What is an Internist and What Do They Do?
If you are considering a career in medicine, you may feel excited, yet slightly overwhelmed, about the many options available for your career path. One of the largest medical fields available is internal medicine, with over 200,000 practicing internists currently working in the United States. Internal medicine is an active community, with internal medicine doctors working in many different job titles and affecting change in the healthcare industry from policy creation all the way down to the individual patient. Review the detailed overview below to help you better understand what is internal medicine and what an internal medicine doctor does.
What is Internal Medicine?
Internal medicine is a medical specialty focused on identifying and treating diseases and other issues inside the body that typically affect multiple internal organs. The study of internal medicine is rooted in a combination of medical disciplines, including pathology (the study of diseases), physiology (the study of bodily functions), and bacteriology (the study of bacteria). By combining this expertise together, doctors specializing in internal medicine can more readily treat conditions that manifest in different ways, such as diabetes, high blood pressure, or infections.
Internal Medicine vs Family Practice
Internal medicine is often confused with family practice medicine. Although both disciplines are focused on the treatment and prevention of a variety of diseases in patients, they are distinct. The biggest difference is that internal medicine doctors will only treat adults, while family practice doctors may treat patients of any age.
There are some additional differences in the way family practice doctors think about and practice medicine, starting from their training in medical school. Since family practice doctors treat patients of any age, they receive an education that includes many special areas not covered in an internal medicine program. However, for areas that are included in both programs, the education tends to be more in-depth for students training in internal medicine.
What is an Internist?
An internist is a doctor who practices internal medicine. While this definition may seem simplistic, the job of an internist is always evolving as new diseases are discovered and new medicines and treatments for those diseases come on the market. Internists must stay current with the latest information available on hundreds of different conditions and medications. Internists are part caregivers, part researchers, part investigators, and part doctors.
Medical School Education
Students who want to become internal medicine physicians can expect a similar educational pathway to doctors in other fields. All doctors must first complete an accredited medical school training program, followed by an average of 3 years in a general residency program. Many internists who decide to specialize will complete an additional 1-2 years of residency in their chosen specialization. During this training, residents are eligible to sit before the American Board of Internal Medicine (ABIM) for a certification process where they demonstrate their skills to become fully licensed and certified internists.
The Accreditation Council for Graduate Medical Education (ACGME) officially recognizes 14 subspecialties of internal medicine. Internists in training can complete additional residency training in any of the following areas:
- Endocrinology – the diagnosis and treatment of diseases affecting the endocrine system, such as diabetes or hormonal diseases
- Rheumatology – the diagnosis and treatment of diseases affecting joints, muscles, and bones
- Pulmonary / Respiratory Medicine – the diagnosis and treatment of diseases involving the lungs and respiratory system
- Cardiovascular care – the diagnosis and treatment of diseases involving the heart
- Critical Care – care for patients who are critically ill, usually involving some type of life support
- Geriatric Medicine – care for elderly patients
- Occupational Medicine – care for workers and prevention of diseases and disabilities directly attributed to environmental factors in the workplace
- Oncology – the diagnosis and treatment of tumors (both malignant and benign)
- Nephrology – the diagnosis and treatment of diseases involving the kidneys
- Hematology – the diagnosis and treatment of diseases involving the blood and blood-forming organs
- Gastroenterology – the diagnosis and treatment of diseases involving the gastrointestinal tract
- Allergy and immunology – the diagnosis and treatment of allergic reactions and diseases of the immune system
- Infectious diseases – the diagnosis and treatment of diseases causes by microorganisms, such as bacteria and viruses
What Does an Internal Medicine Doctor Do?
Internal medicine doctors care for adult patients with a variety of internal diseases. In addition to treating these diseases, internists will work with patients to control and improve quality of life issues that can appear when dealing with certain diseases, such as diabetes. Internal medicine doctors will also work with patients to educate them about early warning signs of these diseases and provide appropriate steps for prevention. Internists will also make referrals to other physicians, write prescriptions, train physician’s assistants, or do any tasks that any other physician would do.
Depending on their background, internists may also split their time between seeing patients and conducting research and training in their chosen specialization. Internal medicine is a dynamic and ever-evolving field, and internists can help advance the field of medicine by sharing their knowledge and experience with the medical community.
Handling Chronic Illness
Some illnesses, such as strep throat or an ear infection, can be treated and cured without the need for extensive ongoing treatment. Other chronic illnesses, such as asthma or Chron’s disease, require continual treatment and careful observation as the condition progresses. Some patients may find a medicine that works well for managing symptoms and only need annual or bi-annual checkups for medication refills. Other patients may have serious side effects to certain medications or have trouble finding the right medication that works well in managing the disease. Since every patient is different, the internist has to be well-versed in a variety of treatments for any condition. Internal medicine physicians must also provide palliative care, or specialized care that focuses on improving quality of life, in addition to simply treating the disease.
Careers in Internal Medicine
Doctors working in internal medicine can choose a variety of career paths. Internists can care for patients in a clinical office or in a hospital setting. Alternatively, internists can choose any of the following non-clinical career paths:
- Education – Internists work in medical schools in a variety of capacities, including as teachers, academic advisors, administrators, and curriculum developers.
- Research – Internists can become professional researchers testing new medicines, developing new treatment procedures or vaccines, furthering research on existing diseases, or learning about new diseases.
- Management / Administration – A background in internal medicine can develop into a leadership role in any organization where adult healthcare is involved, such as Veterans Administration Centers, senior living facilities, or for-profit businesses focused on the adult healthcare sector.
- Public Policy – Some internists want to affect change in the healthcare field on a larger scale and choose to work in public policy. Doctors choosing this path can act as liaisons between public health entities and governmental policy makers.
Just like other medical doctors, internists can expect to make a six-figure salary after completing residency and going into practice. Exactly how much internists will make can vary from $175,000 per year to over $400,000 per year, based on a number of factors:
- Geographic location: Internal medicine doctors who practice in larger cities will generally make more money than those who practice in smaller rural areas. Certain areas of the U.S. will also offer higher wages due to higher cost of living in that area.
- Type of Practice: Internists caring for patients directly in a clinical setting will generally earn more than those working in public policy or management roles when years of experience are equivalent.
- Specializations: Doctors who specialize will typically make more than those who don’t, and certain specializations pay more than others. For example, general internal medicine doctors averaged $243,000/year in 2019, while those specializing in gastroenterology, cardiology, or orthopedic surgery all averaged over $400,000/year.
Students exploring internal medicine as a long-term career option should feel confident about their job prospects. Jobs available in internal medicine are growing at approximately 7% per year – faster than the national average – and are projected to continue doing so until 2028. According to the U.S. Bureau of Labor Statistics, most internists can expect to work in physicians’ offices or hospitals, with a significant number of positions also available at medical schools and outpatient care centers.
Students in medical school can also improve their job prospects by choosing specialties that are highly in demand. The National Center for Health Workforce Analysis projects a significant shortage of physicians specializing in cardiology, gastroenterology, oncology, and pulmonology by the year 2025. Internists who specialize in one of these fields will be in demand and have improved job security for the next several years.
The Future of Internal Medicine
Students who choose a career in internal medicine should be prepared for a challenging, yet rewarding career. As improvements to healthcare help patients live longer and provide doctors with new and innovative ways of treating illnesses, internal medicine physicians will be in even higher demand. By understanding the career pathways and available subspecialties, students can prepare for a lifelong career in internal medicine.