Cardiologist compensation 2023: Well-paid, but are they satisfied?

By Shamard Charles, MD, MPH Published November 21, 2023

We know that doctors are among the top earners in the US—and cardiologists are among the highest paid specialists, according to studies. But like most physicians, cardiologists are burdened by debt, struggling with burnout, and impacted by staffing shortages, administrative load, pay inequities, and other issues that can fuel discontent.

This is the second in a series of MDLinx special reports examining doctor compensation trends, leveraging the most current data from the Medical Group Management Association (MGMA), among other sources. Here, we look at cardiologists' salaries and the factors that affect their compensation.

The state of cardiology compensation

Cardiology offers diverse career paths, branching into numerous specialized fields. More than 34,000 cardiologists practice in the US, performing a wide range of procedures, from noninvasive imaging to bypass surgery and stent implants.[1]

In general, cardiologist salaries vary by subspecialty, with interventional cardiologists, for example, earning more than noninvasive cardiologists. According to the most current MGMA data, national median compensation for noninvasive cardiologists is $559,107, representing a 3.01% year-over-year increase from 2021 to 2022.[2]

The student loan burden

Other factors that influence cardiologist compensation include practice location, scarcity, and work environment. But first, let's talk about the elephant in the room: student loan debt.

According to the Association of American Medical Colleges (AAMC), 73% of general medical students graduate with debt averaging $202,453, and that does not include premedical undergraduate debt and other educational debt incurred.[3] For specialists like cardiologists, that number is a lot higher—it's safe to say that all cardiologists amass significant student loan debt.

It can take up to 14 years to become a cardiologist, encompassing 4 years of medical school, a 3-year residency in internal medicine, and a subsequent 3-5 year cardiology fellowship. Additional subspecialty training, such as interventional cardiology or clinical electrophysiology, could add another year or two, depending on the institution.[4]

This can mean lean times for cardiologists in training; residency programs for cardiologist-hopefuls, for example, pay very little. Most cardiologists start with an internal medicine residency, where they get paid between $50,000 and $70,000 per year, depending on experience and location.[5]

Two notable exceptions to this traditional route include pediatric cardiologists, who enter a pediatrics residency followed by a pediatric cardiology fellowship, and cardiothoracic surgeons, who enter a surgical residency followed by a cardiothoracic surgery residency or fellowship. Compensation for pediatric cardiologists is generally lowest among all cardiology specialties; cardiothoracic surgeons are among the highest earners in the field.

Generally, however, the more specialized the cardiologist, the higher the earning potential—and the easier it is to pay off student debt.

Salary variation by subspecialization

Doctors see an uptick in salary as they train and become more experienced. However, they must also balance the rising cost of training with the goal to maximize their earnings.

As of 2022, a review of 5,700 cardiology providers from over 200 programs found that the median salary per full-time employee was as follows[6]:

Interventional cardiologist: $694,967
Electrophysiologist: $686,209
Invasive cardiologist: $644,146
General noninvasive cardiologist: $599,467
Advanced heart failure physicians: $572,488

Which states pay the most and the least

According to MGMA specialty physician data, the states with the highest median salaries for cardiologists are Oklahoma and South Carolina, while the lowest paying states for cardiologists are Wisconsin and Louisiana.[2]

This underscores the differences in salary based on geographical location. Cardiologist salaries vary widely because of supply and demand. For example, cardiologists in rural Oklahoma earn more than those in Wisconsin—$804,486 compared with just over $380,000—because there are fewer cardiologists in Oklahoma.

Data shows that noninvasive cardiologists earn more in rural areas ($581,250) compared with metropolitan areas ($557,005). This $24,000 difference may not seem large, but when factoring in no or lower state taxes and a lower cost of living, it can make a big difference.

Salary variation by facility

Where a cardiologist decides to work—whether in an academic medical center, outpatient clinic, private hospital, ambulatory care unit, or private practice—plays a major role in their compensation.

In general, cardiologists who work in outpatient centers or private practices earn the most, due to the potential for equity and volume-related bonuses, followed by those who work in general and medical hospitals, then those who work in academic centers.

According to the US Bureau of Labor Statistics, cardiologists who work in outpatient centers earn an average annual salary of $442,410, compared with $376,280 for those who choose to work in a private hospital, and $369,978 for those who work in academic centers.[7]

Experience and tenure

Not surprisingly, there's a linear relationship between years of experience and salary in the field of cardiology. According to MGMA data, noninvasive cardiologists with 18-22 years of experience have an average median salary of $661,725, compared with $474,371 for entry level practitioners.[2]

Challenges

Significant reductions in Medicare payouts, staffing issues, administrative burdens, workplace violence, and general unhappiness in the workplace are contributing to burnout, exacerbating the national physician shortage. This is true for doctors of all specialties, including cardiologists.

These issues became especially evident during the COVID-19 pandemic. Even with promises of paid time off and more autonomy, many tenured doctors thinking about retirement have not been enticed to stay.

In fact, a report published by Doximity found that 2 in 3 physicians said they would not consider accepting a reduction in compensation in exchange for more autonomy, underscoring the need for higher compensation in line with rising inflation, better retirement benefits, and better work-life balance.[8]

Parting thoughts

Cardiologists are among the highest paid physicians in healthcare, but they still experience high debt, burnout, and mixed feelings when it comes to career satisfaction. In general, more specialization translates to higher salary. Other factors that impact physician compensation include location, years of experience, scarcity, and work environment.

All of these factors must be considered in evaluating cardiologists’ satisfaction with their chosen profession, in light of differences in state income taxes, lower insurance reimbursement rates, and rising inflation. Of note, more research needs to be done on the racial, ethnic, and gender differences in pay throughout cardiology.

Explore our Money Matters Rx series!

Want to boost your financial know-how? Grasping money management basics is crucial for doctors—from handling student debt, to running a practice, making investments, and saving for retirement. Check out MDLinx's Money Matters Rx series for doctor-specific advice on making smart financial choices at every career stage.

Sources

Number of active physicians in the U.S. in 2023, by specialty area. Statista. 2023.
Medical Group Management Association (MGMA) DataDive. 2021-2023 data.
Budd K. 7 ways to reduce medical school debt. AAMCNews. October 14, 2020.
AMA FREIDA database. Cardiovascular Disease (IM). Accessed 2023.
Internal Medicine Resident Salary in the United States. Salary.com. 2023.
Taylor M. Median pay for 5 cardiology subspecialties. Becker’s Hospital Review. September 20, 2022.
US Bureau of Labor Statistics. Occupational Employment and Wage Statistics. 29-1212. Cardiologists. May 2022.
2023 Physician Compensation Report. Doximity, Curative. 2023.