Generative AI: foundational models. Natural Language Processing (NLP) and LARGE Language Models (LLM)

This work aims to provide internists with a practical, focused overview of how generative AI based on large language models can be effectively integrated into daily clinical practice. It describes the primary adaptation mechanisms like fine-tuning and retrieval-augmented generation (RAG) for tasks such as report generation, synthesis of clinical findings, and support in differential diagnoses, highlighting real-world examples in Internal Medicine. Technical and organizational requirements for adoption are analyzed, including computing infrastructure, integration with electronic health records, and security/privacy protocols under GDPR and the EU AI Act. Opportunities for enhancing clinical decision-making, optimizing workflows, and reducing administrative burden are emphasized, alongside current limitations like bias, hallucinations, and the need for human oversight. Finally, recommendations are offered for prospective validation in real-world settings and for ensuring explainable transparency, with the goal of empowering internists to incorporate these innovative tools responsibly and efficiently.