Paediatric cardiology

The stereotypical image of a paediatric cardiologist--an aggressive and boisterous male, found in the catheter laboratory at all hours, and lacking in communication skills--is outdated. Some old school paediatric cardiologists may still exist, but the new breed of trainees represents a more modern range of junior doctors, and more women are appointed as consultants than in the past. The specialty has begun to branch into specific areas of expertise: some doctors are mainly interventionalists working in the catheter laboratory, but others specialise in imaging (echocardiography, including fetal and magnetic resonance imaging). So if you are one of those doctors who enjoy using their surgical skills but who also enjoy practising medicine, this is an ideal job. For those who do not want to spend a lot of time in the catheter laboratory, there are lots of other interesting and challenging areas.

Despite some adverse publicity over the past few years, the specialty remains one of the most rewarding. Because of the structurally abnormal nature of the heart defects, they are amenable to logical detection and management. Making a diagnosis in a sick blue newborn baby and quickly carrying out treatment, leading to a healthy pink robust infant in a short time, is rewarding. Paediatric cardiology allows follow up of progress from the fetus to the adult. Until about 20 years ago, treatment of complex heart defects had a mortality of more than 20%, but with major advances mortality has now fallen to less than 5%. Box 1 gives the advantages and disadvantages of paediatric cardiology.