How to Become a Cardiologist | Cardiac Electrophysiologist

Hi, my name is Hafiza Khan. I am a clinical cardiac electrophysiologist, which is a mouthful. I'm in practice in the North Dallas area. So a cardiac electrophysiologist is a cardiologist who specializes in the beat of the heart. So I deal with people who have problems with the electrical part of their heart. Their beat is too slow, too fast, too irregular. So I'm a cardiologist, but I'm an electrical cardiologist. So when I was in med school doing my clinical rotations, I knew pretty much right away that I loved doing surgeries and procedures. So, and I knew also that I couldn't be in the office five days a week. So I was deciding between a surgical subspecialty versus cardiology, because cardiology involves having procedures and office. And I met my mentor, who was a electrophysiologist, and he opened my eyes to the specialty that I didn't even know existed. I thought cardiology meant heart attacks and plumbing problems, heart failure, but I realized that there is a secret hidden specialty, which is mine, dedicated to the beat of the heart. So I like it because it's a nice mix. I'm in the office two to two and a half days a week, but I'm in the hospital the other half time doing procedures. So I like being in the office. It gives me continuity. I see my patients, but I really also enjoy cutting, sewing, suturing, doing procedures. So it's a nice mix of both of that for me. I'm in the office about two to three days a week, and my office days are pretty busy. I start seeing patients at nine in the morning, and when I finish, my procedure days or hospital days are about three days a week. And I start doing my procedures around 7 30, and I do hospital consults. So the type of procedures that I do are related to the electrical part of the heart. So I put in pacemakers. I put in a device called a pacemaker defibrillator, and then I do a procedure called a catheter ablation. So what that means is I go into the heart and try and find the cluster of cells that's abnormal and cauterize or freeze it. So as a person's heart is beating, I'm trying to localize the abnormal cells that are misfiring and cauterize it. That's called an ablation. Those days can be pretty long, 10 hours, maybe longer. So the day ends when the day ends. So after high school, you have to, as in all type of doctors, you have to have a basic undergraduate degree, and it doesn't have to be in science. I did my bachelor's degree in biology, but you should pick whatever field you feel that you want to learn about, and it doesn't have to be a science field. After that, you do four years of medical school, which is what all doctors have to do, and then you have to do a residency. So it is internal medicine, and that's a three-year internal medicine residency. So if you stop at internal medicine, then you are an office-based internist, but from internal medicine, it's a gateway to many different specialties. You could be a pulmonologist, a cardiologist. So for cardiology, you have to do three additional years. Now, then you are a general cardiologist, but if you want to do procedures, obviously that takes more training. So to be an electrical form of a cardiologist, it takes two additional years, so it's a lot of training. So four years of undergrad, four years of med school, three years of internal medicine, three years of general cardiology, and two years of electrophysiology. So I could almost maybe be a neurosurgeon for all the length of the training as that, but the higher you go in specialization, the narrower the amount that you have to know. And also, it makes sense that if you're going to be in somebody's heart, burning heart muscle cells, that there's extra training involved to be able to do that. The disadvantage of being an electrophysiologist is that it takes, it's such a big long run-in to be what we do. The advantage is, in general, in the more you train and the more you do procedures and surgery, the more you're reimbursed. So that makes no sense because our primary care doctors, our pediatricians, our family practice, they work really hard, but unfortunately, they're not recognized financially for all of their hard work in keeping us well. But we surgeons and proceduralists get paid more. So a cardiologist, so if I had just stopped there, the average American cardiologist makes about $350 to $400 per year. But a cardiac electrophysiologist, because I do complicated procedures and I've taken that extra time, the average American cardiac electrophysiologist is making on the order of somewhere between starting salary of $400,000, but then after being in practice for as many years as I am, you know, up to $700, $750, depending on where you practice. So if you practice in an urban area in the Northeast or in California where there's more HMOs, that number may be lower. Here in the South, in Texas, that number is higher. It's not easy, but with anything, it takes a village to, no matter what your medical specialty. So when you're a physician, it's not usually a nine to five job. And when you're a physician who specializes in the beat of the heart, well, the heartbeat is a vital sign because if something messes up, you're dead. So when I get called, I have to be right there because it's an emergency. So I have a host of people who help me. I have a supportive spouse. My mother is also in the area. I have had nannies. So, you know, if you're organized and you have a support system around you, it's very possible. I had both of my two sons when I was in training. I have a 23 year old son and a 20 year old son, and they're all grown. But if I can do it, you can do it. Unfortunately, only about 12 to 15% of all cardiologists are women. And in my specialty, only 6% are women. So women are half the American population and 300,000 women die of heart disease every year. And yet there are so few of us in cardiology and so few of us in cardiac electrophysiology. And part of that is that if you don't see yourself represented, you don't know that that's possible for you. So if you're watching and you're a woman, if you're a woman of color, if you're a woman of a minority background, if you're a woman who's Latino or African American, please dream big. You can do what you want to do. You can have a family. I have been married for 31 years. I have a 20 year old and a 23 year old son. And both of my sons have chosen careers in science. And I haven't messed up. They are happy and healthy. And if I can do it, you can do it. Because in my day, there was no YouTube or social media or internet. There was nobody to guide me. I had no role model and I had to find my own way. Here, you have so many amazing role models, social media, in the real world, as you look around you. So reach out to somebody who inspires you and have confidence that you can do it. There are so many people around us that tell us that women can't do this, or women can't do that, or an African American woman can't do this or that. That's not right. You can do what you want to do and dream big. It's hard work, and it takes support. But people need to see themselves in their doctors. The physicians of our country need to represent and look like the people that we serve. It can't just be one ethnicity, and it can't just be one gender. So if there's any message that you can take away, if you're a young woman, Latino, African American, white, Indian like me, know that you can do it. It may take a while. There may be people all along the way who are telling you you can't. Don't listen to them. If I can do it, and I stumbled along blindly, you can do it too. So internal medicine residency is not as competitive to match in as, for example, dermatology, orthopedics. Internal medicine, though, is a gateway to get your toe in to go into the more competitive specialties. So I'm biased, but I do feel that the most competitive fellowships, so internal medicine is the residency. When you go further, it's called fellowship. So the most competitive fellowship after internal medicine, I believe, is cardiology. The second most is gastroenterology. And what makes it competitive is the financial reimbursement that you get once you become a cardiologist or gastroenterologist. So to get into an internal medicine residency, I don't think is as competitive as to get into a ophthalmology or orthopedic surgery residency. Cardiology rotations, do research, find a mentor, and try and publish, because that's what's then going to get you into a competitive fellowship, which is cardiology. And the more you train, the narrower the number of applicants becomes, because many people don't want to commit so much time to their training. So we need more cardiologists. Heart disease is the number one cause of death in our country, and yet there are only 55,000 practicing board-certified cardiologists in the United States. So over 300,000 people die of heart disease a year, and 55,000 of us cannot help all of them. So we need more cardiologists. The average American cardiologist is aging out. A baby boomer, usually a male baby boomer, who is between the ages of 55 and 56. So we need young people. That's called secession planning, because heart disease is an epidemic. The current cardiology population is aging out, although as I get older, I'm not saying that 56 is old. But we need young people to fill that gap, and yes, applying for cardiology fellowships is competitive, but once you've got your toe in the door in internal medicine, it's your moment to shine by going the extra mile and doing research and publishing. So I microblog, which is brand new for me, because I'm a Gen X-er, and this is a millennial social media world. So about eight months ago, I started microblogging on Instagram, and my Instagram handle is heartbeatdoctor. So that's heart with a period, beat with a period, and doctor, aka electrophysiologist. So it's heartbeatdoctor, and I blog there. You can feel free to follow me or direct message me, and I do respond to all of my messages. Hi, I'm Dr. Hafiza Khan, and I'm a cardiac electrophysiologist, and I absolutely love what I do.