General Internal Medicine in Internal Medicine: At the Core or on the Periphery?

Abstract

In the past decade, faculty in sections of general internal medicine have assumed responsibility for training residents, for staffing clinical practices, and for developing new domains of health services and effectiveness research. These activities form the core of internal medicine: They are integral to the role of internal medicine as an academic and patient care discipline, and they complement the activities of the internal medicine subspecialties. The effect of general internal medicine on internal medicine, therefore, has been to shift the focus away from the subspecialty services--which compartmentalize a patient's medical problems--and back to the concept of the patient as a "whole" person. The role and territory of the general internist are changing as a result of this shift in focus, and general internal medicine is emerging as the new core discipline in internal medicine. These changes have allowed for an expanded capacity of internal medicine to provide new services, modified curricula, and innovative research.