Internal medicine is the specialty that deals with internal organs (as the heart, the lungs, the digestive system, etc.) and therefore deals with a multitude of different pathologies. This is the specialty of complex cases, rare cases. In other words, it is a versatile specialty.

Internal medicine is a relay between general medicine and specialized organ medicine (3). It is also said that the internist is the specialist in diagnoses (4), that he is best equipped to identify and propose treatment for diseases affecting several organs simultaneously.

The specialist takes care of the majority of patients with symptoms that do not belong to a specific disease or that cut across several specialties. He is particularly interested in polypathologies (as is often the case in the elderly) and diseases affecting several organs, such as lupus, diabetes or most rare diseases. Thus, the internist takes care of many conditions:

• common pathologies requiring hospitalization;
• rare diseases with complex diagnosis (we speak of orphan disease):
• inflammatory or systemic autoimmune diseases;
• infectious and tropical diseases;
• pathologies linked to the environment;
• genetic diseases diagnosed in adulthood or progressing from childhood;
• or even immunosuppression.

The internist is considered to be the specialist in conditions left behind by organ specialists (3). He has broad spectrum knowledge coupled with extensive knowledge of several medical specialties.

He most often works in a hospital environment and uses specific examinations not very popular with other specialties, such as a biopsy of the femoral artery (to look for Horton’s disease – inflammation of the artery wall) or a biopsy. accessory salivary glands (to check for tissue infiltration).

Note that unlike cardiologist who performs heart ultrasound or gastroenterologist who performs fibroscopies, the internist does not do all these examinations himself but helps them.

The internist can practice in intensive care units, where patients suffer from multiple pathologies (respiratory failure, systemic infection, coma, etc.) requiring a multitude of treatments (intravenous therapy, ventilatory support, etc.). He is also very involved in the training of future doctors.

The consultation with an internist does not involve any particular risks for the patient. It is in any case the role of the doctor to clearly explain the modalities, the possible difficulties or even the dangers associated with the procedures, examinations and treatments that he will have to perform.

Become an internist in France

To become an internist, the student must obtain a diploma of specialized studies (DES) in internal medicine:

• he must first follow 6 years at the faculty of medicine, after his baccalaureate;
• at the end of the 6th year, students take the national classifying tests to enter the boarding school. Depending on their classification, they will be able to choose their specialty and their place of practice. The internship lasts 5 years and ends with obtaining the DES in internal medicine.

Finally, to be able to practice and carry the title of doctor, the student must also defend a research thesis.

Becoming an internist hasu Quebec

After college studies, the student must:

• follow a doctorate in medicine, lasting 1 or 4 years (with or without a preparatory year for medicine for students admitted with a college or university training deemed insufficient in basic biological sciences);
• then specialize by following a residency in general internal medicine for 5 years (including 3 years of internal medicine in the common core).

To find an internist:

• in Quebec, you can consult the website of the association of specialists in internal medicine of Quebec, which offers a directory of its members (5);
• in France, via the website of the National Council of the Order of Physicians (6).