Uniformed Services University of the Health Sciences
4301 Jones Bridge Road
Bethesda, Maryland 20814
The names "internal medicine" and "internist" derive from the history of the development of medical specialties. In years past when physicians had few diagnostic tests and imaging modalities to fall back on, "internal medicine" became the specialty of a physician who could diagnose disease of the internal organs (heart, lungs, liver, hollow gastrointestinal tract organs, kidneys, etc.) based on study of the patient's symptoms and physical examination findings.
Internal medicine combines the characteristics of humanistic clinician, master diagnostician, expert in a variety of procedures, and medical consultant. The scope of practice involves training in treating patients in the clinic, hospital ward, intensive care unit, in a hospice, and in a patient's own home and/or nursing home. The internist is the specialist who is often called in the hospital and/or clinic to aid in diagnosing complex adult patient presentations involving multiple organ systems.The modern internist is a partner of the patient in wellness and in disease management--ongoing relationships with patients is a core feature of practicing internists. One of the distinguishing characteristics of internal medicine as a discipline is its breadth and versatility. Indeed, for many internists, no two days are alike. Internal medicine is to an adult what a pediatrician is to a child--an internist is an expert in adult medicine.
What sets the internist apart as a practitioner is the three-year breadth and depth of residency training, which exposes him./her to the care of not only acute diseases in fundamentally healthy hosts, but also to the challenges of caring for severe chronic disease in patients with multiple medical problems, including those who have HIV disease, organ transplant recipients, cancer, and chronic heart or lung disease. The graduate of the three-year IM residency is a physician who is both a provider of comprehensive primary care AND a valued consultant for medical problems complicating the management of surgical, psychiatric, and obstetric diseases and health conditions. Internists are routinely involved in the care of pregnant patients with such chronic health conditions as diabetes mellitus, valvular heart disease, lupus, and inflammatory bowel disease. Also, many opportunities exist for pursuing research and/or academic interests in internal medicine. Indeed, the majority of teaching in most medical schools is done by internists. As well as being a highly skilled generalist, the general internist can also pursue additional two to four year fellowship training, the internist can to become a cardiologist, endocrinologist, gastroenterologist, pulmonologist, rheumatologist, nephrologist, allergist, geriatrician, or infectious disease specialist.
A special "perk" of doing IM fellowship training on active duty military status is that one is paid as a general internist throughout fellowship. Given the specialty bonus pay, that means you will be in the 99th+ percentile in fellowship pay worldwide, and won't have to spend all your free time moonlighting to feed your family! By the way, internal medicine is also the most highly compensated of the three largest primary care specialties-- internal medicine, family practice, and pediatrics.
Steven Durning, MD, FACP