Internist



An internist, also known as an internal medicine physician, is a primary care doctor who examines patients in an office, in addition to visiting patients in the hospital. Internists are usually generalists who cover a broad scope of medicine and provide a variety of treatment addressing total body wellness, management of chronic conditions and illnesses, and disease prevention. Internists most frequently treat adults and elderly, as well as some adolescents.

Diabetes, colds and flu, and hypertension are few of the more common ailments internists may treat and manage on a consistent basis. Internists frequently consult with specialists or refer their patients to consult with a specialized medical doctor if an acute or serious condition arises. Internists do not typically perform surgeries, although from time to time they may perform some minor office procedures including stress tests, mole removal, or scopes. Internists also perform physicals, provide dietetic services, prescribe medication, and provide their patients with non-invasive treatments.

Work Environment

Due to the range of services they provide, internists have several options of how and where to work. Internists can be found in medical offices, hospitals, clinics, often in combination of all three. An internist may work independently, having their own practice, or an internist may partner with other doctors to create a group practice in which the doctors each have ownership as well as responsibility. Some internists are even employed as salaried staff by hospitals or clinics.

Internists usually work from 8am to 5pm, 4 to 5 days a week. The average internist will meet with about 20-25 patients a day. In addition to their regular clinic hours, internists often visit patients in a hospital on daily rounds, or on an on-call basis. This could mean an additional 5-15+ hours or work per week, depending on their patient load and needs of the hospital(s) they service. If an internist runs his or her own practice, they may spend quite a bit of additional time each week addressing administrative issues and tasks.

Training and Education

As is the case for all aspiring medical doctors, internists are required to complete a four-year bachelor's degree, followed by four years of school from an accredited institution in order to obtain a medical degree (M.D. or D.O.).

In addition to extensive undergraduate and graduate education, an internist may also be required to complete several years of graduate medical education (GME) (including a one-year internship) plus 3 years in a residency training program. To prove their competency internists must pass specified medical certification and licensing exams including all three steps of the USMLE, and any licensing exams required by the state where they plan on practicing medicine. The majority of internists are also required to be board certified in internal medicine. This is achieved by passing an oral and written board certification.

Compensation

According to the Medical Group Management Association (MGMA), the average annual salary for internists is about $190,000 to $200,000. The 75th percentile for compensation for internists is almost $220,000, with the ability to earn upwards of $277,000 for the most success of this profession. Internists are usually provided 4-6 weeks of vacation per year. However, as most internist work for themselves taking vacation time each year can be difficult.

Career Path

Unlike other medical fields, internal medicine is one of the more versatile medical specialties an aspiring physician can choose, and internists quite possibly have the most opportunity of any physicians in terms of the career paths that are open to them. Internists can choose to be employees of a clinic, a hospital, a group practice, or they can venture out on their own and open a private practice instead. Additionally, an internist can decide to become a hospitalist, with no additional education or training requirements, which often offers higher pay and more days off during the year in exchange for longer hours working during the days the hospitalist is treating patients.

An internist has the option to complete additional GME (graduate medical education) in the form of a fellowship. This enables an internist to sub-specialize in other medical disciplines and focus on a certain condition group or body system. Internist often will specialize in one of the following sub-specialties of internal medicine:

  • Cardiologist: treats diseases of the heart, lungs, blood vessels and complex cardiac conditions; requires a three-year fellowship.
  • Gastroenterologist: treats digestive system including stomach, liver, and intestines; requires a two-year fellowship.
  • Endocrinologist: treats diseases or conditions of the glands, hormones and other internal secretions - requires an additional two years of fellowship after internal medicine residency.
  • Nephrologist: treats kidney disorders; requires 2 year fellowship after residency.
  • Oncologist: treats cancers and solid tumors of all kinds, and administers chemotherapy. Requires 2 years of fellowship after internal medicine residency.
  • Pulmonologist: treats lung diseases and disorders such as COPD, asthma, cancer, breathing and sleep problems. Requires 2 year fellowship.
  • Allergist & Immunologist: diagnoses, evaluates, and manages severe allergies and deficiencies of the immune system. Requires two year fellowship.
  • Rheumatologist: treats disorders of joints, muscles and bones, such as arthritis. Requires 3 years of fellowship training.

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