Ischaemic heart disease is the number one global cause of death and has been for over 20 years (World Health Organisation, 2018) with 7.4 million people living with cardiovascular diseases in the UK (British Heart Foundation, 2019). This places a huge demand on the NHS with a financial burden of an estimated 7.4 billion per year spent on cardiovascular disease-related healthcare costs in England alone (Public Health England, 2019). Cardiac Science is a growing field with 541 applicants in 2018 and 35 direct entry posts. As a Cardiac Science STP trainee, I am based in the Cardiac Investigations Department but we work in many different arms of cardiology including the Outpatients Department, the Cardiology Wards, and the Catheter/Pacing Labs.
Being an STP trainee in Cardiac Science is challenging yet very rewarding. The role is patient facing and involves:
- Using a wide range of tests to diagnose coronary artery disease / ischaemic heart disease
- Analysing and interpreting results and writing reports
- Assisting in the treatment of coronary artery disease/ischaemic heart disease via invasive procedures and being an invaluable member of a multidisciplinary team (consisting of a cardiology consultant, radiographer, nurse and physiologist)
The STP trainee gets a choice between two specialisms; echocardiography and pacing/devices. During the second year (after exposure to both specialisms), the STP will choose one and aim to take the professional examination either in the third year of their STP or once they’ve completed the STP. Although you choose one, you still complete assessments in both.
The first year consists of spending six weeks at University (Manchester or Newcastle) with the first two weeks focused on learning a wide range of subjects from genetics and epidemiology to neuroscience and reproductive physiology. The last four weeks are centred on CVRS (Cardiac, Vascular, Respiratory, and Sleep Science). I found it fascinating learning about the other subjects and how they linked into cardiac science.
At the Trust, the first year will consist of learning the basics of the electrocardiograms (ECG’s) and how to interpret them. I spent the first few months completing ECG’s and setting up heart monitors on inpatients and outpatients. We also complete rotations in respiratory/sleep and vascular science and have competencies and assessments for all rotations.
In Cardiac Investigations we do a multitude of tests including exercise tolerance testing, tilt table testing, ECG’s, heart monitors, echocardiograms, pacemaker/device checks and pharmacological stress testing.
We also assist in the catheter labs during interventional procedures such as angiograms and percutaneous coronary interventions (PCI’s). An angiogram is when pictures are taken of the coronary arteries to see if there are any narrowings due to plaque build up. If there is significant narrowing then this can cause a heart attack. If there is a narrowing and the consultant decides that it needs intervention, a stent or balloon will be inserted in order to ‘open up’ the blocked artery. This is known as a PCI. Tertiary centres have facilities in which they can accept primary PCI’s. These are non-elective patients that are having a heart attack and they get rushed in from outside the hospital to have emergency reperfusion therapy. I am based at New Cross Hospital in Wolverhampton which has a primary PCI service. During the STP, you will complete assessments in the catheter lab.
The last two years will be more focused towards echocardiography and pacing/devices with catheter lab sessions thrown into the mix. I have been getting more exposure in the catheter labs, which I absolutely love but the environment can be quite demanding as the physiologist is in charge of the defibrillator if anything happens (which it can quite often). Don’t worry though because as an STP trainee you will always have someone with you as we are supernumerary.
Cardiac Science is an amazing field to train as a clinical scientist, it can be daunting at times as we can be exposed to medical emergencies but we are fully equipped with immediate life support training and plenty of experienced staff around us. The STP is a great opportunity which opens doors for a lifetime career in healthcare science. The skills that we learn are invaluable and I’ve heard from colleagues that countries like Canada and Australia are desperate for cardiac scientists so it could be a golden chance to work abroad post STP!