Are you considering becoming an internist but don’t know where to start? Read on to learn how to pursue a career in internal medicine.
As the name would suggest, internists are doctors who specialize in internal medicine. This discipline deals with the prevention, diagnosis, and non-surgical treatment of diseases of the internal organs, such as the heart and lungs, in adults.
The inner workings of the human body are complex and certain conditions often involve multiple organ systems. Becoming an internist could be right for you if you are interested in solving puzzling medical issues, helping patients deal with chronic health issues, promoting preventive medicine, and building ongoing relationships with your patients.
If your interest in this discipline is piqued but you don’t know where to go from here, keep reading for a step-by-step guide on how to become an internist.
Keep in mind that while each of these steps is necessary to become a registered internal medicine doctor in the United States, they can be completed at your own pace and at any stage in your life. Don’t be discouraged by how you perceive other people’s professional journeys.
Medical schools in North America and many other countries require that you are enrolled in an undergraduate program for at least two years before applying to medical school. As long as you take the necessary prerequisites, medical schools do not typically care about your major.
However, many students complete four-year Bachelor of Science degrees, such as one focused on health sciences and biology. Such degrees can help guarantee that you have completed the necessary prerequisites for your schools of interest, and also help prepare you for the MCAT (more on this below).
Besides taking the necessary courses, make sure to maintain a high GPA, ideally not below 3.5. Outside of class, partaking in extra-curricular activities, job shadowing physicians, working in a medical office, and taking on internships are great ways to prepare for your pre-med resume.
Taking on these activities outside of class can also develop your sense of self and help you understand if and why you want to become an internist. Remember to be introspective and assess whether you want to go into the medical field for the right reasons. Don’t be afraid to consider a gap year to explore these questions.
Many medical schools require the completion of the MCAT before admission. The MCAT consists of multiple-choice questions that assess the taker’s problem-solving skills, critical thinking, and scientific knowledge.
Some schools require the completion of other tests as well. For instance, some Canadian Universities require the completion of the Computer Based Sampling of Personal Characteristics, known as CASPer, used to assess the applicant’s empathy, communication skills, and more.
While preparing for exams like the MCAT can seem daunting, there are a plethora of private tutors, prep courses, and online materials available to help you succeed.
After completing the necessary examinations and prerequisites for your schools of choice, you are ready to compile your achievements in an application folder and apply to medical school!
Fast forward a series of interviews and months of anticipation, you’ve received your medical school acceptance letter! This is where your official training as a medical doctor starts.
Medical school is typically four years and includes the pre-clinical and clinical phases. In the pre-clinical phase, students complete two years of courses focused on general medical concepts, including anatomy, psychology, pathology, and biomedical ethics.
The clinical phase is when you get more hands-on medical training experience in clinical rotations in hospitals and clinics. Under the supervision of a variety of medical professionals, you can start to get a taste of what specialty you might enjoy and whether being an internist would be right for you.
Finding a mentor is also a beneficial way to learn more about which branch of medicine you would enjoy most.
During medical school, you will be required to take the United States Medical Licensing Examination (USMLE). The USMLE is a three-step examination necessary for medical licensure. Step one must be completed by the end of your second year before starting the clinical phase, and Step two must be completed by your final year before you can apply for residency in the U.S.
After you graduate from medical school and prepare the proper application materials (CV, personal statement, etc.), you can complete the process of being matched into an internal medicine residency program.
Residency is the stage of your medical education where you will primarily spend your time in a hospital or clinic learning a specific specialty. While this is a paid position, you will still be supervised and will need to develop the skills set to become a fully licensed and board-certified doctor.
Internal medicine residency programs typically take around three years and prepare you to become a board-certified general internist. During this time, you will learn how to diagnose and treat a range of illnesses, especially chronic illnesses. For this reason, internal medicine residency programs are regarded as very broad and intensive in nature.
You may choose to undergo a fellowship to subspecialize in a specific area in internal medicine beyond the initial residency program. These include specialties in cardiology, endocrinology, and oncology.
Upon completion of residency, you are now eligible to secure a medical license for your region and then to become board certified. If you’re in the United States, the process of board certification requires that you pass the American Board of Internal Medicine (ABIM)’s certification exam.
Once board certified, you can practice as an internist in a private practice, hospital setting, a professional setting like the American College of Physicians, and more.
As an internist, your patients are entrusting you with their health and well-being. Such a responsibility understandably takes years of training and dedication. To summarize the steps above, becoming a general internist typically takes at least 11 years:
If you wish to subspecialize, this may take an additional 1 to 3 years. Below are examples of the lengths of fellowships for some subspecialties:
As a doctor, your main goal is to aid in the health and well-being of your patients. Specializing allows you to do so by employing your own specific interests and strengths.
As an internist, you are an expert in preventing, treating, and diagnosing a broad spectrum of diseases in adults. There are multiple reasons why going into this specialty can give you a fulfilling and stimulating career.
Internists have the comprehensive knowledge to deal with multiple organ systems and interacting diseases at once. Patients will often come to you with rare and/or complex diseases that other doctors were unable to treat, or even diagnose in the first place. Because of this, internists must employ problem-solving and analytical skills which can be very intellectually gratifying.
Internists typically treat the same patients over a long period, often the length of their adult life. If you value building relationships with your patients, then this is a great specialty to look into.
Moreover, a day in the life of a general internal medicine doctor offers a lot of variety! Because of your broad knowledge and the fact that you are not limited to one organ system, you can see a patient with diabetes one hour and then move on to the treatment of COPD the next. This also allows you to interact with doctors from almost every field.
On the plus side, you can decide to subspecialize if you’d like to narrow your focus.
There is also a lot of variety in where you can work, such as in an office, clinic, or hospital (including all three at once). Some even work in rehabilitation centers or long-term care facilities.
Based on a 2019 U.S. physician employment report, internal medicine rank as the #2 most in-demand specialties.
Below are some frequently asked questions about becoming an internist:
General internists commonly pursue primary care general internal medicine, which involves mainly working in an ambulatory setting such as in a clinic or office. Like a general practitioner, they take on a number of patients over a long period of time and provide them with primary care.
However, unlike general practitioners, primary care general internists have a narrower scope of only treating adults and are more rigorously trained on internal processes. Many people who seek treatment from a primary care general internist are geriatric patients who have chronic diseases such as heart diseases and blood disorders.
General internists that mainly work in a hospital, on the other hand, often practice as hospitalists and focus on providing internal medicine care for hospitalized patients.
It’s important to note that some general internists work in both a hospital and an outpatient setting. For instance, a primary care general internist might treat one of their patients in the hospital if they require in-patient care.
While the two roles mentioned above are the most common for general internists, there are several other types of internists as well.
Compared to many other specialties, internists spend a lot of time talking with other specialists and building relationships with patients.
They also tend not to perform surgery but instead investigate the root cause of their patient’s health concerns.
Another key characteristic of an internist is that they must have a broad and comprehensive knowledge of many organ systems and disease states. This allows them to be able to treat puzzling health issues, such as when a patient presents with multiple interacting diseases or a chronic disease that affects multiple parts of their body.
So with that being said, an internist might be a person who enjoys communicating, learning, and deep-thinking as a bulk of their day, and is less concerned with being able to work with their hands. You might also excel at looking at the big-picture, being able to handle a lot of information at once, and solving complex puzzles.
Most internists only work with adults, but there are subspecialties in adolescent medicine and pediatrics.
Any downsides depend on the type of person you are. For instance, if the prospect of performing surgery excites you, then becoming a general internal medicine doctor might not be the best choice for you.
There are also the general difficulties that come with being a doctor, such as the potential for long hours and the years of required education.
The median salary for internists in the United States is $228,277. Subspecializing can allow you to earn more.
In 2021, the University of California- San Francisco’s Internal Medicine Program was ranked #1 by U.S. News. Harvard University and Johns Hopkins University came in second.
If you are a deep-thinker who is passionate about being able to help your patients with a broad range of health concerns, then becoming an internist might be right for you. While becoming one can seem daunting initially, having a clear picture of the path ahead of you is the first step to achieving your dream.