Internist Education & Training
An internist, also called a general internist or doctor of internal medicine, is a medical doctor that specializes in the diagnosis and medical (nonsurgical) treatment of adults. Internists provide long-term, comprehensive care and manage both common and complex diseases. An internist can serve as a primary care physician or as a consultant to other medical specialists. Many internists also are involved in research and teaching.
Internists provide comprehensive medical care, usually in private practice (e.g., office, clinic), and also care for patients in hospitals (including intensive care units) and in nursing homes. They do not perform surgery. When other specialists, such as surgeons and obstetricians, are involved in a patient's care, internists often coordinate and manage treatment.
Internists generally act as personal physicians and often develop long-term relationships with their patients. They perform examinations, make diagnoses, treat acute illness (e.g., infections, influenza) and chronic disease (e.g., diabetes, high blood pressure), and also incorporate disease prevention and mental health (including substance abuse) into the care they provide. Internists prescribe and administer medications, immunizations, and treatments.
Recommended undergraduate courses include biology, chemistry, and mathematics. The minimum requirement for acceptance into medical school is 3 years of college, but most students have an undergraduate (e.g., Bachelor of Science) or advanced degree. Internists must complete a minimum of 7 years of medical school (usually 4 years) and postgraduate training.
After attaining a Doctor of Medicine (M.D.) or Doctor of Osteopathic Medicine (D.O) degree, the doctor must undergo at least 3 years of special study and training (called a general internal medicine residency) in a program accredited by the American Council for Graduate Medical Education.
This training, which includes a minimum of 2 years of patient contact, is dedicated to the prevention, diagnosis, and nonsurgical treatment of adult diseases. Of these 2 years, 20 months must be spent in ambulatory settings (e.g., outpatient surgical center), in-patient hospital services, and in the services of dermatology or neurology, and 4 months may be spent outside the above areas. The level of patient responsibility increases with each year of training.
Internists may complete an additional 1–3 years of training (called a fellowship) to subspecialize in one of the following areas:
- Allergy and immunology (treatment of immune system disorders)
- Cardiology (treatment of heart disorders)
- Endocrinology (treatment of hormonal disorders)
- Gastroenterology (treatment of digestive system disorders)
- Hematology (treatment of blood and bone marrow disorders)
- Infectious disease
- Nephrology (treatment of kidney disorders)
- Medical Oncology (treatment of cancer with medicine [e.g., chemotherapy])
- Pulmonology (treatment of lung disorders)
- Rheumatology (treatment of musculoskeletal disorders)
Doctors of internal medicine may undergo additional training to attain qualification in adolescent medicine, geriatrics, or sports medicine. To achieve licensure and certification, internists must pass the Internal Medicine Board Certification Examination.