Internal medicine
Encyclopedia
Internal medicine is the medical specialty dealing with the prevention, diagnosis, and treatment of adult diseases. Physicians specializing in internal medicine are called internists. They 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. Although some internists are full-time hospitalists, many fulfill locum tenens (temporary) positions both stateside and internationally. Internal medicine is also a specialty within veterinary medicine
.
The term internal medicine comes 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 doctors 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. Specialists in internal medicine are commonly called internists in the United States. Elsewhere, especially in Commonwealth
nations, such specialists are often simply called physician
s. Because their patients are often seriously ill or require complex investigations, internists do much of their work in hospitals.
s, 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".
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
" or "conditional registration." Then, internists require specialist training in internal medicine or one of its subspecialties. In North America, this postgraduate training is often referred to as residency training
; in Commonwealth
countries, such trainees are often called registrars.
and the American Osteopathic 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.
recognizes the following subspecialties.
, but many subspecialties administer surgical treatment:
Veterinary medicine
Veterinary Medicine is the branch of science that deals with the prevention, diagnosis and treatment of disease, disorder and injury in non-human animals...
.
The term internal medicine comes 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 doctors 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. Specialists in internal medicine are commonly called internists in the United States. Elsewhere, especially in Commonwealth
Commonwealth of Nations
The Commonwealth of Nations, normally referred to as the Commonwealth and formerly known as the British Commonwealth, is an intergovernmental organisation of fifty-four independent member states...
nations, such specialists are often simply called physician
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...
s. Because their patients are often seriously ill or require complex investigations, internists do much of their work in hospitals.
Definition of an internist
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. Although internists may act as primary care physicianPrimary care physician
A primary care physician, or PCP, is a physician/medical doctor who provides both the first contact for a person with an undiagnosed health concern as well as continuing care of varied medical conditions, not limited by cause, organ system, or diagnosis....
s, they are not "family physicians," "family practitioners", or "general practitioners", whose training is not solely concentrated on adults and may include surgery
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...
, obstetrics
Obstetrics
Obstetrics is the medical specialty dealing with the care of all women's reproductive tracts and their children during pregnancy , childbirth and the postnatal period...
, and pediatrics
Pediatrics
Pediatrics or paediatrics is the branch of medicine that deals with the medical care of infants, children, and adolescents. A medical practitioner who specializes in this area is known as a pediatrician or paediatrician...
. The American College of Physicians
American College of Physicians
The American College of Physicians is a national organization of doctors of internal medicine —physicians who specialize in the prevention, detection, and treatment of illnesses in adults. With 130,000 members, ACP is the largest medical-specialty organization and second-largest physician group in...
defines internists as "physicians who specialize in the prevention, detection and treatment of illnesses in adults".
Education and training of internists
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
Tertiary education
Tertiary education, also referred to as third stage, third level, and post-secondary education, is the educational level following the completion of a school providing a secondary education, such as a high school, secondary school, university-preparatory school...
-level courses
Course (education)
The very broad dictionary meaning of the word course is the act or action of moving in a path from point to point . There are multiple meanings for this word, some of which include: general line of orientation, a mode of action, part of a meal, a mode of action, and many more. This article focuses...
, undertaken at a medical school
Medical school
A medical school is a tertiary educational institution—or part of such an institution—that teaches medicine. Degree programs offered at medical schools often include Doctor of Osteopathic Medicine, Bachelor/Doctor of Medicine, Doctor of Philosophy, master's degree, or other post-secondary...
attached to a university
University
A university is an institution of higher education and research, which grants academic degrees in a variety of subjects. A university is an organisation that provides both undergraduate education and postgraduate education...
.
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
Licensure
Licensure refers to the granting of a license, which gives a "permission to practice." Such licenses are usually issued in order to regulate some activity that is deemed to be dangerous or a threat to the person or the public or which involves a high level of specialized skill...
, or registration, is granted, typically one or two years. This period may be referred to as, "internship
Medical intern
A medical intern is a term used in the United States for a physician in training who has completed medical school. An intern has a medical degree, but does not have a full license to practice medicine unsupervised...
" or "conditional registration." Then, internists require specialist training in internal medicine or one of its subspecialties. In North America, this postgraduate training is often referred to as residency training
Residency (medicine)
Residency is a stage of graduate medical training. A resident physician or resident is a person who has received a medical degree , Podiatric degree , Dental Degree and who practices...
; in Commonwealth
Commonwealth of Nations
The Commonwealth of Nations, normally referred to as the Commonwealth and formerly known as the British Commonwealth, is an intergovernmental organisation of fifty-four independent member states...
countries, such trainees are often called registrars.
Subspecialties of internal medicine
In the United States, two organizations are responsible for certification of subspecialists within the field: the American Board of Internal MedicineAmerican Board of Internal Medicine
The American Board of Internal Medicine is a non-profit, independent physician evaluation organization committed to continuously improving the profession for the public good by certifying physicians who practice internal medicine and its sub-specialties...
and the American Osteopathic Board of Internal Medicine.
American Board of Internal Medicine
The following are the subspecialties recognized by the American Board of Internal MedicineAmerican Board of Internal Medicine
The American Board of Internal Medicine is a non-profit, independent physician evaluation organization committed to continuously improving the profession for the public good by certifying physicians who practice internal medicine and its sub-specialties...
.
- CardiologyCardiologyCardiology is a medical specialty dealing with disorders of the heart . The field includes diagnosis and treatment of congenital heart defects, coronary artery disease, heart failure, valvular heart disease and electrophysiology...
, dealing with disorders of the heartHeartThe heart is a myogenic muscular organ found in all animals with a circulatory system , that is responsible for pumping blood throughout the blood vessels by repeated, rhythmic contractions...
and blood vessels - EndocrinologyEndocrinologyEndocrinology is a branch of biology and medicine dealing with the endocrine system, its diseases, and its specific secretions called hormones, the integration of developmental events such as proliferation, growth, and differentiation and the coordination of...
, dealing with disorders of the endocrine systemEndocrine systemIn physiology, the endocrine system is a system of glands, each of which secretes a type of hormone directly into the bloodstream to regulate the body. The endocrine system is in contrast to the exocrine system, which secretes its chemicals using ducts. It derives from the Greek words "endo"...
and its specific secretions called hormones - GastroenterologyGastroenterologyGastroenterology is the branch of medicine whereby the digestive system and its disorders are studied. The name is a combination of three Ancient Greek words gaster , enteron , and logos...
, concerned with the field of digestive diseases - HematologyHematologyHematology, also spelled haematology , is the branch of biology physiology, internal medicine, pathology, clinical laboratory work, and pediatrics that is concerned with the study of blood, the blood-forming organs, and blood diseases...
, concerned with bloodBloodBlood is a specialized bodily fluid in animals that delivers necessary substances such as nutrients and oxygen to the cells and transports metabolic waste products away from those same cells....
, the blood-forming organs and its disorders. - Infectious diseaseInfectious diseaseInfectious diseases, also known as communicable diseases, contagious diseases or transmissible diseases comprise clinically evident illness resulting from the infection, presence and growth of pathogenic biological agents in an individual host organism...
, concerned with disease caused by a biological agentBiological agentA biological agent — also called bio-agent or biological threat agent — is a bacterium, virus, prion, or fungus which may cause infection, allergy, toxicity or otherwise create a hazard to human health. They can be used as a biological weapon in bioterrorism or biological warfare...
such as by a virusVirusA virus is a small infectious agent that can replicate only inside the living cells of organisms. Viruses infect all types of organisms, from animals and plants to bacteria and archaea...
, bacterium or parasite - Medical oncology, dealing with the chemotherapeutic (chemical) treatment of cancerCancerCancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...
- NephrologyNephrologyNephrology is a branch of internal medicine and pediatrics dealing with the study of the function and diseases of the kidney.-Scope of the specialty:...
, dealing with the study of the function and diseases of the kidneyKidneyThe kidneys, organs with several functions, serve essential regulatory roles in most animals, including vertebrates and some invertebrates. They are essential in the urinary system and also serve homeostatic functions such as the regulation of electrolytes, maintenance of acid–base balance, and... - PulmonologyPulmonologyIn medicine, pulmonology is the specialty that deals with diseases of the respiratory tract and respiratory disease. It is called chest medicine and respiratory medicine in some countries and areas...
, dealing with diseases of the lungs and the respiratory tractRespiratory tractIn humans the respiratory tract is the part of the anatomy involved with the process of respiration.The respiratory tract is divided into 3 segments:*Upper respiratory tract: nose and nasal passages, paranasal sinuses, and throat or pharynx... - RheumatologyRheumatologyRheumatology is a sub-specialty in internal medicine and pediatrics, devoted to diagnosis and therapy of rheumatic diseases. Clinicians who specialize in rheumatology are called rheumatologists...
, devoted to the diagnosisMedical diagnosisMedical diagnosis refers both to the process of attempting to determine or identify a possible disease or disorder , and to the opinion reached by this process...
and therapy of rheumatic diseases. - Adolescent medicineAdolescent medicineAdolescent medicine is a medical subspecialty that focuses on care of patients who are in the adolescent period of development, generally ranging from the last years of elementary school until graduation from high school...
- Clinical cardiac electrophysiologyClinical cardiac electrophysiologyCardiac Electrophysiology , is a branch of the medical specialty of clinical cardiology and is concerned with the study and treatment of rhythm disorders of the heart. Cardiologists with expertise in this area are usually referred to as electrophysiologists...
- Critical care medicineCritical Care MedicineCritical Care Medicine is a peer-reviewed medical journal in the field of intensive care medicine. It is the official publication of the Society of Critical Care Medicine, and is published by Lippincott Williams & Wilkins. The editor-in-chief is Joseph E. Parrillo....
- Geriatric medicine
- Interventional cardiologyInterventional cardiologyInterventional cardiology is a branch of cardiology that deals specifically with the catheter based treatment of structural heart diseases. Andreas Gruentzig is considered the father of interventional cardiology after the development of angioplasty by interventional radiologist, Dr. Charles...
- Hospital medicineHospital medicineHospital medicine in the United States is the discipline concerned with the medical care of acutely ill hospitalized patients. Physicians whose primary professional focus is hospital medicine are called hospitalists; this type of medical practice has extended beyond the US into Canada...
- Sleep medicineSleep medicineSleep medicine is a medical specialty or subspecialty devoted to the diagnosis and therapy of sleep disturbances and disorders. From the middle of the 20th century, research has provided increasing knowledge and answered many questions about sleep-wake functioning. The rapidly evolving field has...
- Sports medicineSports medicineSports medicine is a branch of medicine that deals with physical fitness, treatment and prevention of injuries related to sports and exercise...
- Transplant hepatologyHepatologyHepatology is the branch of medicine that incorporates the study of liver, gallbladder, biliary tree, and pancreas as well as management of their disorders. Etymologically the word Hepatology is formed of ancient Greek hepar or hepato- meaning ' liver' and suffix -logia meaning 'word' or 'speech'...
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.
American College of Osteopathic Internists
The American College of Osteopathic InternistsAmerican College of Osteopathic Internists
The American College of Osteopathic Internists is one of two medical associations in the United States for Internal medicine physicians, the other being the American College of Physicians....
recognizes the following subspecialties.
- AllergyAllergyAn Allergy is a hypersensitivity disorder of the immune system. Allergic reactions occur when a person's immune system reacts to normally harmless substances in the environment. A substance that causes a reaction is called an allergen. These reactions are acquired, predictable, and rapid...
/ImmunologyImmunologyImmunology is a broad branch of biomedical science that covers the study of all aspects of the immune system in all organisms. It deals with the physiological functioning of the immune system in states of both health and diseases; malfunctions of the immune system in immunological disorders ; the... - CardiologyCardiologyCardiology is a medical specialty dealing with disorders of the heart . The field includes diagnosis and treatment of congenital heart defects, coronary artery disease, heart failure, valvular heart disease and electrophysiology...
- Critical care medicineCritical Care MedicineCritical Care Medicine is a peer-reviewed medical journal in the field of intensive care medicine. It is the official publication of the Society of Critical Care Medicine, and is published by Lippincott Williams & Wilkins. The editor-in-chief is Joseph E. Parrillo....
- EndocrinologyEndocrinologyEndocrinology is a branch of biology and medicine dealing with the endocrine system, its diseases, and its specific secretions called hormones, the integration of developmental events such as proliferation, growth, and differentiation and the coordination of...
- GastroenterologyGastroenterologyGastroenterology is the branch of medicine whereby the digestive system and its disorders are studied. The name is a combination of three Ancient Greek words gaster , enteron , and logos...
- Geriatric medicine
- HematologyHematologyHematology, also spelled haematology , is the branch of biology physiology, internal medicine, pathology, clinical laboratory work, and pediatrics that is concerned with the study of blood, the blood-forming organs, and blood diseases...
/OncologyOncologyOncology is a branch of medicine that deals with cancer... - Infectious diseaseInfectious diseaseInfectious diseases, also known as communicable diseases, contagious diseases or transmissible diseases comprise clinically evident illness resulting from the infection, presence and growth of pathogenic biological agents in an individual host organism...
s - Nuclear medicineNuclear medicineIn nuclear medicine procedures, elemental radionuclides are combined with other elements to form chemical compounds, or else combined with existing pharmaceutical compounds, to form radiopharmaceuticals. These radiopharmaceuticals, once administered to the patient, can localize to specific organs...
- NephrologyNephrologyNephrology is a branch of internal medicine and pediatrics dealing with the study of the function and diseases of the kidney.-Scope of the specialty:...
- PulmonologyPulmonologyIn medicine, pulmonology is the specialty that deals with diseases of the respiratory tract and respiratory disease. It is called chest medicine and respiratory medicine in some countries and areas...
- RheumatologyRheumatologyRheumatology is a sub-specialty in internal medicine and pediatrics, devoted to diagnosis and therapy of rheumatic diseases. Clinicians who specialize in rheumatology are called rheumatologists...
Medical diagnosis and treatment
Medicine is mainly focused on the art of diagnosis and treatment with medicationMedication
A pharmaceutical drug, also referred to as medicine, medication or medicament, can be loosely defined as any chemical substance intended for use in the medical diagnosis, cure, treatment, or prevention of disease.- Classification :...
, but many subspecialties administer surgical treatment:
- CardiologyCardiologyCardiology is a medical specialty dealing with disorders of the heart . The field includes diagnosis and treatment of congenital heart defects, coronary artery disease, heart failure, valvular heart disease and electrophysiology...
: angioplastyAngioplastyAngioplasty is the technique of mechanically widening a narrowed or obstructed blood vessel, the latter typically being a result of atherosclerosis. An empty and collapsed balloon on a guide wire, known as a balloon catheter, is passed into the narrowed locations and then inflated to a fixed size...
, cardioversionCardioversionCardioversion is a medical procedure by which an abnormally fast heart rate or cardiac arrhythmia is converted to a normal rhythm, using electricity or drugs. Synchronized electrical cardioversion uses a therapeutic dose of electric current to the heart, at a specific moment in the cardiac cycle...
, cardiac ablation, intra-aortic balloon pumpIntra-aortic balloon pumpThe Intra-aortic balloon pump ' is a mechanical device that increases myocardial oxygen perfusion while at the same time increasing cardiac output. Increasing cardiac output increases coronary blood flow and therefore myocardial oxygen delivery... - GastroenterologyGastroenterologyGastroenterology is the branch of medicine whereby the digestive system and its disorders are studied. The name is a combination of three Ancient Greek words gaster , enteron , and logos...
: endoscopyEndoscopyEndoscopy means looking inside and typically refers to looking inside the body for medical reasons using an endoscope , an instrument used to examine the interior of a hollow organ or cavity of the body. Unlike most other medical imaging devices, endoscopes are inserted directly into the organ...
and ERCP - PulmonologyPulmonologyIn medicine, pulmonology is the specialty that deals with diseases of the respiratory tract and respiratory disease. It is called chest medicine and respiratory medicine in some countries and areas...
: BronchoscopyBronchoscopyBronchoscopy is a technique of visualizing the inside of the airways for diagnostic and therapeutic purposes. An instrument is inserted into the airways, usually through the nose or mouth, or occasionally through a tracheostomy. This allows the practitioner to examine the patient's airways for... - NephrologyNephrologyNephrology is a branch of internal medicine and pediatrics dealing with the study of the function and diseases of the kidney.-Scope of the specialty:...
: dialysisDialysisIn medicine, dialysis is a process for removing waste and excess water from the blood, and is primarily used to provide an artificial replacement for lost kidney function in people with renal failure... - Critical care medicineCritical Care MedicineCritical Care Medicine is a peer-reviewed medical journal in the field of intensive care medicine. It is the official publication of the Society of Critical Care Medicine, and is published by Lippincott Williams & Wilkins. The editor-in-chief is Joseph E. Parrillo....
: mechanical ventilationMechanical ventilationIn medicine, mechanical ventilation is a method to mechanically assist or replace spontaneous breathing. This may involve a machine called a ventilator or the breathing may be assisted by a physician, respiratory therapist or other suitable person compressing a bag or set of bellows...
See also
- Royal College of Physicians and Surgeons of CanadaRoyal College of Physicians and Surgeons of CanadaThe Royal College of Physicians and Surgeons of Canada ' , French: Collège royal des médecins et chirurgiens du Canada, is a national, private, nonprofit organization established in 1929 by a special Act of Parliament to oversee the medical education of specialists in Canada...
- Royal Australasian College of PhysiciansRoyal Australasian College of PhysiciansThe Royal Australasian College of Physicians, or RACP, is the organisation responsible for training, educating, and representing over 9,000 physicians and paediatricians in Australia and New Zealand. It was founded in 1938....
External links
- International Society of Internal Medicine
- Internal Medicine Society of Australia and New Zealand
- Western US Internal Medicine Positions
- The American Board of Internal Medicine
- Canadian Society of Internal Medicine
- The American College of Osteopathic Internists
- Henry Ford Hospital Internal Medicine
- American College of Physicians