What we would like to discuss with you is what its like to work as a consultant cardiologist. We have a few questions to ask: what is it really like being a consultant cardiologist? How did you at the age of 17 or 18 decide what you wanted to do? And were there any challenges that you had to overcome?
What is a consultant cardiologist?
My name is Doctor Emanuel and I’m an interventional cardiologist. What does that mean? That means I treat problems with the blood supply to the heart or also if there is a problem to do with the heart valves I can do a keyhole surgery. In fact, we can work on beating hearts which is quite cool. We’re able to get patients who are having a heart attack up and healthy within two days. It used to take a month of bed rest to treat patients who had a heart attack.
How did you become a consultant cardiologist?
First of all, you do GCSEs and then A levels. When I was doing it, you needed 3 subjects in A Levels. Now you probably need 4 or something extra to stand out. I did three A Levels in maths, chemistry and physics. I needed to resit my A Levels because in my first attempt I got two As and a B. So I had to resit the B to get three As to be accepted into medical school at UCL.
I thoroughly enjoyed medical school and then had preclinical. It was 2 years of just pure theory which after the first year, I think about 25% of my cohort thought this was not for them and left. We then did an intercalated BSc. This is where you can get a bachelors in science within a year of your training. So I did mine in space medicine and physiology. We learnt about going up to space, deep diving, climbing up Everest and I learned about the extreme environment affects on the physiology of the heart and the systems. I found this very interesting so I applied to go to NASA but I was rejected. I didn’t let that deter me so I went on to do cardiology.
How long does it take to become a consultant cardiologist?
You do a minimum of six years of medical school and then you become a FY1 which is a foundation year doctor. In foundation year 2, you then decide if you’re going to go into surgery or medicine. I chose the medicine aspect and then went into core medical training and then sub specialised in cardiology. At about four years in you go into a speciality of medicine.
I chose cardiology and then did interventional cardiology and became a consultant in 2016 and never looked back since then. I get to do work with innovative minded people and it’s a thoroughly enjoyable profession, I have to say.
From A levels, it’s normally a 6 year course at university and then add another 10 years to be a consultant. So roughly it’s about 16 years.
How did you choose to do medicine at a young age?
I think people change and a lot of that is from the influences they come across like people they’ve seen and people that inspire them. First of all, I started out wanting to be a priest. My upbringing was in Nigeria and the priest was the one that everyone respected in the community. So I thought I want to be that guy. I think that only lasted a year. Then, I wanted to be a pilot, and that’s because right next to my primary school was a military Air Force Base. So I went and applied to a military school and they said I was too small.
So I think your experiences shape where you go and I always knew I liked the sciences and I really enjoyed A Levels. I thought medicine was just a three year course without researching it more. With whatever you end up doing, its good to really enjoy what you do. I think the 25% of people who left in the first year were those who were either forced into doing something, they really didn’t want. You also need to be self motivated because medicine is a course where you get knock backs. We work with patients and patients may survive may or may not survive so you need that self motivation.
What A Levels do you need to do medicine?
I did maths, chemistry and physics but now to do medicine you need biology. I think I was in the last year where if you didn’t do biology, you would still get into medical school. Initially I got two As and a B and I had to resit my B to got three As.
I think most places now want you to do something extracurricular and some people do four A Levels. First of all, look at the university requirements and start building your CV towards that. If you’re going into medicine, it’s always good to do a placement in a hospital. There’s now lots of volunteering schemes and hospital ward shadowing. Get an experience you can put on your CV and personal statement. For example there are some people who do music or other people do dancing so there are lots of extracurricular activities.
What is the most interesting case you’ve seen?
You get to a point where the cases become routine and almost second nature. You feel that you can almost do it with your eyes closed. I think what really gets to you is probably the patients. You will get some patients that you will forever remember and sometimes it may be a case that’s not so good, but you did all you could for the patient.
I remember one case when I was a FY1, so a foundation year doctor in a hospital on a surgical ward. It was a weekend and I was looking after a retired nurse. Back in the day, you’d get a hand over of the patients blood results and she came in with what we call an INR. This is a blood level marker and she was on warfarin and had an INR level of eight. This means that her blood is very thin and I had to recheck the results. I went to see her and her tummy was just expanding in front of me. I said, “Oh my goodness, what is this?” and in essence, she was bleeding into her abdomen. Back then I was one of those people who may have been a bit stubborn.
I immediately called for senior help and arranged a CT scan to see what’s going on in the stomach. When it was confirmed she was bleeding, I told them to take us straight to theatre. This was on the weekend and the consultants are not normally around. I got the most incredible call from a consultant having a go at me. I heard things like who did I think I was ordering this patient in to theatre without discussions, etc. But in my training, if someone is bleeding they need lifesaving treatment and the operating theatre was the place to go.
After a lot of shouting, he eventually came in, opened up the abdomen and she was bleeding from her liver because she had a cyst that had ruptured. Due to her blood being so thin they couldn’t stop it so he just packed it and she ended up surviving. For me that’s the case, I have never forgotten and that’s probably because of the amount of shouting I got when I thought I was doing the right thing. All that shouting later on became well done for doing this, etc.
So that case I will always remember. It’s nothing I did personally as an interventionist, but it was those key decisions that you make at critical moments that can save or cost someone’s life.
What would you say to someone who wants to be a consultant cardiologist for the money?
It’s really not about the money, you come out of it with so much more than money. Everyone understands that we have to survive and have to pay the bills, but it’s really not about the money. So if you go into it purely thinking this is a field where you can make lots of money, drive a Ferrari and live in a big house, not all doctors live that lifestyle. Especially as a consultant cardiologist in the UK. In my experience, I’ve taught in China, Bangladesh, Thailand, the Middle East and Africa and I’ve worked with professional football players. These are experiences that money can’t buy.
Your mental health is also important, so you need to enjoy what you are doing. For example I would get a call at three in the morning, 5:00 in the morning, someone having a heart attack. If you don’t enjoy doing that, not only would you be miserable, but your family would be miserable or colleagues would be miserable because they just won’t enjoy working with you. Your mental health and the well-being of your family, or people you interact with is very important. So if money is the driver you won’t get much out of it.
Can medicine be changed in the future?
The good thing about medicine is, for example, artificial intelligence. So you can have someone who has an interest in one thing but likes medicine and they can combine the two very well. There are lots of people who do artificial intelligence or app designing. We need innovative ventures in medicine. If that is you, you can make a very creative career. If you like engineering, you can design the new heart valve or the new procedures for the hip and so on. The medical field is expanding. This is not something that 10-15 years ago was very possible but now with artificial intelligence and new technology the field is expanding.