Internal medicine or general medicine (in Commonwealth nations) is the medical specialty dealing with the prevention, diagnosis, and treatment of adult diseases. Physicians specializing in internal medicine are called internists, or physicians (without a modifier) in Commonwealth nations. Internists are especially skilled in the management of patients who have undifferentiated or multi-system disease processes. Internists care for hospitalized and ambulatory patients and may play a major role in teaching and research.
The term internal medicine originates from the German term Innere Medizin, popularized in Germany in the late 19th century to describe physicians who combined the science of the laboratory with the care of patients. Many early-20th century American physicians studied medicine in Germany and brought this medical field to the United States. Thus, the name "internal medicine" was adopted in imitation of the existing German term. Because their patients are often seriously ill or require complex investigations, internists do much of their work in hospitals. Internists often have subspecialty interests in diseases affecting particular organs or organ systems.
Internal medicine is also a specialty within clinical pharmacy and veterinary medicine.
Internists are qualified physicians with postgraduate training in internal medicine and should not be confused with "interns", who are doctors in their first year of residency training (officially the term intern is no longer in use). Although internists may act as primary care physicians, they are not "family physicians," "family practitioners," or "general practitioners," whose training is not solely concentrated on adults and may include surgery, obstetrics, and pediatrics. The American College of Physicians defines internists as "physicians who specialize in the prevention, detection and treatment of illnesses in adults".
The training and career pathways for internists vary considerably across the world.
First, they must receive the "entry-level" education required of any medical practitioner in the relevant jurisdiction. The entry-level for medical education programs are tertiary-level courses, undertaken at a medical school attached to a university.
Programs that require previous undergraduate education are usually four or five years in length. Hence, gaining a basic medical education may typically take eight years, depending on jurisdiction and university. Following completion of entry-level training, newly graduated medical practitioners are often required to undertake a period of supervised practice before the licensure, or registration, is granted, typically one or two years. This period may be referred to as "internship", "conditional registration", or "foundation programme". Then, doctors may finally follow specialty training in internal medicine if they wish, typically being selected to training programs through competition. In North America, this period of postgraduate training is referred to as residency training, followed by an optional fellowship if the internist decides to train in a subspecialty. In Commonwealth countries, during that training period in Internal Medicine, trainees are often called senior house officers, and advance to registrar grade when they undergo a compulsory subspecialty training whilst commonly continuing service provision in the main speciality.
In the United States, three organizations are responsible for certification of trained internists (i.e., doctors who have completed an accredited residency training program) in terms of their knowledge, skills, and attitudes that are essential for excellent patient care: the American Board of Internal Medicine, the American Osteopathic Board of Internal Medicine and the Board of Certification in Internal Medicine.
In the United States, two organizations are responsible for certification of subspecialists within the field: the American Board of Internal Medicine and the American Osteopathic Board of Internal Medicine. Physicians (not only internists) that successfully pass board exams get "board certified" status, and, as of 2011, earn on average an 88.8% higher salary in the USA.
The following are the subspecialties recognized by the American Board of Internal Medicine.
Internists may also specialize in "allergy" and "immunology." The American Board of Allergy, Asthma, and Immunology is a conjoint board between internal medicine and pediatrics.
The American College of Osteopathic Internists recognizes the following subspecialties:
Medicine is mainly focused on the art of diagnosis and treatment with medication, but many subspecialties administer surgical treatment:
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