the Best Medical Schools for Cardiology?

According to U.S. News and World Report, medical schools that offer the best programs in Cardiac and Cardiovascular Systems include:

  • Harvard Medical School
  • Vagelos College of Physicians and Surgeons, of Columbia University
  • Duke University School of Medicine
  • Icahn School of Medicine at Mount Sinai
  • Stanford Medicine, of Stanford University

6. How Long is Cardiology Fellowship?

A cardiology fellowship is typically three years long. Getting into cardiology training is tough because a lot of people want to do it. It takes three more years of training after you finish internal medicine.

Final Thoughts

The road to becoming a cardiologist is certainly a long and rigorous one. However, if cardiology is something that your heart truly yearns for, and you have the necessary work ethic and grit, you’ll be heavily rewarded with an extremely respected profession. 

Best wishes on achieving your goals!

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