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Like many aspiring to become a doctor, you may be inclined to pursue a career in medicine because you enjoy helping patients restore and maintain their health. If you are social, attentive, trustworthy, and like interacting with people, chances are you are drawn to primary care, which spans across the medical landscape and includes the specialties of internal medicine, family medicine, and pediatrics. As a primary care physician, you get the opportunity to create long-term patient relationships by providing treatment and preventative care over many years.

After considering the 100+ specialties and subspecialties that you can pursue after graduating from medical school and narrowing it down to primary care, you may still be trying to learn more about the difference between internal medicine and family practice. Which of these primary care specialties is best for you?

Doctors often pursue these specialties if they seek variety in their work and want to develop relationships with patients. Internal medicine doctors serve as primary care physicians for adult patients from age 18 through old age. In comparison, family medicine physicians provide treatment to patients of all ages.

Internal Medicine vs Family Medicine

The difference between family medicine and internal medicine also involves the specialty’s focus, training, and patient care, according to the American College of Physicians (ACP).

After completing your medical degree from a four-year medical school like Ross University School of Medicine(RUSM), a three-year residency is required for internal and family medicine. Internal medicine residency focuses only on treating adults. Additional pediatric training is needed if you want to treat children, as well. Internal medicine training focuses on general medical conditions and includes significant experience in each of the internal medicine subspecialties (such as endocrinology, rheumatology and infectious diseases) and neurology. Medical students must also gain adequate experience in psychiatry, dermatology, ophthalmology, office gynecology, otorhinolaryngology, non-operative orthopedics, palliative medicine, sleep medicine, geriatrics and rehabilitation medicine to care for adults comprehensively, according to the ACP.

Another difference between internal and family medicine is that internal medicine training must also occur in both outpatient and inpatient settings. At least one year of internal medicine training must involve caring for hospitalized patients, including training in intensive/critical care settings. Most training programs require more than one year of hospital-based work with additional training in inpatient subspecialty services, such as cardiology, hematology-oncology, or gastroenterology. 

After residency, internal medicine doctors can choose to become primary care internal medicine doctors or become specialists by completing a fellowship.

Family physicians complete extensive training beyond medical school to provide the best possible patient care, including a three-year residency and in-depth training across a human lifespan—from birth to death.  Family doctors can then pursue fellowships and certificates of added qualifications in fields like adolescent medicine, maternal-child health, sports medicine, geriatrics, faculty development, and more while still being a primary care doctor.

The clinical setting you work in is not always dependent on the specialty you choose, yet there is a generalization associated with each. When it comes to internal medicine and family medicine job settings, internists usually work in an inpatient hospital setting more often than family doctors. Family doctors often work in the outpatient setting.

Internal medicine vs family medicine: What sets them apart?

Internal Medicine: What does an internist do?

Because internal medicine education focuses only on adults and includes experience in general medicine and the internal medicine subspecialties, training in adult medical issues is comprehensive and deep. The general and subspecialty nature of training equips internists to develop expertise in diagnosing the wide variety of diseases that commonly affect adults and in managing complex medical situations where multiple conditions may affect a single individual, according to the (ACP).

According to the ACP, internists follow patients over the course of their lives—from young adulthood through old age—and establish long relationships with their patients. They are specially trained to solve puzzling diagnostic problems and handle severe chronic illnesses and situations where several different illnesses may strike simultaneously. 

Internists are well prepared to provide primary care to adults through their outpatient continuity experience during training, particularly for medically complicated patients. Their training also enables them to effectively interact with their internal medicine subspecialty colleagues in co-managing complex patients (such as those with transplants, cancer, or autoimmune disease) and easily managing the transitions from outpatient to inpatient settings (and vice versa) for their patients who require hospitalization. 

Family Medicine: Healthcare for all ages

As its name suggests, family medicine provides medical care for all family members, and often these physicians can treat multiple generations of family members, from newborns to the elderly.

Family Medicine is considered the most versatile out of all specialties, according to the AAFP. As multipurpose specialists, family physicians must be flexible. They provide patients care in various settings, from office practices and hospitals to in-patient facilities and health centers. Over time the needs of their patients and community evolve, and family doctors have the ability to adapt their procedures and skills to meet those needs by tailoring their clinical services to patients and their unique situations.

A family physician works with patients as partners in their healthcare, helping them stay healthy, managing chronic conditions like diabetes and high blood pressure, or treating acute conditions, such as neck pain or shingles. Family physicians walk alongside patients through all of life’s stages, from birth through adolescence to childbirth, midlife and eldercare. They are wellness-centered, working with patients to maintain good health and prevent disease. Also, they collaborate with other experts when specialized care is needed, according to the (AAFP).

The range of influence for family physicians is broad, according to the AAFP. It includes:

  • Caring for patients regardless of age or health condition, sustaining an enduring and trusting relationship.
  • Understanding community-level factors and social determinants of health.
  • Serving as a patient's first contact for health concerns.
  • Navigating the health care system with patients, including specialist and hospital care coordination and follow-up.
  • Using data and technology to coordinate services and enhance care.
  • Considering the impact of health on a patient’s family.
  • Providing most of the care for America’s underserved rural and urban populations.

Family physicians are skilled experts, patient advocates, problem solvers, and medical team leaders, according to the American Academy of Family Physicians. Internal Medicine Physicians are attentive listeners, hardworking individuals, and dedicated medical professionals. Choosing between internal medicine and family medicine is a highly personal decision. Our comparisons above should help guide you to take the next step in your medical career. 

Ready to begin your journey to become a doctor?? Learn more about RUSM’s medical program.

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In 2020, 91% of RUSM students passed the initial step of the United States Medical Licensing Examination® (USMLE®) on the first attempt. And in 2022-2023, results show yet another strong year for RUSM with a 97% first-time residency attainment rate* thus far. Located on the island of Barbados and with a network of more than 15,000 alumni, RUSM is one of the largest providers of doctors for the U.S. healthcare system. RUSM graduates practice in all 50 states and in Puerto Rico.

*First time residency attainment rate is the percent of students attaining a 2023-24 residency position out of all graduates or expected graduates in 2022-23 who were active applicants in the 2023 NRMP match or who attained a residency position outside the NRMP match.