At their most basic levels, both internal and family medicine physicians are primary care providers—versatile and widely skilled general practitioners who are qualified to treat many different medical issues.
As such, they often see the same patients regularly and repeatedly, diagnosing and treating ailments and injuries, or identifying problems that require a specialist or other advanced treatment. Internal and family medicine doctors can be quite similar, but they also have some distinct differences.
In this article, we’ll look at both medical disciplines and compare them, internal medicine vs. family medicine. And if you’re considering a medical career, we’ll also look at what it takes to become an internist or a family physician.
The first step in any physician’s career is graduating from an accredited medical school such as Ross University School of Medicine (Ross Med). After earning a Doctor of Medicine (MD) degree, you’ll have to choose a residency path. What will it be? Internal medicine or family medicine? Or maybe something altogether different? There are more than 160 medical specialties and subspecialties from which to choose, but you may be surprised how many are directly related to either internal or family medicine—or both.
Internal Medicine vs. Family Medicine: Similarities
Each year, two of the most popular medical residency matches for MD seniors are internal medicine and family medicine. Annual data from the National Resident Matching Program® (NRMP®)—the Match®—shows that 3,592 MD seniors matched into first-year post-graduate (PGY-1) internal medicine positions in 2023, far more than any other discipline. Pediatrics finished second with 1,635 matches, but family medicine was a close third with 1,484 matched PGY-1 positions. At Ross Med, the top two residency matches for our 2023 MD grads were internal medicine (220 matches) and family medicine (148 matches).
Residencies for both internal medicine and family medicine last three years, and both teach diagnostic and treatment skills for a wide variety of problems.
Ross Med’s Dr. Elizabeth Gero (MD ‘23) reflected on her recent match into family medicine: “My dad was really kind and compassionate. He was honest with his patients, and I noticed that throughout the years he would treat the entire family, including parents and children. Even if the children went away to college, they would come back and see my dad,” Gero said. That model of caring for the entire family over the course of a lifetime was at the core of her decision to transition from being a general podiatrist to going to medical school and matching in family medicine.
Internal medicine and family medicine physicians both must have a deep understanding of disease prevention, wellness, substance abuse, mental health, and the effective treatment of common problems. As stated above, they both may serve as primary care physicians, so they must have good communication skills and be prepared for long-term, comprehensive care.
After three years of residency, both internists and family physicians are ready for licensing and practicing medicine—or for further training in subspecialties. So, what’s the big difference, you ask?
Internal Medicine vs. Family Medicine: Differences
The principal difference of internal medicine vs. family medicine involves the age of the patients. Internal medicine physicians have the MD knowledge to treat just about anyone, but their expertise lies in the treatment of adults 18 and older. Family medicine doctors, on the other hand, cover all ages. They are trained to treat people from before they are born, throughout childhood and adulthood, and into old age. Both internists and family physicians may treat the same people for many years, but family physicians are more likely to treat patients through different life stages.
Because of the age differences in patients, the training for internal medicine vs. family medicine must also differ. Internists are experts in treating the fully grown, adult body and have deep knowledge of such chronic adult conditions as diabetes and cardiovascular disease. Family physicians must be experts in diseases particular to different age groups, as well as in the different treatments for the same ailments in a baby or child, or in adults of any age.
Another difference between internal vs. family medicine physicians is where they work. Family physicians provide most of the care for underserved rural and urban populations, and they work mainly out of outpatient offices or clinics. Internists also often work in outpatient locations, but many internal medicine doctors work in an inpatient hospital setting, where they may have access to more advanced technology and can quickly consult staff and physicians in other specialties.
The last big difference of family medicine vs. internal medicine deals with subspecialization and dual residencies. (Dual, double, or combined residency programs integrate two specialties in a single course of study.) Family medicine is often an end discipline, meaning many family physicians go directly from residency into practice. Family physicians may continue training, however, in such subspecialties as:
- Adolescent, geriatric, internal, pain, sleep, sports, or hospice and palliative medicine
- Health care administration, leadership, and management
Family medicine may also be combined in a dual residency with such specialties as psychiatry or emergency or preventive medicine.
Internal medicine is also commonly an end discipline, but the American College of Physicians (ACP) says that only about half of all internists stop training at the end of residency. Many doctors use internal medicine as a preliminary specialty before entering a wide range of other medical specialties or subspecialties. Internal medicine subspecialties include:
- Cardiovascular, infectious, or pulmonary disease
- Critical care, emergency, geriatric, hospital, pain, sleep, sports, or hospice and palliative medicine
- Endocrinology, diabetes, and metabolism
- Gastroenterology
- Hematology
- Medical oncology
- Nephrology
- Rheumatology
- Transplant hepatology
In a dual residency, internal medicine may be paired with such specialties as:
- Anesthesiology
- Dermatology
- Emergency, family, pediatric or preventive medicine
- Medical genetics
- Neurology
- Psychiatry
Both family medicine and internal medicine are versatile specialties with various possible paths, but internal medicine has more specialty and subspecialty options if you wish to advance or expand your medical training.
There are many more subtle differences too, when comparing family medicine vs. internal medicine. To learn more, see our individual family medicine and internal medicine blog posts.
If all this has piqued your interest and you are serious about going to medical school, check out the MD program and requirements at Ross Med. You may have what it takes to become a physician—of any specialty.