Internal Medicine

Internists are specialists who care for adult patients through comprehensive, clinical problem solving. They integrate the history, physical examination, and all available data to deliver, direct, and coordinate care across varied clinical settings, both in person and remotely through telemedicine. Internists are diagnosticians who manage the care of patients who present with undifferentiated, complex illnesses, and comorbidities; promote health and health equity in communities; collaborate with colleagues; and lead, mentor, and serve multidisciplinary teams. Internists integrate care across organ systems and disease processes throughout the adult lifespan. They are expert communicators, creative and adaptable to the changing needs of patients and the health care environment. They advocate for their patients within the health care system to achieve the patient’s and family’s care goals. Internists embrace lifelong learning and the privilege and responsibility of educating patients, populations, and other health professionals. The discipline is characterized by a compassionate, cognitive, scholarly, relationship-oriented approach to comprehensive patient care.

The successful, fulfilled internist maintains this core function and these core values. Internists find meaning and purpose in caring for individual patients with increased efficiency through well-functioning teams, and are equipped and trained to manage change effectively and lead those teams. They understand and manage the business of medicine to optimize cost-conscious care for their patients. They apply data management science to population and patient applications and help solve the clinical problems of their patients and their community. Internists communicate fluently and are able to educate and clearly explain complex data and concepts to all audiences, especially patients. They collaborate with patients to implement health care ethics in all aspects of their care. Internists display emotional intelligence in their relationships with colleagues, team members, and patients, maximizing both their own and their teams’ well-being. They are dedicated professionals who have the knowledge, skills, and attitudes to effectively use all available resources, and bring intellectual curiosity and human warmth to their patients and community.

What does an internist do?

Internists are physician specialists uniquely trained to apply scientific knowledge to the care of adults across the spectrum from health to complex illness.

As an internist, a physician may choose to become  a general internist or an internal medicine subspecialist. A general internist handles the broad, comprehensive spectrum of illnesses that affect adults. General internists are recognized as experts in diagnosis, in treatment of chronic illness, and in health promotion and disease prevention—they are not limited to one type of medical problem or organ system. 

Many general internists provide care for their patients in an ambulatory (office or outpatient) setting, often serving as their primary care physician over the duration of their adult lives, which provides the opportunity to establish long and rewarding personal relationships with their patients. Some general internists choose to focus their practice exclusively in inpatient settings, functioning as what are termed as “hospitalists.”

Still other general internists will function in a primary care role and continue to care for their patients when they are admitted to the hospital.  Additionally, many general internists practice in other clinical settings, such as rehabilitation centers, hospices, and extended care facilities.

An internist also has the option of choosing to become a subspecialist in internal medicine by receiving additional in-depth training and board certification in the diagnosis and management of diseases of a specific type (e.g., infectious diseases) or diseases affecting a single organ system (e.g., the cardiovascular system). Subspecialists often see patients on a limited basis in consultation with a general internist or another medical specialist, though they too may develop long, rewarding relationships with patients who have ongoing or chronic illnesses.

For most general internal medicine specialists and subspecialists, caring for patients is their primary daily activity. Nonetheless, there are many other activities available in the field of internal medicine that may suit the needs of physicians who have additional interests. One such choice is teaching medical students, residents, and/or subspecialty fellows and other health professionals. Teaching responsibilities can be an important component of a career that is based in a teaching hospital or medical school setting. Internists make up the largest proportion of medical school faculty of any clinical field.

Another career choice may be in medical research, ranging from bench research (i.e., basic science) to applied translational or clinical research. Again, these research responsibilities can be a primary component of an internist’s professional activities or can complement other activities in patient care and/or teaching.

Many internists pursue careers in administration (activities related to managing the business side of healthcare). Work in this area provides opportunities for developing managerial and leadership skills.

No matter the setting, there is a need for administrative expertise.

Finally, health policy, health care delivery and public health are areas of interest for internists. Internists who wish to impact populations of people rather than provide direct patient care may pursue a career working in such settings as public health departments, public health schools, or a variety of governmental or other nonprofit organizations.

How to become an internist?

Specialty training required prior to certification: Three years