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An electrophysiologist is a physician who specialises in a type of cardiology called electrophysiology. Electrophysiology entails the diagnosis and treatment of irregular heartbeats, or arrhythmias of the heart.

Electrophysiologists complete all the training requirements of a cardiologist, (medical school, residency, and fellowship), plus additional years of training in electrophysiology.

Electrophysiologists study the electrical properties of biological cells and tissues. They measure the voltage change or electrical current flow on a great variety of scales. They might work with single ion channel proteins or whole organs such as the heart. In neuroscience, electrophysiologists measure the electrical activity of neurons, as well as action potential activity.

There are two main divisions of electrophysiology: extracellular recording and intracellular recording. Intracellular recordings are usually (but not in every case) made from cells “in vitro” (in a glass or plastic tube), while extracellular recordings are usually “in vivo” (in living animals or organisms). Intracellular recording devices include the voltage clamp and the current clamp. Extracellular recording involves field potential recording, single unit recording, single channel recording, and amperometry.

There are numerous branches of electrophysiology:
electrocardiography for the heart
electromyography for the muscles
electrophalography for the brain
electrocorticography for the cerebral cortex
electrooculography for the eyes
electroretinography for the retina

A cardiac electrophysiologist performs an electrophysiologic study (EPS) of the electrical conduction system of the heart by inserting catheters within the heart. There are a number of different tests the electrophysiologist is able to carry out. If the heart is stimulated electrically via the catheter, it is known as programmed electrical stimulation (PES). Doctors use PES to help diagnose certain types of heart disease.

Employment in this profession is expected to grow at a much faster pace than the national average for the next few years. As the population grows and becomes older there will be an increasing demand for specialists in heart-related illnesses. There is already a growing need for paediatric electrophysicists. Public awareness of heart-related health issues is also increasing the demand for high tech equipment in hospitals, and trained people to operate the machinery.

Satisfying Aspects
- being able to assist patients by prolonging their life and relieving pain and suffering
- saving lives
- working as part of the medical profession in a very specialised field

Demanding aspects
- losing a patient under your care
- having to work extremely hard
- being on call 24 hours
- working weekends and holidays when necessary
- working under extreme pressure, requiring intense concentration
- dealing with bereaved families

- able to perform well under pressure
- perform well as part of a team
- a perfectionist, accurate and meticulous
- emotionally balanced, patient and calm
- tactful, able to put patients at ease
- able to make quick, sound decisions in an emergency situation
- responsible and ethical

School Subjects
National Senior Certificate meeting degree requirements for the medical degree course

Each institution has its own entry requirements.

Compulsory Subjects: Mathematics, Physical Sciences
Recommended Subjects: Life Sciences

Note: Competition to enter medical studies is stiff and there are usually many applicants with excellent grades who are naturally given preference.

MBChB degree at UP, UCT, UFS, Wits, US, UL, UKZN:
Theoretical training: 6 years
Student internship: 1 year
Practical work at a hospital: 1 year (also known as the house doctor year).

The UCT / Groote Schuur Hospital Cardiac Clinic is the only academic electrophysiology unit in South Africa. It offers training and exposure to electrophysiology not only to local cardiologists-in-training (Senior Registrars) but to those from other training institutions.

Registration: on successful completion of the examination to qualify as a specialist, the candidate must register with the IMDC as an electrophysiologist.

Because electrophysiologists deal directly with patients, it is recommended that students also take a course in psychology. At the post-secondary level students in undergraduate and graduate programmes for electrophysiology study subjects such as anatomy and cell biology, pharmacology, physiology, cellular and tissue biomechanics, biochemistry and molecular genetics.

- medical schools
- general hospitals
- clinics
- private hospitals
- private practice

Health Professions Council of South Africa (HPCSA)
P O Box 205
Pretoria, 0001
Tel: (012) 338-9300
Fax: (012) 328-5120