Internal medicine or general internal medicine (in Commonwealth nations) is

the medical specialty dealing with the prevention, diagnosis, and treatment

of internal diseases. Physicians specializing in internal medicine are called internists,
or physicians (without a modifier) in Commonwealth nations.

Because internal medicine patients are often seriously ill or require complex investigations, internists
do much of their work in hospitals. Internists often have subspecialty interests in diseases affecting
particular organs or organ systems.
Internal medicine is also a specialty within clinical pharmacy and veterinary medicine.

Internal medicine specialists, also known as general internal medicine specialists or general
medicine physicians in Commonwealth countries,[10] are specialist physicians trained to manage
particularly complex or multisystem disease conditions that single-organ-disease specialists may not
be trained to deal with.[11] They may be asked to tackle undifferentiated presentations that cannot be
easily fitted within the expertise of a single-organ specialty,[12] such as dyspnoea, fatigue, weight loss,
chest pain, confusion or change in conscious state.[13] They may manage serious acute illnesses that
affect multiple organ systems at the same time in a single patient, and they may manage multiple
chronic diseases or "comorbidities" that a single patient may have.[14]
General internal medicine specialists do not provide necessarily less expertise than single-organ
specialists, rather, they are trained for a specific role of caring for patients with multiple simultaneous
problems or complex comorbidities.[15]
Perhaps because it is complex to explain treatment of diseases that are not localised to a single-
organ, there has been confusion about the meaning of internal medicine and the role of an
"internist."[16] Internists are qualified physicians with postgraduate training in internal medicine and
should not be confused with "interns",[17] who are doctors in their first year of residency training
(officially the term intern is no longer in use).[18][19] Although internists may act as primary care
physicians, they are not "family physicians," "family practitioners," or "general practitioners," or
"GPs," 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".[20]

Education and training of internists[edit]

Main article: Medical education
The training and career pathways for internists vary considerably across the world.
Many programs require previous undergraduate education prior to medical school admission.
This "pre-medical" education is typically four or five years in length. Graduate medical education
programs vary in length by country. Medical education programs are tertiary-level courses,
undertaken at a medical school attached to a university. In the United States, medical school
consists of four years. 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", "conditional registration", or
"foundation programme". Then, doctors may finally follow specialty training in internal medicine if
they wish, typically being selected to training programs through competition. In North America, this
period of postgraduate training is referred to as residency training, followed by an optional fellowship
if the internist decides to train in a subspecialty.
In the United States and in most countries, residency training for internal medicine lasts three years
and centers on secondary and tertiary levels of care. In Commonwealth countries trainees are often
called senior house officers for four years after the completion of their medical degree (foundation
and core years). After this period, they are able to advance to registrar grade when they undergo a
compulsory subspecialty training (including acute internal medicine or a dual subspecialty including
internal medicine). This latter stage of training is achieved through competition rather than just by
yearly progress as the first years of postgraduate training.[21][22]