Intended for healthcare professionals


How to become a physician in general internal medicine

BMJ 2019; 367 doi: (Published 31 October 2019) Cite this as: BMJ 2019;367:l6219
  1. Jacqui Wise
  1. London, UK

Doctors specialising in general internal medicine are part of the acute medical care workforce. Their work involves diagnosing and treating a wide spectrum of diseases and conditions that present acutely to hospital emergency departments and acute medical units. They also refer patients for specialist opinion and care as needed.

Physicians in general internal medicine need to have expertise in diagnostic reasoning and in managing comorbidities, including for elderly patients with frailty and dementia. Most doctors that practise general internal medicine are also trained in another specialty or sub-specialty.

Two phenomena are driving an increasing recognition of the importance of general internal medicine: the rising number of older people with multiple long term conditions and the increasing focus within medicine on specialisation. These factors mean that patients may be referred from one specialist to another without one individual physician taking overall responsibility for their care.

The Royal College of Physicians’ Future Hospital Commission report1 highlighted the importance of general internal medicine in the delivery of holistic, person centred …

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