Earning a college degree is qualification enough for a lot of career paths. Earning two is even better. But if you want to be a doctor, that's only your starting point. Before you can practice medicine in your chosen field, you'll need to spend several more years in residencies and fellowships to nail down a medical specialty. Doctors of internal medicine, or internists, spend at least three years in residency after graduating from medical school.
First you'll need an undergraduate premedical degree, which usually takes four years. You can pick any major that appeals to you as long as the program includes the coursework you need for admission to medical school. This typically includes a selection of humanities courses, calculus or statistics, basic physics, chemistry and biology, and more advanced work in organic chemistry or microbiology. Your best bet is to get in touch with any school you're interested in attending, and ask for their admission prerequisites. That way you'll know your degree includes all the classes you need.
Once you've finished your undergraduate degree and been accepted into medical or osteopathic school, you're looking at another four years for your doctoral degree. In most schools, your first two years are devoted to classroom and laboratory time. This is when you get the rest of your scientific training, including medical genetics, immunology, anatomy and physiology, pharmacology and biochemistry. You'll also be taught medical law and ethics, and practical considerations about running your practice. During the third and fourth years you'll do several clinical rotations, treating patients and gaining exposure to each of the major branches of medicine. It'll give you a broad understanding of medicine and help you decide which specialty you want to pursue.
Earning those degrees will make you a doctor, but not an internist. For that, you'll need to spend three years in an internal medicine residency. You'll treat patients with a wide range of illnesses under the supervision of experienced internists, learning diagnostic skills and the relationships between the body's major systems. Other doctors specialize in specific aspects of medicine, but as an internist you'll understand the "big picture" of health and wellness and how symptoms can reveal apparently-unrelated conditions. Many internists are primary-care physicians, diagnosing and treating adult patients throughout their lifetimes. In addition, other doctors might lean on your expertise to diagnose difficult cases.
Certification and Sub-Specialties
By the end of your residency you'll be ready to face the certification process. Your board exam will be a day-long marathon, with questions based on hypothetical patient scenarios. They're designed to test your clinical skills and decision-making, rather than your ability to memorize answers to questions. If you pass, you'll become a board-certified internist. Most of the body's major organs and systems are part of internal medicine, so you could also opt to pursue a narrower specialty in one aspect of internal medicine. You can choose from gastroenterology, cardiology, oncology or a number of other fields. That requires one to four more years of training in specialized fellowships, and another set of board exams.
- American College of Physicians: About Internal Medicine
- Washington University School of Medicine in St. Louis: Internal Medicine
- Saint John's University: Guide for Planning your Pre-med Curriculum
- UT Southwestern Medical Center: Medical School Curriculum
- U.S. Bureau of Labor Statistics: Occupational Outlook Handbook -- Physicians and Surgeons
Fred Decker is a trained chef and certified food-safety trainer. Decker wrote for the Saint John, New Brunswick Telegraph-Journal, and has been published in Canada's Hospitality and Foodservice magazine. He's held positions selling computers, insurance and mutual funds, and was educated at Memorial University of Newfoundland and the Northern Alberta Institute of Technology.