Physicians of all types have earned a bachelor's degree and completed a four-year medical school program. The vast majority of medical school graduates continue their training with a post-graduate residency in a specific field such as family practice, internal medicine, neurology or anesthesiology. Residency programs typically last three to five years, and most doctors choose to take the rigorous exam to become board certified in their specialty after completing their residency.
General practitioners see all types of patients. The first year of a residency is called an internship, and you work in different rotations with experienced doctors to learn about the actual practice of medicine. After your internship year, you mainly practice in your residency specialty area. A few physicians decide they do not want to specialize, and they become general practitioners after completing their internship. Although relatively common in the 1950s and 60s, general practitioners are becoming rare in the U.S. today, as most physicians are opting for the family practice specialty. Very few female general practitioners remain for historical and demographic reasons, and practically all female medical school graduates interested in primary care today choose to specialize in family practice.
An internist specializes in internal medicine and has completed a three-year general internal medicine residency. However, the vast majority of modern internists specialize further, and undertake one- to three-year fellowships in cardiology, pulmonology, gastroenterology and so forth. Specialists are typically referred to by their field of practice such as cardiologists or pulmonologists, while those who don't specialize further are typically called internists. Nonspecialized internists are often primary care physicians. An increasing number of female doctors are choosing internal medicine as their specialty, according to Medscape.
Nearly all doctors who want to work as primary care physicians choose the family practice specialty today. The thinking is that modern medicine has become so complex that several years of post-graduate training are required to learn everything you need to know to become a top-flight doctor. Family practice is a three-year residency program teaching doctors to provide primary care to patients of all ages, including conditions relating to any organ system, as well as care of acute conditions and management of chronic diseases.
The situation surrounding the titles of modern primary care physicians is confusing on several levels. The first areas of confusion is that there are very few true "general practitioner" M.D.s remaining. Given that virtually all medical school graduates choose to specialize, most who call themselves general practitioners today are doctors of osteopathy or older M.D.s. To add to the confusion, some family practice specialists describe themselves as in "family and general practice." Another potential confusion is that some internal medicine specialists -- cardiologists, endocrinologists, rheumatologists and the like -- also call themselves internists.
Clayton Browne has been writing professionally since 1994. He has written and edited everything from science fiction to semiconductor patents to dissertations in linguistics, having worked for Holt, Rinehart & Winston, Steck-Vaughn and The Psychological Corp. Browne has a Master of Science in linguistic anthropology from the University of Wisconsin-Milwaukee.