How to become a cardiac physiologist

Cardiac physiologists carry out the tests that show how a patient’s heart is working: ECGs, 24-hour and longer heart monitoring, exercise tests, echocardiograms and pacemaker checks. The standard route is a three-year healthcare science degree through the NHS Practitioner Training Programme, which leads to practitioner posts at Agenda for Change band 5 (£32,073 in England from 1 April 2026). You can also start without a degree as a cardiographer or healthcare science assistant at band 2 or 3 and train up through apprenticeships.

The tests and procedures

Cardiac sciences, sometimes called cardiac physiology, sits within healthcare science. Depending on your level and the hospital, the work includes:

• resting ECGs on wards, in clinics and in emergency departments
• ambulatory ECG and blood pressure monitoring, where patients wear a recorder at home and you analyse the results
• exercise stress testing, monitoring a patient on a treadmill and stopping the test safely if something goes wrong
• echocardiography, using ultrasound to look at the structure and function of the heart
• pacemaker and defibrillator implantation support and follow-up, including checking and reprogramming devices
• work in the catheter lab during angiograms, angioplasty and electrophysiology studies

The work is patient-facing and covers all ages, though most patients are adults. You produce technical reports that doctors rely on, and in some areas, such as pacing clinics and echo, experienced physiologists see patients and make decisions with considerable independence.

Job titles you will see

The same work is advertised under several names, which can make searching confusing.

Title on the advert	Level	Usual band
Cardiographer, healthcare science assistant (cardiology)	Assistant	2 or 3
Associate practitioner, assistant cardiac physiologist	Associate	4
Cardiac physiologist, healthcare science practitioner	Practitioner	5
Echocardiographer, specialist cardiac physiologist	Specialist	6, 7 or 8a
Clinical scientist (cardiac)	Scientist	6, 7 or 8a

In England, band 2 pays £25,272, band 3 £25,760 to £27,476, band 4 £28,392 to £31,157 and band 5 £32,073 to £39,043 from 1 April 2026. Band 6 runs from £39,959 to £48,117 and band 7 from £49,387 to £56,515. In Scotland, band 5 points are £34,494, £36,857 and £42,977. NHS band 5 pay explains how you move through the points.

Routes into the job

Starting without a degree

Cardiographer and assistant jobs are open to people with GCSEs, usually including English, maths and a science. Employers train you to record ECGs and help in clinics. From there, a level 4 healthcare science associate apprenticeship takes you to associate level, and a level 6 degree apprenticeship can take you to practitioner level while you keep earning. NHS apprenticeships explains how trusts advertise these places.

The degree route

The Practitioner Training Programme is a three-year degree in healthcare science, with the cardiac pathway sitting in the cardiac, critical care, vascular, respiratory and sleep sciences theme. Health Careers says the full-time course combines academic study with 50 weeks of workplace training. Universities usually ask for three A levels or equivalent, including one or two sciences or maths.

Graduate and specialist routes

Graduates with a relevant science degree can apply for the Scientist Training Programme to become a clinical scientist, which needs a first or 2:1 (or a relevant higher degree). For echo, Health Careers describes a postgraduate Echocardiography Training Programme lasting 18 months, which leads to British Society of Echocardiography accreditation and eligibility for the Academy for Healthcare Science register for specialist echocardiographers. Places and vacancies are advertised on NHS Jobs.

Registration

Cardiac physiologist is not a protected title in law, but practitioners can join a voluntary accredited register, such as the one held by the Academy for Healthcare Science, and many NHS employers ask for it. Clinical scientists must be registered with the HCPC. Professional body subscriptions and registration fees may qualify for tax relief; tax relief on professional fees explains how to check and claim.

On-call and catheter lab work

Outpatient testing runs mostly in the daytime, but hospitals with a heart attack centre need cardiac physiologists available around the clock for emergency procedures in the catheter lab. Many physiologists join an on-call rota once trained, and some trusts run shifts instead. On-call and unsocial hours payments under Agenda for Change can add a useful amount to basic pay. Ask at interview how often you would be on call and how quickly you would need to reach the hospital.

Catheter lab work means wearing lead aprons for long periods and working near X-ray equipment under radiation protection rules. Echo work is physically repetitive, with long periods holding a probe in awkward positions, which is similar to the strain described in sonographer jobs.

Getting your first post

Search NHS Jobs for “cardiac physiologist”, “cardiographer”, “healthcare science practitioner” and “trainee cardiac physiologist”. Trainee posts, where a trust employs you and funds your training, appear regularly in some regions. Applications need a supporting statement against the person specification, and interviews often include questions about ECG basics and patient safety. NHS vacancies are listed under allied health jobs.