Want to learn more about Internal Medicine?

What is internal medicine?
Internal medicine (sometimes abbreviated to "IM" or just "Medicine") is a broad specialty focused on care of adults. Most adult medical problems that don't involve pregnancy or surgery fall within the discipline of internal medicine--and even pregnant patients and those who need surgery often need the help of an internist, especially if they are older or have lots of medical problems.
What's an "internist" and how does it differ from an "intern"?
Doctors who practice internal medicine are called "internists" in the United States. The name "Internal Medicine" comes from the German Innere Medizin, which translates literally as "Interior Medicine." The "interior" in the original usage referred to the laboratory, and the term was used to describe doctors who combined research and patient care. When medical education in the US was rebuilt on the German model in the late 1800s, "Internal Medicine" came with it. Even though most internists don't work in the lab anymore, the name stuck.
"Intern" is a generic term used for first-year residents of all disciplines. Thus an intern in an internal medicine residency is an internist, but a fully trained internist is no longer an intern.
How long is internal medicine training?
After getting an MD degree, most internists do a three-year residency. Those who pursue additional specialty training usually spend 1-3 years after that in fellowship. There is an alternate pathway that provides a two-year residency and longer fellowship for those who plan to spend most of their time in research--this is officially known as the Research Pathway, but is often called the "short track" or the "fast track", even though the total training time is the same.
What are the internal medicine specialties?
Graduates of internal medicine residency programs often work in the following specialties after graduation without additional training:
  • Hospital Medicine
  • Primary Care 
However, many internists seek additional fellowship training. Some opportunities available to internists after completing residency include:
  • Adolescent Medicine
  • Addiction Medicine
  • Cardiology
  • Clinical Genetics (often combined IM/Clinical Genetics with 2-3 yrs primary specialty training first)
  • Critical Care Medicine (often combined with Pulmonary or Nephrology)
  • Endocrinology
  • Gastroenterology
  • General Internal Medicine
  • Geriatric Medicine
  • Hematology (usually combined with Oncology)
  • Hospice & Palliative Medicine
  • Infectious Disease
  • Medical Genetics
  • Oncology (usually combined with Hematology)
  • Nephrology
  • Pulmonary Disease (usually combined with Critical Care Medicine)
  • Rheumatology
  • Sleep Medicine (often combined with Pulmonary/Critical Care)
Note that for some of these specialties, internal medicine is not the only way to get there: for example, some neurologists pursue additional training in sleep medicine, while family practitioners may pursue training in geriatrics or sports medicine.
What's the difference between internal medicine and family practice?
The differences are both obvious and subtle. On the obvious side, internists aren't trained in pediatrics or obstetrics, so our scope of practice is more focused. Primary care internists don't see young children or babies, although some do see adolescents, and conversely a greater proportion of internists' patients are often elderly. A typical internal medicine resident will spend more of her time learning in the hospital and critical care units, while a family practice resident will spend more of her time polishing her skills in the outpatient clinic. Internists also get more exposure to internal medicine subspecialties during training, so they are often more comfortable with hospitalized and medically complex patients. In smaller communities with limited access to specialists, an internist will sometimes function as a consultant, similar to specialists in urban areas.
The subtle differences have more to do with idiosyncrasies in culture and approach between the two specialties than they do with training or expertise. Most students interested in primary care take hard looks at internal medicine, family practice, and pediatrics. The best advice is to pay attention not only to the patients you will care for but also the people you will work with: Where do you really feel at home? Think hard about that when making career decisions.
Where can I get more information?
The American College of Physicians, the professional organization for internal medicine, has a web site with more information on careers in internal medicine.
Ask questions at every turn - that's what we're here for.
For general advising and questions throughout the year, contact Medicine Student Programs at 206-543-3237
First Year
Did you come to medical school knowing you want to be an internist? The first thing to accept is that you might change your mind. That's a normal part of training--don't be alarmed if your interest shifts all over the place. That said, we certainly support your interest! Some resources available to first year include:
  • Osler Club. This is a student-run organization for those interested in internal medicine. It meets once or twice a quarter and provides opportunities for exposure to primary care medicine, hospital rounds, and subspecialty practice.
  • Preceptorships. Doing a preceptorship with an internist can give you a great sense of what their practice is like. Be sure to ask them questions about their practice and their career path.  Contact Yvonne Horner,, to be matched with a preceptor. 
  • ICM-1 small groups. Your small group leader may be an internist. If they're not, it's very likely they know one and can help you set up a time to chat with them.
  • MSRTP Program. For students with a strong interest in research, the MSRTP program can offer a chance to get involved during the summer after first year. That research experience can both help to clarify career goals and can strengthen your residency application down the road.
  • R/UOP Program. If you are interested in primary care, we strongly recommend the R/UOP program during the summer of your first year. Hopefully you will have a chance to work with an internist, but even if that's unavailable the chance to spend time seeing patients in a working doctor's office is invaluable.
Second Year
The most important message about second-year career planning is DON'T PANIC! Remember, most students don't have any idea what there specialty will be--and many who do change their mind. You don't have to do anything specific to plan your career during second year--the third year clerkships will help you get a sense of where you fit best.
For second-year students who have a specific interest in internal medicine, the best resources are the College Faculty. Although your college mentor may or may not be an internist, he or she can certainly direct you to a colleague who is. Osler club and preceptorships are also good opportunities, as they are in the first year.
You'll be asked during last autumn quarter to rank your preferences for third year clerkship timing and site placement. 
Remember - don't be afraid to ask questions - we're here to help.  Our advising staff is available to meet with any student about questions regarding all things Medicine,

Sign up for a Medicine Preceptorship

contact Yvonne Horner to inquire and schedule MED505,
MED 505 - Preceptorship in Medicine
To provide opportunity for first- and second-year medical students to gain personal experience with medical practice situations by being stationed with carefully selected clinical faculty members in their offices, clinics or hospital services. Credit/no-credit only. Prerequisite: permission of department.


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