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Commentary: training internists for practice focused on meeting patient needs.

F Daniel Duffy¹

¹University of Oklahoma College of Medicine's School of Community Medicine, Oklahoma City, Oklahoma, USA. dduffy@abim.org

Academic Medicine : Journal of the Association of American Medical Colleges

|September 30, 2008

Summary

Internal medicine practice has evolved through four ages, driven by science and patient needs. Continuous professional development and competency-based evaluation ensure lifelong learning and focused patient care.

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Area of Science:

Internal Medicine
Medical Education
Healthcare Evolution

Background:

The practice of internal medicine has evolved significantly over time.
This evolution is shaped by scientific advancements, changing patient requirements, and market dynamics.
Four distinct eras mark this progression: the Oslerian diagnostic consultant, the subspecialist, the primary care internist, and the emerging era of focused general internal medicine.

Discussion:

Competency-based learning and continuous practice evaluation can replace traditional training duration requirements.
Specialty boards can ensure professional accountability through valid, competency-based certification standards.
Lifelong learning and performance evaluation facilitate the recognition of skills acquired through practice.

Key Insights:

Ongoing reflection on performance metrics demonstrates the integration of new knowledge and skills.
This process aligns physician practice with evolving patient needs.
Continuous professional development, through maintenance of certification, identifies and acknowledges expertise in focused internal medicine practice.

Outlook:

Training standards for certification may need to adapt to the evolving demands of internal medicine.
Evaluation of continuous professional development is crucial for recognizing proficiency.
This approach supports the identification and acknowledgment of expertise in specialized areas within internal medicine.