Embarking on a cardiology fellowship is the final, intensive step toward a career at the pinnacle of medicine. While the journey is long and demanding, the professional and financial rewards are substantial. An attending cardiologist is consistently one of the highest-paid medical specialists, often earning well over $500,000 annually. However, before reaching that peak, fellows undergo several years of specialized training.
This article provides a data-driven look at a cardiology fellowship salary, exploring what you can expect to earn during this critical training period and the factors that influence your compensation.
What Does a Cardiology Fellow Do?
A cardiology fellowship is a three-year (or longer for sub-specialties) advanced training program that a physician undertakes *after* completing a three-year internal medicine residency. A cardiology fellow is a fully licensed physician who is learning the specialized skills of cardiovascular medicine under the supervision of senior cardiologists (attendings).
Key responsibilities include:
- Advanced Patient Care: Managing patients with complex cardiovascular conditions like heart failure, coronary artery disease, arrhythmias, and valvular heart disease in both inpatient and outpatient settings.
- Diagnostic Interpretation: Learning to perform and interpret advanced diagnostic tests, including electrocardiograms (EKGs), echocardiograms, stress tests, and cardiac catheterization results.
- Procedural Training: Gaining hands-on experience with procedures, which can range from diagnostic angiograms to more complex interventions depending on the fellowship track.
- Research and Academics: Participating in clinical research, publishing papers, and presenting at conferences, which are often requirements of academic fellowship programs.
- Teaching and Mentoring: Supervising and teaching junior medical residents and students.
A fellowship is an intense period of long hours and profound learning, designed to forge a highly competent and independent cardiologist.
Average Cardiology Fellowship Salary
A fellowship salary is more accurately described as a stipend, as it is part of a GME (Graduate Medical Education) program. It is not commensurate with the salary of a fully independent physician but is intended to cover living expenses during training.
Based on the most recent data, the average salary for a cardiology fellow in the United States falls between $70,000 and $85,000 per year.
According to the Association of American Medical Colleges (AAMC), the average resident/fellow stipend for the 2023-2024 academic year increases with the post-graduate year (PGY) level. Since a first-year cardiology fellow is a PGY-4, their stipends are higher than those of junior residents.
- Salary.com reports a median cardiology fellow salary of around $79,900, with a typical range of $73,100 to $86,700.
- Glassdoor data corroborates this, with most reported salaries falling in the $75,000 to $92,000 range, which may include additional compensation or be reflective of positions in higher cost-of-living areas.
It is crucial to understand that this modest stipend is a temporary phase before a dramatic increase in earning potential upon completion of the fellowship.
Key Factors That Influence Salary
While fellowship stipends are more standardized than attending salaries, several key factors can influence your exact compensation.
### Level of Education (Post-Graduate Year)
In the context of a fellowship, "level of education" directly translates to your Post-Graduate Year (PGY). A cardiology fellowship typically begins at the PGY-4 level (after three years of internal medicine residency). Stipends are structured to increase with each year of training.
- PGY-4 (First-year fellow): Est. $70,000 - $78,000
- PGY-5 (Second-year fellow): Est. $73,000 - $82,000
- PGY-6 (Third-year fellow): Est. $76,000 - $86,000
- PGY-7+ (Sub-specialty fellow): Those pursuing further fellowships in areas like interventional cardiology or electrophysiology will see continued incremental increases.
### Years of Experience
Directly tied to the PGY level, your years of experience as a physician in training dictate your stipend. A PGY-6 fellow has two more years of clinical experience than a PGY-4 and is entrusted with greater responsibility, which is reflected in the slightly higher pay. However, experience prior to residency (e.g., research years) generally does not impact this standardized pay scale.
### Geographic Location
Location is one of the most significant variables. Training institutions in high cost-of-living (HCOL) areas must offer higher stipends to ensure their fellows can afford to live there.
- High-Cost Regions: Fellowships in major metropolitan areas like New York City, San Francisco, Los Angeles, and Boston will offer stipends at the higher end of the range, often exceeding $85,000 for senior fellows.
- Lower-Cost Regions: Programs in the Midwest and Southeast may offer stipends closer to the lower end of the national average, but the lower cost of living can make this financially comparable.
### Company Type (Institution)
The type of institution hosting the fellowship plays a role in compensation and benefits.
- University-Based Academic Medical Centers: These are the most common fellowship sites. They typically have very structured, GME-funded pay scales that are publicly available and strictly follow PGY levels.
- Large Private Hospital Systems: Some large, non-university-affiliated hospital systems may offer slightly more competitive stipends or better benefits packages (e.g., housing stipends, meal allowances) to attract top-tier candidates.
- Government/VA Hospitals: Fellowships at Veterans Affairs hospitals are funded by the federal government and offer competitive, standardized stipends along with excellent federal benefits.
### Area of Specialization
This factor is the single greatest determinant of your *future* salary after fellowship. While stipends during a general cardiology fellowship are relatively uniform, the path you choose dramatically impacts your earning potential as an attending physician.
The Medscape Physician Compensation Report 2023 highlights these stark differences:
- Cardiology (Overall/Non-Invasive): Average annual salary of $507,000.
- Invasive/Interventional Cardiology: These cardiologists perform procedures like stenting and angioplasty. Their specialized, high-revenue-generating skills command much higher salaries, often in the $600,000 to $750,000+ range, making them some of the highest earners in all of medicine.
- Electrophysiology (EP): Specialists who treat heart rhythm disorders also have extremely high earning potential, comparable to or even exceeding interventional cardiologists.
Therefore, the decision to pursue an additional 1-2 year sub-specialty fellowship after the general three years is the most impactful financial decision a cardiology fellow can make.
Job Outlook
The career outlook for cardiologists is exceptionally strong. The U.S. Bureau of Labor Statistics (BLS) projects that employment for physicians and surgeons will grow by 3% from 2022 to 2032, which is about average. However, the demand for cardiologists is expected to be much stronger than the average due to two key factors:
1. An Aging Population: The large baby boomer generation is aging, leading to a higher incidence of age-related cardiovascular diseases.
2. Prevalence of Chronic Conditions: High rates of obesity, hypertension, and diabetes continue to drive demand for cardiovascular care.
Cardiology is a specialty with high demand and a projected physician shortage, ensuring excellent job security and continued high earning potential for those who complete the rigorous training.
Conclusion
A cardiology fellowship is an investment in your future. While the stipend, averaging $70,000 to $85,000, is modest compared to the workload, it is a temporary stage. The key takeaways for any prospective fellow are:
- It's a Stipend, Not a Salary: View your fellowship pay as a living stipend designed to support you through your final years of training.
- Location and PGY Level Matter Most: These are the primary drivers of your salary *during* fellowship.
- Specialization Dictates Future Earnings: The choice to sub-specialize in a field like interventional cardiology or electrophysiology is the single biggest lever for maximizing your lifetime earning potential.
- The Reward is Immense: Upon finishing your training, you will enter one of the most respected, impactful, and financially rewarding professions in the world, with a potential salary increase of 500-800% almost overnight.
The path is challenging, but for those with a passion for cardiovascular medicine, the career offers unparalleled opportunities for professional growth and financial security.