Internists deliver care to
adults, applying both detailed scientific knowledge and a humanistic approach
to their diagnosis and treatment and management plans, and most commonly care
for patients over the course of their lifetime. Some internists serve
exclusively as primary care physicians for adults, some confine their practices
to a subspecialty area within internal medicine, and others pursue a
combination of these two approaches. The practice venues may be exclusively
office-based or involve mainly care of hospitalized patients (for example, by
so-called "hospitalists" and “intensivists”
in critical care areas). Other career paths include teaching and research in academic
medicine, leadership roles in governmental agencies such as the NIH, CDC,
etc., in the pharmaceutical industry, and in international health. The
subspecialty areas of internal medicine include:
|
Allergy and Immunology |
Hematology/Oncology |
|
Cardiology |
Infectious Disease |
|
Clinical Pharmacology |
Nephrology |
|
Endocrinology and Metabolism |
Pulmonary Disease, Occupational Medicine, and Critical Care |
|
Gastroenterology and Hepatology |
Rheumatology |
|
Geriatrics |
Palliative care |
There is no prescribed set
of electives for students planning a career in Internal Medicine, although an
inpatient elective (colloquially known as a sub-internship) in general internal
medicine is highly recommended (and is a requirement for graduation). One
or more electives in the internal medicine subspecialties also are recommended,
but electives need not be limited to internal medicine, since many electives in
other areas would also be valuable to the future internist. Examples of
electives in other areas include Ambulatory Gynecology, Dermatology, Sports
Medicine, Ambulatory Psychiatry, Ambulatory Neurology, and
Adolescent Medicine.
Students pursuing other specialties, but who will be caring for adult patients,
will find internal medicine senior electives provide an excellent background.
To meet American Board of Internal Medicine eligibility requirements, an
individual must complete 3 years of graduate training in an accredited internal
medicine residency training program. To become eligible for additional certification
within one of the subspecialty areas of internal medicine, an individual must
complete a minimum of two years of fellowship in that subspecialty (some
fellowship programs now require a total of three years, with additional
training required for certification in certain highly specialized areas such as
transplant nephrology or hepatology, interventional
cardiology, and so on).
Individuals interested in
an academic career may elect to obtain training in the Research Pathway. This
ABIM-sanctioned path requires 2 years of general medicine training, followed by
fellowship training, which includes 3 years of research. Substantial previous
experience in research will be expected for most physicians entering this
pathway, and evidence of excellent clinical skills gained during the first two
years of general medicine. The net effect of participation in this program is
spending one additional year of training to become board eligible in internal
medicine and the specialty of interest, and to be very well-trained to take a
faculty position as a physician investigator in a medical school. Participation
in NIH-sponsored training and research grants now provides opportunities for
educational loan repayment. Interested students should contact the Program
Director (Dr. Lia Logio),
or Chair of the Department ( Dr. David Crabb).
Students planning an internal medicine career should consider multiple factors
in choosing residency training programs that would be optimal for them and
should discuss the options with their internal medicine faculty advisors. (If a
student will be applying for an internal medicine residency but has an advisor
from another field, at least one meeting with an internal medicine advisor is
recommended). The Chairman is very interested in meeting with students
considering internal medicine as a career, both to provide information
about training programs and to write a Chairman's letter of recommendation that
is required by many categorical internal medicine and medicine-pediatrics
training programs. The departmental leaders participate in a workshop on
application to internal medicine programs and the interviewing process under
the auspices of the Internal Medicine Student Interest Group (IMSIG) in July or
August. Interested students are encouraged to meet with the Program Director or
Chair at their convenience to discuss their options in more detail.