When I heard my fourth-year sub-internship was going to be in Cardiology, I was extremely intimidated, as most students who had rotated through Cardiology were. Cardiology is such an intricate and complex subject that I felt I never mastered, and it didn’t help that I still felt less than subpar in my EKG reading skills. After completing 3 weeks of my sub-I, I can say that while it is a very complicated field, it is a lot less daunting once you have cared for enough patients with STEMI, NSTEMI, heart failure, arrhythmias, etc. The treatment regimen tends to stay quite consistent amongst the same presenting problems, so now I feel confident in the assessment and plan of these patients. Additionally, there has been an incredible amount of teaching on this service. Very helpful topics have been EKG practice, learning how to read an echocardiogram, reviewing the management of atrial fibrillation. Higher-level topics that have gone over my head but were also interesting included the ins and outs of sensitivity/threshold of pacemakers, reading nuclear stress tests, calculating peak gradients as part of the echocardiogram analysis. The physicians and residents on this service have been extremely encouraging and kind, which has helped in creating such a positive experience. Although I do not think I will be pursuing Cardiology in my future career, I am thankful I got this experience as I am sure I will encounter numerous cardiac issues in my practice as an internal medicine resident. I still may not be able to spot a junctional rhythm or be able to distinguish when ventricular tachycardia is pathologic or an artifact on telemetry, but at least I can identify and localize infarcts, arrhythmias, and conduction abnormalities on EKG. All of which is much more than I would’ve been able to say just three weeks ago!
