WOW What Is Internal Medicine? An Inside Look at the Role of an Internist

People tend to describe you as empathetic, caring, and communicative. You’re a people person. You also happen to be deeply passionate about medicine, and you dream about the possibility of working closely with patients.

Because the way doctors interact with individuals can vary from one specialty to the next, you want to make sure you choose a field that allows you to build longitudinal relationships with the people who seek your care. You envision working alongside patients to promote long-term wellness.

Internal medicine may be the field for you. Internists are the primary care providers many adults see for their annual appointments. They’re also the first providers patients visit when faced with a new health concern. 

But what is internal medicine, exactly? And what type of work do internists do? We have the answers you’re seeking, so settle in as we explore this vital physician role.

WHAT IS INTERNAL MEDICINE?

Even if you’ve heard of internal medicine before, you might not have a clear understanding of the definition. You’re certainly not alone. It’s a relatively vague term, so we asked an expert to help provide a simple answer.

"When people ask me what I do, I say, ‘Internal medicine,’ which is primary care for adults."

“When people ask me what I do, I say, ‘Internal medicine,’ which is primary care for adults,” explains Dr. Albert Fuchs, an Internist who owns a private practice in Beverly Hills, California. The answer doesn’t get much more clear-cut than that, but let’s take a closer look at what exactly the position entails.

WHAT DO INTERNISTS DO?

Based on the above definition, you can see that internal medicine is a vast field. Internists might treat patients as young as 18 years old and as old as a full century. The types of cases they see are equally varied.

“We see anything from chronic illnesses like heart failure, diabetes, and hypertension to acute problems like sprains and sinus infections,” Dr. Fuchs says. They perform exams, make diagnoses, prescribe treatments, administer vaccinations, and recommend preventive measures.

Internal medicine is a great field for those who appreciate variety. In fact, it’s one of the reasons Dr. Fuchs ultimately pursued the specialty. “It wasn’t really a default choice,” he clarifies. “It was an all-of-the-above choice for me. I didn’t want to limit myself to just fixing a patient’s heart or their hormones.”

"I didn’t want to limit myself to just fixing a patient’s heart or their hormones"

The expansive nature of internal medicine means internists are well equipped to handle many different conditions. They also have a better understanding of when a referral is needed, and what type of referral is necessary.

“It's not just that a good internist can take care of a whole lot of problems without a specialist,” Dr. Fuchs notes. “It's that patients are often poorly educated about which specialist they need when they do need one.” This is where an internist’s skills come in — to determine when their patient needs to seek more specialized care.

WHERE DO INTERNISTS WORK?

The practice Dr. Fuchs runs is a little different than most. The model he follow goes by many names: retainer-based medicine, concierge medicine, direct primary care, and boutique medicine. Regardless of terminology, the idea is that patients pay an annual or monthly fee to cover services. It eliminates insurance company billing.

"A typical internist practice nowadays means working for some sort of medical group or large hospital system"

But Dr. Fuchs acknowledges most practitioners don’t follow this model. “A typical internist practice nowadays means working for some sort of medical group or large hospital system and involves mostly seeing patients in an office setting,” he says.

WHAT TYPE OF EDUCATION DO YOU NEED TO BECOME AN INTERNIST?

The road to becoming a doctor starts the same way, regardless of specialty. You need to obtain both a four-year bachelor’s degree and a four-year medical degree. In order to gain acceptance to medical school, you need to demonstrate solid academic metrics, experience working with patients in a clinical setting, and a passion for medicine.

Once in school, expect to complete two years of basic science instruction in a classroom setting. You’ll spend the final two years of medical school completing clinical rotations to gain experience working directly with patients. It’s also during medical school that you’ll start the licensure process, which begins with completing the United States Medical Licensing Examination (USMLE) Step 1 near the end of your second year. Most students take the USMLE Step 2 CK and Step 2 CS during their third or fourth year.

You’ll need to apply for a postgraduate internal medicine residency position as you draw closer to the end of medical school. This formal training process is required to obtain your medical license and is typically three years for internists. You’ll also complete the third and final USMLE test during residency. Once you’ve accomplished these requirements, you can obtain board certification and begin practicing. 

WHAT SKILLS ARE REQUIRED TO PRACTICE INTERNAL MEDICINE?

Good doctors need a robust set of both hard and soft skills. According to the US Bureau of Labor Statistics, leadership skills, problem-solving abilities, physical stamina, and communication skills are all important. Dr. Fuchs notes that the last one is especially crucial for internists.

"You need to listen to patients and understand how to gain their trust and tell you what’s bothering them."

“You need to listen to patients and understand how to gain their trust and tell you what’s bothering them,” Dr. Fuchs explains.

A commitment to lifelong learning is also important. Dr. Fuchs mentions it’s quite possible that a treatment you’re taught in medical school could be replaced by something else later in your career. You’ll need to keep educating yourself to maintain board certification, anyway.

For those who plan to operate their own practice, a solid foundation in medicine isn’t enough. “You need some business skills if you’re going to work for yourself,” Dr. Fuchs notes. It’s worth taking some business courses to make sure you’re prepared. 

"You need some business skills if you’re going to work for yourself."

HOW MUCH DO INTERNISTS MAKE?

Physicians, including internists, are among the highest earners in the US. The BLS reports the median annual salary for internists in 2017 was $198,370. As with any role, salaries vary among internists. Factoring in your experience level, geographic location, and the type of practice you choose will influence your earning potential.

WHAT IS THE JOB OUTLOOK FOR INTERNISTS?

Primary care physicians, including internists, are in high demand. Employment among internists is projected to grow 15 percent or more though 2026. This is much faster than the average for all other occupations. 

Why such a sunny outlook? We’re already experiencing a shortage of primary care physicians, and it’s projected to grow even larger in the future. We simply need internists to address our needs.

"That's an important place where you can make connections and potentially land your first job as an internist."

As for how to secure an internal medicine position, you should be thinking about it while completing residency. “That's an important place where you can make connections and potentially land your first job as an internist,” Dr. Fuchs says. From there, you’ll be on the path to a lasting and rewarding career.

PURSUE AN IMPACTFUL CAREER IN INTERNAL MEDICINE

So, what is internal medicine? You now know it’s a crucial field that requires practitioners have a deep understanding of all types of conditions. By working closely with patients, internists help prevent disease and promote wellness.

If this dynamic role sounds exciting to you, then it may be time to consider your next move. Applying to medical school is obviously an important step, and there are a lot of components to keep in mind. Make sure you’re prepared by reading our article, “A Sneak Peek at the Medical School Application Process.”

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