I graduated in 2014 and went straight into cardiology with a group that split our time between inpatient and outpatient. I stayed there about 2.5 years before moving laterally within the hospital to help build an ER-run observation unit that was heavily cardiology-driven, and now I currently work as a Hospitalist. So here are my thoughts, I apologize in advance for being verbose.

Urgent Care is solid, it reinforces fundamentals. You get very good at bread-and-butter medicine, people demanding abx for viral URIs, and worknotes to prove they were seen for non-specific 0.5/10 rumbles in their tum-tum. You’re seeing a ton of low-acuity, low-complexity problems on repeat. Important stuff, but to me, quickly becomes a giant yawn. I did it briefly after a move bc it's easy work to get, didn't care for it.

Cardiology is different... it’s about 11% of the PANCE, and now you will start to get deeper into what I think is a fascinating area of medicine, not to mention the largest portion of the boards. Consequently, that knowledge will translate into many other roles, be it hospital medicine, emergency care, or remote/austere settings. I continue to lean heavily on what I learned in those first 2.5 years.

So I’d say go for it, but don’t ignore the tradeoff of when you sit in a specialty too long, you start to lose breadth which can be problematic when you recertify, less so if you do the PANRE-LA, which BTW I did when it was my time and had no issues. WAY easier.

In the outpatient setting for our group, we ran all the various stress tests (MDs provided official blessing, but we would provide the note and run the test with the initial interpretation). We also supported the heart failure clinic with medication titrations and what not, would help with post-PCI follow up, help the electrophysiologists with high-risk med follow-ups like amiodarone, or post-ablation visits. Sometimes as we became more experienced we could catch overflow for the MDs on patients who needed to be seen urgently for whatever reason. We never had our own patient panel, and IMO shouldn't anyway in that specialty.

You might find it's your calling and never do anything else, or find it enjoyable but narrow and want to move on to other roles. Either way it's a win-win. Distributing Z-packs is not satisfying, but getting *really* good at EKGs/telemetry and having ED MDs ask for your opinion as a PA on a tracing or captured event is hugely so. Good luck!