Introduction to Internal Medicine

What is an internist, and what does an internist do? Internists are specialists in adult medicine who provide the majority of health care to adults in the hospital or in the office. They: Internists are specialists in adult medicine who provide the majority of health care to adults in the hospital or in the office. They:  Provide comprehensive, continuing care (primary care) to adolescents, adults, and the elderly. This includes women’s healthcare, depression, and anxiety.  Treat acute and chronic medical conditions.  Treat episodic, urgent, and emergent conditions.  Arrange consultations with other physicians and conduct preoperative evaluations for surgical colleagues.

What opportunities are available for an internal medicine specialist? Academic medicine Academic medicine Private practice: Private practice:  Solo  Single-specialty  Multiple-specialty Salaried Internist: Salaried Internist:  Staff member at an HMO  Hospitalist  Hospital-owned office  Emergency Room

Specialistvs. Subspecialist Complete a traditional 3-year internal medicine residency Complete a traditional 3-year internal medicine residency Care for patients with a variety of medical conditions Care for patients with a variety of medical conditions Manage both chronic and acute patient problems Manage both chronic and acute patient problems Complete a traditional 3-year medicine residency and then a 2-3 year subspecialty fellowship Complete a traditional 3-year medicine residency and then a 2-3 year subspecialty fellowshipOR Complete a combined residency: Complete a combined residency:  Med/Peds (4 yrs)  Med/Emerg (5 yrs)  Med/Neurology (5 yrs)  Med/Psych (5 yrs)

Internal Medicine Subspecialty Fields Adolescent Medicine Adolescent Medicine Allergy and Immunology Allergy and Immunology Cardiovascular Medicine Cardiovascular Medicine Endocrinology Endocrinology Infectious Disease Infectious Disease Gastroenterology Gastroenterology Geriatrics Geriatrics Hematology Hematology Hepatology Hepatology Nephrology Nephrology Oncology Oncology Pulmonary Disease / Critical Care Medicine Pulmonary Disease / Critical Care Medicine Rheumatology Rheumatology Sleep Medicine Sleep Medicine These subspecialties require completion of a 3-year internal medicine residency and additional fellowship training of up to 3 years.

Competitive, salary, time

Residency Times Cardiovascular Disease (36/24) Endocrinology, Diabetes, and Metabolism (24/12) Gastroenterology (36/18) Hematology (24/12) Infectious Disease (24/12) Medical Oncology (24/12) Nephrology (24/12) Pulmonary Disease (24/12) Rheumatology (24/12) Hematology & Medical Oncology (36/18) Pulmonary Disease & Critical Care Medicine (36/18) Rheumatology & Allergy and Immunology (36/12 rhem & 18 allergy/immu) Adolescent Medicine (24/) Clinical Cardiac Electrophysiology (12/12, requires cardiovascular disease certification) Critical Care (3 pathways, see Geriatric Medicine (12/12) Interventional Cardiology (12/12, requires cardivascular disease certification) Sports Medicine (12/) Transplant Hepatology (12/12, requires gastroenterology certification) Cardiovascular Disease (36/24) Endocrinology, Diabetes, and Metabolism (24/12) Gastroenterology (36/18) Hematology (24/12) Infectious Disease (24/12) Medical Oncology (24/12) Nephrology (24/12) Pulmonary Disease (24/12) Rheumatology (24/12) Hematology & Medical Oncology (36/18) Pulmonary Disease & Critical Care Medicine (36/18) Rheumatology & Allergy and Immunology (36/12 rhem & 18 allergy/immu) Adolescent Medicine (24/) Clinical Cardiac Electrophysiology (12/12, requires cardiovascular disease certification) Critical Care (3 pathways, see Geriatric Medicine (12/12) Interventional Cardiology (12/12, requires cardivascular disease certification) Sports Medicine (12/) Transplant Hepatology (12/12, requires gastroenterology certification)

Which subspecialties are more competitive to get into then others? Right now, most people agree with the following order of competitiveness: Most Competitive: Cardiology Gastroenterology Allergy and Immunology Moderately Competitive: Pulmonary Nephrology Hematology/Oncology Mildly Competitive: Infectious Diseases Endocrinology Rheumatology Geriatric Medicine Right now, most people agree with the following order of competitiveness: Most Competitive: Cardiology Gastroenterology Allergy and Immunology Moderately Competitive: Pulmonary Nephrology Hematology/Oncology Mildly Competitive: Infectious Diseases Endocrinology Rheumatology Geriatric Medicine

5 Most Commonly Encountered Medical Issues Hypertension Diabetes Acute Myocardial Infarction Chronic Obstructive Pulmonary Disorder Asthma 5 Most Commonly Encountered Medical Issues Hypertension Diabetes Acute Myocardial Infarction Chronic Obstructive Pulmonary Disorder Asthma 5 Most Challenging Medical Issues to Treat Diabetes AIDS and related diseases Systemic Lupus, Erythematosus Acute Myocardial Infarction Cancer/Carcinoma/Oncology 5 Most Challenging Medical Issues to Treat Diabetes AIDS and related diseases Systemic Lupus, Erythematosus Acute Myocardial Infarction Cancer/Carcinoma/Oncology

From Clinical Information and Education Resources… to Physician and Patient Advocacy… ACP provides products and services for all stages of an internist’s career. Plus, Medical Student Membership is FREE!! Why Join ACP?

Thank you!

What is ACP? Founded in 1915 Founded in 1915 Nation's largest medical specialty society, with 124,000 members Nation's largest medical specialty society, with 124,000 members  23,000 medical students (19% of ACP membership)  Over 19,000 residents and fellows-in-training (15% of ACP membership) Mission Mission  To enhance the quality and effectiveness of health care by fostering excellence and professionalism in the practice of medicine

Personal and Professional Guidance for Medical Students Online internal medicine residency database Online internal medicine residency database Medical Student mentoring programs at Internal Medicine 2008 and online Medical Student mentoring programs at Internal Medicine 2008 and online Medical Student Abstract Competition Medical Student Abstract Competition Council of Student Members, who work with ACP on policy development and advocacy for medical students and all physicians Council of Student Members, who work with ACP on policy development and advocacy for medical students and all physicians Access to ACP’s clinical and ethical guidelines Access to ACP’s clinical and ethical guidelines

ACP Council of Student Members History History  Established in 1998 to help medical students emerge as leaders in the medical community Mission Mission  To promote the excellence and professionalism in medical students, thereby promoting internal medicine as a career 14-Member Council 14-Member Council  Chair (member of Board of Regents)  Vice-Chair (member of Board of Governors)  10 U.S. regions  Canadian Liaison  Osteopathic Representative

Council of Student Members Activities Works with ACP to provide advocacy for educational debt and loan relief Works with ACP to provide advocacy for educational debt and loan relief Contributes to IMpact Contributes to IMpact Coordinates student activities at the annual Internal Medicine meeting, such as the residency fair, abstract competition, and sessions such as “Stump the Professor” Coordinates student activities at the annual Internal Medicine meeting, such as the residency fair, abstract competition, and sessions such as “Stump the Professor” Assists with planning student programming at local chapter scientific meetings, including mentoring breakfasts and educational sessions about careers in internal medicine Assists with planning student programming at local chapter scientific meetings, including mentoring breakfasts and educational sessions about careers in internal medicine Provides resources to local internal medicine interest groups to help increase membership and establish productive programs Provides resources to local internal medicine interest groups to help increase membership and establish productive programs

Monthly e-newsletter especially for Medical Student Members Monthly e-newsletter especially for Medical Student Members Articles include: Articles include:  Tips for students to succeed in medical school  Explanations of current issues facing medical students and public health  Highlights activities of outstanding Internal Medicine Interest Groups  Profiles practicing internists  Clinical questions and answers taken from MKSAP for Students  Advocacy Briefs  Career Information

ACP and Public Policy ACP is rated as one of the most effective physician advocacy organizations in America ACP is rated as one of the most effective physician advocacy organizations in America Through the Key Contact Program, members can actively participate in ACP’s grassroots advocacy effort by contacting their Senators and Representatives on key issues of importance to internists Through the Key Contact Program, members can actively participate in ACP’s grassroots advocacy effort by contacting their Senators and Representatives on key issues of importance to internists Through the Council of Student Members, issues concerning medical students are brought to the attention of ACP’s leadership and made a part of the College’s Public Policy agenda Through the Council of Student Members, issues concerning medical students are brought to the attention of ACP’s leadership and made a part of the College’s Public Policy agenda

Advocating for Young Physicians and their Patients Regarding: Ways to diminish the financial burdens of undergraduate medical education Ways to diminish the financial burdens of undergraduate medical education Medical liability reform Medical liability reform Feasible and appropriate quality performance measures Feasible and appropriate quality performance measures Access to care for 46+ million uninsured Americans Access to care for 46+ million uninsured Americans Quality improvement and patient safety Quality improvement and patient safety Public health issues such as flu vaccine shortages and bioterrorism threats Public health issues such as flu vaccine shortages and bioterrorism threats

Internal Medicine 2008 & Chapter Meetings Opportunities to present abstracts Opportunities to present abstracts Networking, mentoring and social opportunities Networking, mentoring and social opportunities Educational workshops with world-renowned faculty Educational workshops with world-renowned faculty Didactic, interactive and hands-on formats Didactic, interactive and hands-on formats ACP Medical Student Members attend FREE!

ACP provides world-class, peer-reviewed medical journals and in-depth analysis of issues for internists

Physicians’ Information and Education Resource (PIER) Online guidance in caring for patients Online guidance in caring for patients Problem-based learning Problem-based learning FREE to members FREE to members Over 450 modules focusing on: Over 450 modules focusing on:  Diseases  Ethical and legal issues  Screening and prevention  Procedures  Complementary and alternative medicine

MKSAP for Students 3 MKSAP stands for Medical Knowledge Self-Assessment Program MKSAP stands for Medical Knowledge Self-Assessment Program Designed by Clerkship Directors for all students taking the medicine clerkship exam Designed by Clerkship Directors for all students taking the medicine clerkship exam Over 400 new patient-centered self-assessment questions, answers, and critiques Over 400 new patient-centered self-assessment questions, answers, and critiques Based on the format physicians use for board prep Based on the format physicians use for board prep ACP Medical Student Members receive a 33% discount!

Essentials Designed to aid medical students during their third year internal medicine clerkship Designed to aid medical students during their third year internal medicine clerkship Contains supplemental learning materials, such as: clinical photographs, tables and screening tools Contains supplemental learning materials, such as: clinical photographs, tables and screening tools Available in both print and online Available in both print and online Material content is based upon two ACP evidence-based resources: Medical Knowledge Self-Assessment Program (MKSAP) and Physician Information and Education Resource (PIER) Material content is based upon two ACP evidence-based resources: Medical Knowledge Self-Assessment Program (MKSAP) and Physician Information and Education Resource (PIER)

Don’t forget to visit ACP Online! Online journals Online journals Access to PIER Access to PIER Legislative Action Center Legislative Action Center Residency & career resources Residency & career resources ACP products catalog ACP products catalog Membership directory Membership directory Information about additional ACP benefits relevant to internists throughout their careers Information about additional ACP benefits relevant to internists throughout their careers