What is Internal Medicine?
Internal Medicine is best defined as having a holistic approach to medicine when treating the adult patient. In contrast with the majority of medical specialties, Internal Medicine does not refer to a specific organ or function, it is characterized by the treatment of the whole person, taking into account mental and social factors, rather than just the signs and symptoms of a disease. Core competencies in Internal Medicine1,2 include aspects related to patient care, clinical knowledge, technical skills, communication skills, professionalism, and academic activities. Internal Medicine differs from Family Practice or General Medicine, which have exclusively primary care objectives.
The recent advances in medical technology have logically led to more narrowly defined specialized medicine. This evolution has been unquestionably highly beneficial to many patients. However, the need for a broad and holistic approach to treating medical conditions not only remains, it is increasing, particularly in an ageing population.
Patients are in general referred to the Internist by other practitioners for unsolved diagnosis, complex or intricate symptomatology, and cases of multiple medical conditions (multimorbidities). Internists are sometimes called “diagnosticians”. This expertise requires not only a broad medical knowledge of frequent occurring diseases, but also to be familiar with uncommon conditions and rare diseases.
Rare diseases in adults often involve several different organs: an internist aims to diagnose and care for these patients. As academics, Internists are involved in many areas of clinical research. They also play a key role in teaching clinical practice to medical students.
The proportion of internists among doctors and their missions differ from one country to another. In a majority of them (mainly in northern and central Europe), internists can also have a subspecialized practice like endocrinology, rheumatology, nephrology, etc.
European Internists have in common as extended period of training; one or two years longer than other medical specialists. They need to acquire a high level of expertise covering a broad spectrum of medical conditions. Internists play a central role in hospitalized or outpatient medical care of adults by insuring:
- The care of patients with severe chronic diseases
- The care of patients admitted to the hospital for acute conditions which do not require highly specialized medical technology
- The diagnosis in complex and unusual medical presentations
- The diagnosis and care of patients with systemic and rare diseases
- The coordination of care for patients with severe multiple morbidities
Internal Medicine is the cornerstone of the healthcare system.
Professor Daniel Sereni President of the Foundation for the Development of Internal Medicine in Europe
- Core competencies of the European Internist. Authors: Palsson R, Kellett J, Lindgren S, Merino J, Semple C, Sereni D. European Journal of Internal Medicine 2007 18: 104-108.
- The practice of Internal Medicine in Europe: organisation, clinical conditions and procedures. Authors: Mark Cranston, Colin Semple, Roger Duckitt, Moshe Vardi, Stefan Lindgren, Christopher Davidson, Runolfur Palsson - for the European Board of Internal Medicine Competencies Working Group. European Journal of Internal Medicine 2013 24: 627–632.
Note: For additional information about Internal Medicine in Europe, follow the link to the website of the European Federation of Internal Medicine (EFIM) : https://www.efim.org/about/what-internal-medicine