Internal Medicine / internal medicine books
Internal Medicine, nonsurgical medical specialty
concerned with diseases of internal organs in adults. Physicians
who specialize in the field, known as internists, are skilled in
disease prevention and in managing complex disorders of the body.
Internists may be either generalists or specialists.
General internists typically act as personal physicians, developing
long-term relationships with patients. Internists give patients
regular physical examinations, offer preventive care, diagnose and
treat most nonsurgical illnesses, and refer serious or unusual cases
to an appropriate specialist. If a patient complains of persistent
stomach problems, for example, a general internist might refer the
patient to a gastroenterologist, an internist who specializes in
disorders of the digestive system.
Within the field of internal medicine, nine subspecialties are recognized:
cardiology, the treatment of diseases of the heart and blood vessels;
endocrinology, the study of glands and other structures that secrete
hormones; gastroenterology, the care of conditions of the digestive
tract, liver, and pancreas; hematology, the study of blood and blood-forming
tissues; infectious disease, the study of severe or unusual infections;
nephrology, the diagnosis and treatment of kidney diseases; oncology,
the study and treatment of cancerous tumors; pulmonary disease,
concerned with disorders of the lungs and other components of the
respiratory system; and rheumatology, the treatment of disorders
involving joints and other connective tissues. An additional subspecialty
gaining prominence is geriatrics, the study of diseases affecting
older adults.
The development and widespread use of many technologies have enabled
internists to perform procedures that formerly were considered the
responsibility of surgeons. For example, a procedure called endoscopy,
performed using an illuminated tubular instrument called an endoscope,
permits doctors to examine and photograph internal organs and manipulate
tools inside the body without invasive surgery. Another tool, a
narrow tubular device called a cardiac catheter, permits physicians
to inject drugs or fluids directly into the heart.
The origins of internal medicine date back to the late 19th century,
when the practices of general medicine and surgery began to split
into separate disciplines. Over time, internists became hospital-based
generalists who played a role somewhere between those played today
by family physicians and surgical specialists. Since the mid-1900s
internal medicine in the United States has shifted from a primarily
generalist field to a discipline in which roughly 65 percent of
all internists are certified as subspecialists.
Those seeking a career in internal medicine must obtain a medical
degree and complete a three-year in-hospital internal medicine training
program. Internists interested in a subspecialty must spend one
or two additional years studying that discipline and must pass a
certification test. The specialty board for internal medicine, the
American Board of Internal Medicine, was established in 1936.
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