Post-graduate training in Internal Medicine: the generalist and sub-specialisation
Keywords:
Internal Medicine, sub-specialities, generalist, specialistAbstract
After a short introduction, the author describes a
personal view of the different possible aspects of
Internal Medicine. A definition, historical
perspective, organisation, vocation and formation,
with reference to the different realities in the USA
(where these problems have been much discussed)
and Portugal, including several well-known expert
citations, is made. The dichotomy between General
Internal Medicine and its Sub – Specialities, as well
as the relation between the General Internist and
the Specialist is elaborated. Special emphasis is given
to the priority need of future investment in Primary
Care and in the formation of Generalists (Internists,
Paediatricians and Family Physicians who are in
short supply in our country) on which,
unquestionably, our Health System must be based.
Also attention is drawn to the undesirable number
of General Physicians without suitable formation
and institutional employment. A plan to differenciate
Internal Medicine as a Medical Speciality, based
on a common period of 3 years, is presented and
justified. The division of General Internal Medicine
into three different but complementary fields is
suggested: Primary Care Internist, Hospital
Specialist and Emergency Specialist, adapting the
recognised American and German models. The final
conclusions emphasise the need to face these
problems with determination and coherence, putting
patients suffering and the way Health System works,
as our top priority.
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