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Cardiology training in the USA
  1. Jacob J Mayfield
  1. Division of Cardiology, University of Washington, Seattle, Washington, USA
  1. Correspondence to Dr Jacob J Mayfield, Division of Cardiology, University of Washington, Seattle, WA 98195, USA; Jake.Mayfield{at}

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Modern medical education in the USA is a competitive, highly regulated and highly regimented process.1 In order to specialise in cardiovascular diseases, aspiring cardiologists must at minimum complete a college (bachelor’s) degree, medical school (MD or DO), internal medicine residency and cardiology fellowship. The required length of training in cardiology has significantly increased in parallel with the proliferation of subspecialties and rapid expansion of medical knowledge,2 such that the typical minimum length of training following high school graduation is now 14 years (figure 1).

Figure 1

Timeline of typical training in cardiovascular diseases in the United States. AAMC, Association of American Medical Colleges; ABIM, American Board of Internal Medicine; ACT, American College Testing; ASE, American Society of Echocardiography; ASNC, American Society of Nuclear Cardiology; SAT, Scholastic Assessment Test; SCCT, Society of Cardiovascular CT.

Training overview

The path to a career in cardiology begins before US students graduate from high school with preparation for the competitive college admissions process. Especially for students of limited financial means, admission offers and scholarship awards from universities with a track record of successful matriculation into medical schools are critical, given the cost of tuition, which ranges between $9000 and $40 000 per year excluding living expenses. Once accepted to a university, potential medical students are free to study the major or majors of their choice, though minimum prerequisite coursework is necessary for application. Potential applicants generally take the Medical College Admissions Test in the junior year. Medical training involves obtaining an additional professional doctorate, MD or DO, and requires a separate application process towards the end of college education. It is often undertaken at an institution different from the student’s university. Admission has become more competitive over time, with approximately 36% of applicants being successful and, on average, having taken two gap years between university and medical …

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  • Correction notice This article has been corrected since it was first published to amend author name Jacob J Mayfield.

  • Contributors JM wrote the manuscript and created the figure.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests JJM serves on the Heart Editorial Board.

  • Provenance and peer review Commissioned; internally peer reviewed.