How to Become an Internist: A Comprehensive Guide

Updated on January 20, 2024

Becoming an internist takes many years of education and training. First and foremost, one must complete a bachelor’s degree program, typically four years, in a relevant field such as biology or chemistry to gain foundational knowledge (Bureau of Labor Statistics). Subsequently, prospective internists must attend medical school and obtain their MD degree, which generally takes another four years. After that, they need to complete a multi-year residency program in internal medicine where they receive supervised training in diagnosing and treating diseases in adult patients. Specifically, internists manage chronic illnesses and complex, undifferentiated conditions. Throughout this journey, commitment and diligence are necessary. The good news is that those who put in the hard work required are rewarded with a meaningful and well-compensated career improving people’s health and well-being.

What is an Internist?

An internist is a doctor who specializes in internal medicine. Internal medicine physicians, or internists, are primary care physicians who focus on adult medicine and have special training and skill in the prevention, diagnosis, and treatment of adult diseases.

Internists are sometimes referred to as the “doctor’s doctor” because they often act as consultants to other physicians to help diagnose complex or unusual cases. They have comprehensive knowledge and expertise across a wide spectrum of illnesses and have had special training in advanced diagnostic testing and therapeutics.

Training and Certification

After completing four years of medical school, internists undertake a three-year internal medicine residency program where they receive in-depth training in the diagnosis, treatment, and management of illnesses in adult patients. Following residency training, many internists pursue additional subspecialty training in fields like cardiology, gastroenterology, or endocrinology.

Board certification in internal medicine is required to practice as an internist. Doctors must pass rigorous exams conducted by the American Board of Internal Medicine (ABIM) to demonstrate sufficient expertise in the diagnosis and treatment of the broad range of illnesses encountered in internal medicine. ABIM certification must be renewed every ten years through further examination or completion of a maintenance of certification program.

What do Internists Do?

Internists are physicians who specialize in the diagnosis and medical treatment of adults. As an internist, your main responsibilities involve:

As an internist, you have a long-term relationship with patients, acting as their primary healthcare provider for life. You get to diagnose complex mysteries, walk patients through difficult illnesses, and promote wellbeing. It is an immensely fulfilling career for those who enjoy continuity of care, diagnostic challenges, and making a difference in people’s lives.

Educational Requirements for Becoming an Internist

Becoming an internist requires extensive education and training. At a minimum, aspiring internists must complete the following:

Medical School

The first step is earning a medical degree (MD) or doctor of osteopathic medicine degree (DO) by completing 4 years of study at an accredited medical school. The coursework covers topics like anatomy, biochemistry, pharmacology, pathology, medical ethics, and laws governing medicine. Students also gain hands-on clinical experience during clerkship rotations in various specialties.

After graduating, new physicians must pass the medical licensing exam to become eligible for residency programs. The United States Medical Licensing Examination (USMLE) is a three-step exam assessing a physician’s ability to apply knowledge, concepts, and principles that are important in health and disease.

Residency Training

The next requirement is completion of a 3-year internal medicine residency program. This provides supervised training in:

Through rotations in hospital wards and outpatient clinics, residents gain extensive clinical experience. They also have opportunities to conduct research.

Board Certification

After finishing residency, internists must become board certified by passing exams administered by the American Board of Internal Medicine (ABIM). This evaluates their expertise in areas like cardiology, pulmonology, gastroenterology, and more.

Lifelong learning is essential for internists to stay up-to-date on the latest advancements in internal medicine. Many pursue subspecialty fellowship training or earn Maintenance of Certification through activities like teaching and research.

Postgraduate Training for Internists

Becoming an internist requires significant postgraduate training. After completing 4 years of medical school and earning their MD, future internists must then complete a residency program in internal medicine which generally takes 3 years.

After completing an internal medicine residency, some physicians may choose to do a fellowship for 1-3 additional years of subspecialty training in a specific area like cardiology or oncology. However, internists can go directly into general internal medicine practice without a fellowship.

In summary, while the road is long, internists are richly trained in whole-person, evidence-based patient care with emphasis on diagnosis and medical management of complex, chronic, or undifferentiated disease. Their broad medical foundation equips them to excel in various healthcare settings.

Skills and Qualities of a Successful Internist

Becoming a successful internist requires developing a specific skillset and embodying certain qualities that are essential for excellence in this medical specialty.

Skills

Internists require strong diagnostic skills to identify complex and often obscure diseases and conditions. As they treat adults across a wide spectrum of illnesses, excellent listening and communication abilities enable them to tease out subtle patient clues and develop rapport during consultations.

Additionally, computational skills empower internists to interpret lab results and diagnostic tests to uncover abnormalities. They lean on strong critical thinking as well, weighing signs and symptoms to reach accurate diagnoses while avoiding cognitive biases. Logical reasoning guides effective evidence-based treatment plans tailored to each patient’s unique health profile.

Internists must excel in time management and organizational skills as well, allowing them to juggle patient loads, documentation, referrals to specialists, and hospital rounds. Competence using the latest medical technologies and information systems assists them in accessing patient history for fact-based follow-up care.

Qualities

The most successful internists demonstrate intellectual curiosity that drives lifelong learning as medicine continues to advance. They are motivated self-starters, studying current research and treatments to provide up-to-date care. Additionally, confidence helps internists act decisively when making high-stakes diagnoses and treatment decisions.

Compassion and patience also allow engaging patient relationships to form. By listening actively and explaining conditions and care plans clearly, the best internists put patients at ease during vulnerable times. Furthermore, physical and mental stamina give them the resilience to manage the demanding workloads and stress.

When prospective internists develop these well-honed skills and supportive qualities, they put themselves on the path to rewarding, high-impact medical careers. Resources like the American College of Physicians (ACP) offer mentorship and growth opportunities to help individuals realize their professional goals.

Internist Salary

Internists are some of the highest paid physicians. According to the Medical Group Management Association’s (MGMA) Physician Compensation and Production Survey, the average salary for internists in 2020 was $261,729. However, salaries can vary widely based on factors like location, experience, and subspecialty.

In general, internist salaries tend to increase with more years in practice. Here is a table showing average salary by years of experience for internists:

Years ExperienceAverage Salary
Less than 1 year$185,000
1-4 years$195,000
5-9 years$210,000
10-14 years$230,000
15-19 years$248,000
20 or more years$271,000

As you can see, the average internist just entering the field can expect to earn around $185,000, while those who have over 20 years of experience have an average salary of $271,000.

In addition to years of experience, salaries also differ based on subspecialty. For example, according to Doximity’s 2020 Physician Compensation Report, the average salaries by subspecialty are:

So subspecializing, particularly in cardiology or critical care, has the potential to boost an internist’s earning potential.

The job outlook for internists is also very positive. According to the Bureau of Labor Statistics, employment of physicians and surgeons, including internists, is projected to grow 4% from 2019 to 2029, about as fast as the average across all occupations. So in addition to a high salary, becoming an internist offers excellent job stability and demand.

Career Opportunities and Advancement

Becoming an internist opens up a wide range of career opportunities and room for advancement. After completing medical school and a 3-year internal medicine residency program, internists have several paths they can take.

Many internists choose to open or join a private practice. This allows them the freedom to manage their own schedule and care for patients long-term. Some internists focus on primary care, acting as a patient’s main doctor and coordinator of any specialty care needed. Others specialize in certain conditions like cardiology, gastroenterology, or endocrinology. Private practice allows for advancement into leadership roles in the practice or local medical community. According to the Medical Group Management Association, some internists pursue the role of a physician practice administrator, overseeing the business aspects of a busy practice.

For internists seeking teaching opportunities, academic medicine provides intellectual stimulation and chances to mentor future physicians. Entry-level roles involve instructing medical students and resident physicians while providing patient care. With experience, internists can advance to become a residency program director determining the curriculum and oversight of residents. Later in one’s career, the role of a tenured professor combines teaching opportunities with research in a chosen subspecialty.

Internists who enjoy policy and analysis can carve out careers in public health, government agencies, nonprofits, and health technology companies. The Centers for Disease Control and Prevention and local health departments recruit physicians for roles focused on population health. Consulting firms and startups value internists’ insights into improving care delivery and patient outcomes through innovative solutions. Within these roles, internists can advance to directing programs and initiatives applying their medical expertise.

The broad medical foundation internists gain makes them versatile clinicians. This creates diverse career possibilities with room to grow as a practicing internist, teacher, researcher, public health leader, or consultant improving the quality of patient care. The clinical and leadership skills developed as an internist open doors across the healthcare industry.

Conclusion

In summary, becoming an internist requires many years of education and training, but it can be a rewarding career path for those dedicated to caring for adult patients across a range of illnesses. After finishing medical school and obtaining a medical license, aspiring internists must complete a 3-year internal medicine residency program to gain hands-on experience. They may then complete additional subspecialty fellowship training if they want to focus on a specific area like cardiology or gastroenterology. With hard work and commitment, internists can find great fulfillment in this multifaceted medical role that allows them to develop long-term relationships with patients. Those interested in learning more about this specialty can get more details from the American College of Physicians website.

Additional Resources

Frequently Asked Questions (FAQ)

What is an Internist?

An internist is a doctor who specializes in internal medicine. They focus on the prevention, diagnosis, and treatment of diseases in adults and are often consulted by other physicians to help diagnose complex or unusual cases.

How long does it take to become an Internist?

The process to become an internist takes many years. After a four-year bachelor’s degree, it includes four years of medical school, followed by a three-year residency in internal medicine. Some internists may also choose to do additional subspecialty training, which can take 1-3 additional years.

What is the average salary of an Internist?

According to the Medical Group Management Association’s (MGMA) Physician Compensation and Production Survey, the average salary for internists in 2020 was $261,729. However, salaries can vary widely based on factors like location, experience, and subspecialty.

What are some skills required to be a successful Internist?

Successful internists need strong diagnostic skills, excellent listening and communication abilities, computational skills, critical thinking, time management and organizational skills, and competence using medical technologies and information systems.

What qualities should an Internist have?

Internists should demonstrate intellectual curiosity, confidence, compassion, and patience. They should also have physical and mental stamina to handle the demanding workloads and stress.

What does a typical day for an Internist look like?

A typical day for an internist can involve diagnosing and treating complex or chronic medical conditions, managing acute illnesses and injuries that require hospitalization, providing preventive care, coordinating patient care activities among different specialists, and educating patients on their conditions and treatment options.

What are the different areas of subspecialty within Internal Medicine?

There are many different areas of subspecialty within internal medicine. Some of these include cardiology, gastroenterology, endocrinology, oncology, and infectious disease.

Do Internists need to be board certified?

Yes, internists must become board certified to practice. This involves passing exams administered by the American Board of Internal Medicine (ABIM) and requires renewal every ten years.

What is the job outlook for Internists?

The job outlook for internists is very positive. According to the Bureau of Labor Statistics, employment of physicians and surgeons, including internists, is projected to grow 4% from 2019 to 2029, about as fast as the average across all occupations.

Where can I find more resources about becoming an Internist?

More information about becoming an internist can be found from organizations like the American College of Physicians, the Association of American Medical Colleges, and the American Board of Internal Medicine.