Internal Medicine

  • Master Clinician Program: Information for Students

    Internal Medicine and Subspecialties

    Internal Medicine Physician (Internist):

    Doctors of internal medicine focus on adult medicine and have had special study and training focusing on the prevention and treatment of adult diseases. Internists are trained in the diagnosis and treatment of cancer, infections, and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory, and vascular systems. They are also trained in the essentials of primary care internal medicine which incorporates an understanding of disease prevention, wellness, substance abuse, mental health, and effective treatment of common problems of the eyes, ears, skin, nervous system, and reproductive organs. Internists are sometimes referred to as the "doctor's doctor," because they are often called upon to act as consultants to other physicians to help solve puzzling diagnostic problems.

    Career Paths  

    Traditional General Internist: Physicians who manage a broad and comprehensive spectrum of illnesses that affect adults, and 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. General internists often care for patients over the duration of their adult lives, providing the physician an opportunity to establish long and rewarding personal relationships with their patients. Most general internists provide care for their patients in an ambulatory (office or outpatient) setting, and in an inpatient setting when their patients become hospitalized.

    Hospitalist: Hospitalists are internists who dedicate most of their career to the care of hospitalized patients. They focus on clinical management, with an added eye to quality, safety, and utilization. Some hospitalists begin their practice directly after residency, although another large demographic group gained decades of experience in more traditional primary care before becoming hospitalists.

    Ambulist: Ambulist are internists who dedicate most of their career to providing care for their patients in an ambulatory (office or outpatient) setting.

    Specialties of Internal medicine
    Internists can choose to focus their practice on general internal medicine or take additional training to "subspecialize" in additional areas of internal medicine. The 13 subspecialties of internal medicine that internists can subspecialize in after medical school include:

    Adolescent medicine:  Adolescent medicine specialists focus on the physical, psychological, social and sexual development of adolescents and young adults.
    Adolescent medicine specialists must first complete seven or more years of medical school and postgraduate training and become board certified in Internal Medicine (or pediatrics). Then, for an additional one to three years, they study conditions specific to adolescents.

    Cardiovascular Disease: Specialists treat patients with acute and chronic cardiovascular conditions including chronic coronary heart disease, congestive heart failure, arrhythmia, acute myocardial infarction, and other congenital heart disease.
    Training consists of a three-year fellowship following completion of an internal medicine residency. One year is devoted to research.
                   
    Endocrinology: Specialty of internal medicine that deals with the hormonal regulation of normal physiology including the pituitary, thyroid, adrenal, pancreas, ovaries/testes and their target tissues. Dysregulation of the physiologic hormone profiles result in systemic illnesses with significant ramifications. In addition, the practice of endocrinology includes the management of neoplasia occurring in endocrine tissues.
    Training consists of either a two-year clinical curriculum or a three-year combined clinical and research fellowship following completion of an internal medical residency.

    Gastroenterology: Specialists with advanced training, who research, diagnose and treat disorders of the gastrointestinal tract and liver.
    Training consists of a three-year fellowship following completion of an internal medicine residency.

    Hematology: Specialists with advanced training who specialize in diagnosis, treatment, and prevention of disorders affecting the blood, bone marrow, and the immunologic, hemostatic and vascular systems.
    Training consists of a two-year fellowship following completion of an internal medicine residency.

    Hematology/Medical Oncology: Specialty of internal medicine that deals with 1) the diagnosis, treatment and prevention of disorders affecting the blood, bone marrow, immunologic, and hemostatic/vascular systems, and 2) all forms of cancer and its therapy.
    Training consists of a three-year fellowship following completion of an internal medical residency.

    Infectious Disease: Specialists diagnose and treat contagious diseases. At the onset of the antibiotic era, the specialty was thought to be on the edge of extinction. It is now making a large comeback due to the great diversity of drug-resistant bacteria and the AIDS epidemic. Disease specialists also practice general internal medicine.
    Training consists of a two-year fellowship following completion of an internal medicine residency.

    Medical Oncology: Specialty of internal medicine that deals with the diagnosis and, more specifically, the management of the treatment of cancer. An oncologist may have a special interest in certain types of cancer or certain therapies such as biological therapy, but has the training, experience, and skills for finding out the latest information on all forms of cancer and all types of therapy.
    Training consists of a two-year fellowship following completion of an internal medicine residency.

    Nephrology: Specialty of internal medicine that deals with disorders of the kidney, including those that affect kidney function, kidney stone formation, fluid and electrolyte homeostasis, and regulation of blood pressure. Nephrologists diagnose and treat kidney diseases, including both the conditions these diseases can produce -- such as hypertension -- as well as diseases that can cause kidney failure -- such as diabetes mellitus and polycystic kidney disease.
    Training consists of a two-year fellowship following completion of an internal medicine residency. Additional years for research are available.

    Pulmonary Disease: Specialists treat patients with diseases of the lungs in both the inpatient and outpatient setting.
    Training consists of a two-or-three year fellowship following completion of an internal medicine residency.

    Rheumatology: Specialist experienced in the diagnosis and treatment of arthritis and other diseases of the joints, muscles and bones. Many rheumatologists conduct research to determine the cause and better treatments for these disabling and sometimes fatal diseases.
    Training consists of a two-year fellowship following completion of an internal medicine residency

    Geriatrics: Specialty of internal medicine concerned with the health and well-being of older adults. They study conditions specific to aging, including geriatric assessment and rehabilitation, preventive medicine, management of patients in long-term care settings, and psycho-social, ethical, legal, and economic issues pertinent to geriatric patients.
    Training consists of a one/two-year fellowship following completion of an internal medicine residency

    Allergy and Immunology: Specialty of internal medicine concerned with the prevention, diagnosis and treatment of problems with the human immune system.
    Training consists of a two-year fellowship following completion of an internal medicine residency

    Sports Medicine: Specialists are concerned with all problems -- injury and illness alike -- related to athletics and physical fitness. They decide when to refer patients to a surgical specialist or prescribe treatments, such as physical therapy. They are especially well-suited to care for people with medical problems (for example, asthma, diabetes, arthritis, osteoporosis, or obesity) who wish to begin an exercise program, improve their fitness, and reduce risks to their health.
    Training consists of a one-year fellowship following completion of an internal medicine residency