Internal medicine is a medical specialty in which physicians apply scientific knowledge and clinical expertise to diagnose and treat adults with a very broad range of health concerns and illnesses. Physicians who specialize in internal medicine are known as internists or general internists.

What is Internal Medicine?


While they are both primary care doctors — and the terms are frequently used interchangeably — internists are not the same as general practitioners and family physicians. One of the main differences is that internists see only adults, and family practitioners see both children and adults.

General Internists

General internists are particularly qualified to practice primary care and follow patients through their adult lives. Some internists work as hospitalists, delivering primary care in hospital settings; others offer only outpatient care. General internists might also practice in rehabilitation centers and long-term care facilities.

Internal medicine doctors are trained to offer:

  • Precise diagnoses of and immediate treatment for a broad range of symptoms and diseases
  • Expertise in the conditions that affect any of the body’s systems
  • Guidance, counseling, and preventive interventions to improve the overall health
  • Lifetime comprehensive care and palliative care
  • Care for mental health disorders, like depression and anxiety caused by abnormal activities in the brain, a chronic disease, or hormonal imbalance

General Internists

General Family Practitioners

Unlike internists, general family practitioners do not solely concentrate on adults and might practice pediatrics, obstetrics, and do minor surgery.

Family physicians could treat a full range of medical issues and provide acute, chronic, and wellness services for patients.

Family physician training includes:

  • Adult critical care (1 month)
  • Care for children in the hospital or emergency settings (nearly 2 months)
  • Geriatric care (1 month)
  • Gynecology (1 month)
  • In-patient hospital experience (6 months minimum)
  • Musculoskeletal medicine (2 months)
  • Newborn encounters
  • Obstetrics (2 months)
  • Surgery (1 month)

Family medicine training also includes behavioral health, common skin conditions, population health, health system management, wellness, and disease prevention.


Internists are medical doctors who specialize in preventing, diagnosing, and treating a wide variety of diseases and other health problems that affect adults. They are experts in health promotion, disease prevention, and the treatment of problems both simple and complex, acute and chronic.

Internal medicine training involves general medical education, as well as time spent rotating among a variety of subspecialty clinics, both in-patient and out-patient.

Internal Medicine Subspecialties

Internal medicine trainees gain experience working in areas that involve:

  • Endocrinology
  • Rheumatology
  • Infectious diseases
  • Pulmonary diseases
  • Cardiovascular diseases
  • Critical care medicine
  • Hematology
  • Oncology
  • Gastroenterology
  • Nephrology
  • Neurology
  • Psychiatry
  • Dermatology
  • Ophthalmology
  • Gynecology
  • Otorhinolaryngology
  • Non-surgical orthopedics
  • Palliative medicine
  • Sleep medicine
  • Geriatrics
  • Rehabilitation medicine

Internal medicine trainees spend at least 1 year caring for hospitalized patients, with at least 3 months in intensive/critical care settings. They undergo hospital-based training for at least one 1, with additional exposure to in-patient subspecialties like cardiology, hematology-oncology, or gastroenterology.

Many internal medicine doctors have a specific subspecialty. To gain expertise for those subspecialties, students complete an additional 1 to 3 years of fellowship training after a required three-year internal medicine residency.


  • Allergy and Immunology (immune system)
  • Cardiovascular Disease (heart and vascular system)
  • Advanced Heart Failure and Transplant Cardiology
  • Interventional Cardiology (heart health)
  • Critical Care Medicine (patients whose organ system is failing)
  • Clinical Cardiac Electrophysiology (heart rhythm)
  • Endocrinology, Diabetes, and Metabolism (diabetes and other glandular and metabolic diseases)
  • Gastroenterology (gastrointestinal system, liver, and gallbladder)
  • Transplant Hepatology (liver)
  • Hematology (blood)
  • Infectious diseases (bacterial, viral, fungal, and parasitical infections)
  • Nephrology (kidneys)
  • Oncology (cancer)
  • Pulmonary Disease (lungs and respiratory system)
  • Rheumatology (joints and musculoskeletal system)


Internal medicine is the study, diagnosis, and treatment of conditions that affect the internal organs — conditions like heart disease, hypertension, diabetes, obesity, and lung disease. Internal medicine specialists usually care for people with complex, chronic, and multisystem disorders.

Based on their subspecialties, internists might work with doctors in other medical specialties or consult on patients referred by another specialist.


Internal medicine doctors diagnose, manage, and treat a broad range of conditions. These are cancer, infections, and conditions affecting the heart, blood, kidneys, joints, and the digestive, respiratory, and vascular systems. Examples of conditions treated by internists are:

  • Abnormal liver biochemical and function tests
  • Abnormal uterine bleeding
  • Acid peptic disease related to upper gastrointestinal bleeding
  • Acquired thrombotic thrombocytopenic purpura (TTP)
  • Acquired von Willebrand syndrome
  • Acute aortic dissection
  • Acute aortic regurgitation
  • Acute bacterial meningitis
  • Acute bronchitis
  • Acute calculous cholecystitis
  • Acute cholangitis
  • Acute colonic diverticulitis
  • Acute decompensated heart failure
  • Acute diverticulitis
  • Acute exacerbations of asthma
  • Acute ischemic stroke
  • Acute liver failure
  • Acute lower extremity ischemia
  • Acute mesenteric arterial occlusion
  • Acute migraine
  • Acute myocardial infarction
  • Acute pancreatitis
  • Acute pericarditis
  • Acute pharyngitis
  • Acute pulmonary embolism
  • Acute respiratory distress syndrome
  • Acute sinusitis and rhinosinusitis
  • Acute variceal hemorrhage
  • Acute viral gastroenteritis
  • Adrenal insufficiency
  • Airway foreign bodies
  • Allergic rhinitis
  • Anal fissure
  • Angioedema
  • Aseptic meningitis
  • Aspiration pneumonia
  • Atrial fibrillation
  • Bacterial brain abscess
  • Balanitis and balanoposthitis in children and adolescents
  • Bell’s palsy
  • Bleeding peptic ulcers
  • Cancer pain
  • Cardiac arrest
  • Cardiogenic shock complicating acute myocardial infarction
  • Cellulitis and skin abscesses
  • Chronic complications as well as age-associated comorbidities in people suffering from hemophilia
  • Chronic limb-threatening ischemia
  • Clostridial myonecrosis (“gas gangrene”)
  • Clostridioides difficile (“C. Diff”) infection (formerly called Clostridium difficile)
  • Cognitive impairment and dementia
  • Colonic ischemia
  • Constrictive pericarditis
  • Convulsive status epilepticus in adults
  • Corneal abrasions and corneal foreign bodies
  • Cushing’s syndrome
  • Diabetic ketoacidosis as well as the hyperosmolar hyperglycemic condition in grown-ups
  • Disseminated intravascular coagulation
  • Dysphagia in adults
  • Electrocardiographic abnormalities indicating myocardial ischemia and infarction
  • Emergency contraception
  • Epilepsy and electroencephalogram (EEG)
  • Esophageal disease
  • Exacerbations of chronic obstructive pulmonary disease (COPD)
  • Exercise-associated hyponatremia
  • External otitis
  • Failed fibrinolysis (thrombolysis) and threatened reocclusion in acute ST-elevation myocardial infarction
  • Fasting ketosis and alcoholic ketoacidosis
  • Gastrointestinal infections
  • Giant-cell arteritis
  • Gout flares
  • HELLP syndrome (hemolysis, high liver enzymes, and low platelets)
  • Hepatic encephalopathy
  • Hereditary thrombotic thrombocytopenic purpura (TTP)
  • Hyperkalemia
  • Hypotonic hyponatremia
  • Infections of cerebrospinal-fluid shunts and other devices
  • Ingested foreign bodies and also food impactions on adults
  • Intestinal ischemia
  • Intracranial epidural abscess
  • Invasive group A streptococcal infection and also toxic shock syndrome
  • Lactic acidosis
  • Lower gastrointestinal bleeding
  • Lyme disease
  • Malignancy-related superior vena cava syndrome
  • Massive hemoptysis
  • Mechanical colorectal obstruction
  • Mechanical small-bowel obstruction
  • Mesenteric venous thrombosis
  • Metabolic acidosis
  • Metabolic acidosis in chronic kidney disease
  • Metabolic alkalosis
  • Mineral and bone metabolism
  • Mitral-valve prolapse and flail mitral leaflet
  • Moderately to severely hypertensive retinopathy as well as hypertensive encephalopathy
  • Myopericardial disease
  • Narrow QRS complex tachycardias
  • Necrotizing soft-tissue infections
  • Neoplastic epidural spinal-cord compression
  • Neuromuscular disease
  • Neuropathies
  • New-onset atrial fibrillation
  • Non-HIV viral infections
  • Non-sustained ventricular tachycardia
  • Nonocclusive mesenteric ischemia
  • Open-angle glaucoma
  • Osmotic demyelination syndrome (ODS) as well as over-rapid correction of hyponatremia
  • Osteonecrosis (avascular necrosis of bone)
  • Ovarian and fallopian-tube torsion
  • Pelvic inflammatory disease
  • A perianal and perirectal abscess
  • Peripheral nerve and muscle disease
  • Pneumothorax
  • Pregnancy complications
  • Prerenal disease and acute tubular necrosis in acute kidney injury
  • Pulmonary infections
  • Retinal detachment
  • Rhabdomyolysis
  • Right-sided native-valve infective endocarditis
  • Second- and third-degree atrioventricular blocks
  • Secondary spontaneous pneumothorax
  • Segmental colitis related to diverticulosis
  • Severe Crohn’s disease
  • Severe hypovolemia or hypovolemic shock
  • Severe ulcerative colitis
  • Sickle cell disease
  • Simple and mixed acid-base disorders
  • Sinus bradycardia
  • Spinal epidural abscess
  • Spontaneous bacterial peritonitis
  • Staphylococcal toxic shock syndrome
  • Stevens-Johnson syndrome and toxic epidermal necrolysis
  • Streptococcal pharyngitis
  • Subacute kidney injury
  • Supraventricular arrhythmias after myocardial infarction
  • Suspected acute coronary syndrome (myocardial infarction, unstable angina)
  • Suspected nephrolithiasis
  • Suspected nonvertebral osteomyelitis
  • Sustained monomorphic ventricular tachycardia in patients suffering from the structural heart disease
  • Symptomatic aortic stenosis
  • Syncope
  • Thoracic aortic aneurysm
  • Thyroid storm
  • Transient ischemic attack (TIA)
  • Tubo-ovarian abscess
  • Tumor lysis syndrome
  • Unexplained thrombocytopenia
  • Unstable angina and non-ST elevation myocardial infarction
  • Upper gastrointestinal bleeding
  • Urinary tract obstruction and hydronephrosis
  • Ventricular arrhythmias
  • Ventricular arrhythmias during acute myocardial infarction
  • Vertigo
  • Viral encephalitis
  • Wide QRS complex tachycardias

Internal Medicine


Internal medicine specialists conduct or order tests, procedures, and surgeries based on patients’ condition, overall health, and wellness goals. With the increase in the incidence of head and neck cancers, internists are on the front lines of oropharyngeal cancer screening.

The Centers for Disease Control and Prevention (CDC) suggests that all adults 18 and older get screened annually.

Internists — as well as nurses and other providers — are trained to perform many types of medical procedures, the use of which could vary greatly by specialty, diagnosis, and treatment. Providers require experience and skill — and in many cases, additional training and medical credentials — to perform these procedures, as well as to minimize patient discomfort, optimize outcomes, and reduce side effects.

Internal medicine specialists commonly conduct procedures that include:

  • Venipuncture (“blood draw”) to test blood
  • Arterial puncture to analyze blood gases
  • Endotracheal intubation
  • Flexible sigmoidoscopy
  • Intravenous (IV) line insertion
  • Nasogastric (NG) tube placement
  • Urinary catheters placement

Some internists have been trained in more complex and/or invasive diagnostic and therapeutic procedures, like thoracentesis, lumbar puncture, and paracentesis.

Categories and other types of tests and procedures an internist may perform include:

  • Allergy – Skin testing, rhinoscopy
  • Cardiology – Cardiac stress testing, echocardiograms, coronary catheterization, angioplasty, stent insertion, pacemakers, electrophysiology testing as well as ablation, implantable defibrillators, cardioversion, placement of intra-aortic and intra-ventricular devices
  • Endocrinology – Thyroid biopsy, dynamic hormone testing, and bone density testing
  • Gastroenterology – Upper and lower endoscopy, esophageal manometry, endoscopic retrograde cholangiopancreatography (ERCP), stent insertion, endoscopic ultrasound, and liver biopsy
  • Hematology/oncology – Bone marrow biopsy, stem cell transplant, lymph node biopsy, and plasmapheresis
  • Pulmonary – Intubation and ventilator management, bronchoscopy, chest tube thoracostomy, and tracheostomy placement
  • Renal – Kidney biopsy, dialysis
  • Rheumatology – Joint aspiration and therapeutic injection

Internal medicine and several other medical specialties use ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) to guide invasive procedures. Flexible fiberoptic instruments might be used to access hard-to-reach areas of the body.


Major professional societies for internists include:

  • Alliance for Academic Internal Medicine
  • American Association for the Study of Liver Diseases (AASLD)
  • American College of Cardiology
  • American College of Gastroenterology
  • American College of Physicians (ACP)
  • American Diabetes Association
  • American Geriatrics Society
  • American Heart Association
  • American Medical Association
  • American Society of Gastrointestinal Endoscopy
  • American Society of Hematology
  • American Thoracic Society
  • Endocrine Society
  • Infectious Diseases Society of America

If you or anyone you know is suffering from diseases, disorders, and illnesses, our expert providers at Specialty Care Clinics will take care of your health and help you recover.

Call 469-545-9983 to book a telehealth appointment for an at-home check-up.

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