If you are interested in becoming a doctor who focuses on treating a wide range of diseases and conditions in adults, you might consider a career in internal medicine. You may be wondering what internal medicine involves and what training is required to practice in this field. As a doctor of internal medicine, you diagnose and treat conditions of internal organs while providing comprehensive primary care to adult patients.
Internal medicine often attracts medical students interested in broad primary care training and long-term patient management. If you are considering the internal medicine training pathway, ask yourself these questions:
If your answer to these questions is “yes,” then pursuing training as a doctor of internal medicine—also called an internist—may be the right path for you.
Internal medicine originated in Germany, where the specialty of combining laboratory research with patient care was called innere medizin. In the early 1900s, the specialty was introduced to the United States and became known as internal medicine. While the name may suggest a narrow focus, internal medicine physicians receive specialized residency training to manage diseases affecting multiple organ systems in adult patients.
Internal medicine combines advanced clinical diagnostics with comprehensive patient care. Physicians in this specialty complete residency training focused on diagnosing and managing both complex and common conditions affecting adult patients, including diseases of the heart, kidneys, liver, and lungs.
Internal medicine physicians are trained to address disease prevention, mental health, substance use disorders, and common conditions affecting multiple body systems. They also manage chronic adult diseases such as diabetes and cardiovascular disease and coordinate care with other specialists when advanced treatment is required.
To become an internist, you must first become a physician by graduating from an accredited medical school*—such as Ross University School of Medicine (RUSM). The steps to a medical degree at RUSM, which is located on the Caribbean island of Barbados, are the same as at United States-based schools: two years of medical science classes and two years of hands-on clinical training. For RUSM students, the medical sciences curriculum is completed on the Barbados campus; the clinical training can be completed at affiliated teaching hospitals in the United States.
During clinical training, RUSM students complete core rotations in internal medicine, surgery, pediatrics, family medicine, obstetrics/ gynecology, and psychiatry. Each individual student, then, selects from among 40 specialty elective clerkships to fulfill their remaining clinical requirements.
During the fourth and final year of medical school, students prepare for the next step in their medical education: residency. At RUSM, the Office of Career Advisement (OCA) helps students determine which residency specialty—such as internal medicine—suits them best. The OCA then helps students negotiate the National Resident Matching Program® (NRMP®)—a placement system which medical students who want to obtain licensure in the United States use to “match” with a medical residency. Residencies are required to become a licensed physician, and they last from three to eight years. A residency in internal medicine is typically three years, but the American College of Physicians® reports that only about half of all internists stop there to practice general internal medicine and serve as primary care physicians. The other half uses internal medicine as a preliminary residency before moving on to one of the many branches of internal medicine. These subspecialties include:
An internal medicine resident may also combine training with another specialty, which allows them to be “double-boarded” by both the American Board of Internal Medicine® and the certification board of their other medical specialty. Common specialty residencies paired with internal medicine include:
In 2021, RUSM had a first-time residency attainment rate of 92 percent for 2020-2021 graduates, a match percentage rate comparable with the overall match rate (93 percent) for medical schools in the United States. In recent years, RUSM MD’s have matched with hundreds of internal medicine residencies at hospitals across the United States. These hospitals include Ascension Providence Hospital in Michigan; the Cleveland Clinic Florida; Kern Medical Center in California; and Mount Sinai Beth Israel in New York.
Melissa A. Woo, MD, a 2016 RUSM graduate, completed internal medicine residency training and now practices as a hospitalist at Cleveland Clinic Florida in the Miami-Fort Lauderdale metro area. We asked Dr. Woo to describe her training experience and role in internal medicine practice.
Q: Why did you decide to go into internal—and then hospital—medicine?
A: When I was a third year medical student I came to learn that I loved non-surgical specialties, and I wanted to work with adults. The third year core internal medicine rotation at Cleveland Clinic Florida (CCF) showed me the wide variety of cases, both bread and butter and rare cases, that one can come across in Internal Medicine, and in a very academic setting. I realized that I really enjoyed being able to manage all of the organ systems, so I knew that internal medicine would be the right fit for me. As time went on during residency training at CCF, I fell in love with my hospital rotations, so I knew becoming a hospitalist was the right path for me. I loved CCF so much from my time as a medical student and resident, and I am so thankful that I have been able to stay on as a staff hospitalist!
Q: Any advice to medical students considering the specialty?
A: My advice is to keep an open mind. When I was a third year medical student at RUSM, it became quite clear during my rotations that I was falling in love with internal medicine. However I really gave my all with each core rotation. When I started my journey at RUSM I did not know what specialty was for me, but I kept in very close touch with the RUSM OCA who helped guide me in the decision making process of choosing a specialty, and they were a hugely important part of my journey; it is a very personal decision and can be difficult to choose a specialty. Choose 4th year electives that will help to show you what it will be like being an internist in the clinic versus the hospital, as well as what it would be like to be a different kind of internal medicine sub-specialist (i.e., cardiologist, gastroenterologist, etc.).
Q: What’s the most rewarding part of your job?
A: I love the pace of hospital medicine and I love being able to see real-time results. Although I only see hospitalized patients for a short period of time while in the hospital, I enjoy forming connections and relationships with my patients each day and seeing them recover. It is a wonderful and emotional feeling for me and my patients to experience their recovery together and to be their cheerleader, resource, and support system through difficult medical decision-making.
Because internists complete broad residency training in adult medicine, they are prepared to practice in a variety of healthcare settings. These settings may include clinics, hospitals, or group practices. Practice schedules for internists can vary depending on clinical setting and subspecialty focus, and responsibilities may include outpatient care, inpatient management, and on-call coverage.
Clinical responsibilities may vary depending on subspecialty training and practice environment. Internal medicine offers diverse pathways within adult medicine, including primary care and subspecialty practice.
Regardless of subspecialty focus, internal medicine physicians apply their residency training to help adult patients manage long-term health and complex medical conditions. For students interested in comprehensive adult medicine, internal medicine represents a structured and impactful training pathway.
A 2020 report by the Association of American Medical Colleges (AAMC) projected a significant physician shortage in the United States by 2033, including an estimated shortage of up to 55,200 primary care physicians. Internal medicine plays a central role in addressing adult primary care needs, making residency training in this specialty an important component of the future physician workforce.
As populations increase and people age, the need for physicians trained in internal medicine continues to grow. At the same time, like doctors across many specialties, a significant portion of the internal medicine workforce is nearing retirement. In July 2020, an AAMC report showed that one third of U.S. physicians are age 60 or older, and well over half—57 percent—are over 50 years old. This shift underscores the importance of preparing future physicians through medical school and internal medicine residency training.
Ross University School of Medicine has a strong history of preparing graduates for internal medicine residency and subspecialty training. RUSM reported a 90% first-time residency attainment rate for 2020–2021 graduates. If you are considering the internal medicine pathway, explore RUSM’s MD program and residency preparation resources.
The information and material contained in this article and on this website are for informational purposes only and should not be considered, or used in place of, professional medical advice. Please speak with a licensed medical provider for specific questions or concerns. Ross Med is not responsible for the information maintained or provided on third-party websites or external links.
