Internal Medicine

"Internists take care of the general medical problems of adults. In a single day, they can act as a diagnostician, an educator, a director, an advocate, a motivator, a healer, and a comforter. In the clinic, they treat their patients' aches, pains, and sniffles. They also come to their bedsides in the hospital and manage their inpatient care. Some internists spend their time providing acute and chronic primary care; others become sub-specialists in cardiology, gastroenterology, endocrinology, and more."

— Freeman, B. (2013). The Ultimate Guide to Choosing a Medical Specialty. 3^rd Ed. Lange Medical Books/McGraw-Hill: New York.p.239.

M1 and M2 Students

What advice would you offer first- and second-year students who are interested in pursuing your specialty?

Internal medicine is a broad tent. It encompasses primary care, specialty care and subspecialty care. An internist could see a very broad or a very narrow scope of patients. A primary care physician sees urgent conditions, manages chronic conditions and acts as a diagnostician. A specialist such as a rheumatologist could see a variety of patients with acute and chronic musculoskeletal conditions or could just see patients with scleroderma. All medicine specialties have this spectrum (e.g., an oncologist who sees a wide variety of patients with cancer or an oncologist who just sees patients with lymphoma). Internists also vary in the amount of procedures they perform. Primary care doctors primarily talk to their patients. In contrast, some interventional specialists perform procedures most of the day. Examples are interventional cardiology (cardiac catheterizations/valve replacements), interventional pulmonary (pleural biopsy, tracheostomy) and interventional gastroenterology (endoscopic drainage and biopsies of pancreatic masses and biliary obstruction).

Internal medicine residency is three years long. Many people go into practice after this. Many other residents continue on to a specialty. These include allergy, cardiology, endocrinology, gastroenterology, geriatrics, hematology/oncology, infectious disease, nephrology, palliative care and rheumatology. Additional subspecialties include interventional cardiology, cardiac electrophysiology, heart failure and transplant hematology. Internal medicine is the largest department at Feinberg and most other medical schools.

How important is a research experience in your specialty? If important, does it need to be in the specialty itself?

AOSC offers Feinberg students a taste of research. We encourage those who find research intriguing to pursue research further. A summer or several months of research will not improve your chances in medicine. A year or two of research may impress a program director. We encourage students to pursue research because you are interested, not to improve your CV. Internal medicine has the most grants of any department at Feinberg and a long history of excellence in research. Doing research in medical school helps to determine your career path. It is not necessary to do research within internal medicine to match in internal medicine.

M3 and M4 Students

What M4 electives would you recommend to a student who is interested in pursuing your specialty?

We recommend at least one medicine subspecialty. Feinberg students are usually well prepared for their medicine residency due required experiences in sub-I, ICU and emergency medicine.

Does your specialty recommend doing away rotations?

It is not necessary to do this. The vast majority of residents did not do an away rotation at the program they matched at. If you want to explore an area of the country, it can be helpful to do an away rotation. But this rotation will have a small effect on your competitiveness. Internal medicine programs classically look at your clinical record and the quality of the school as they rank applicants.

If your specialty recommends doing away rotations, how many "aways" do you recommend?

Not applicable.

If away rotations are necessary, when should they be completed?

Fall of M4 year.

Which month do you recommend taking off to interview?

December has the most interview dates. Many programs now offer more dates in November than January. Any month is okay (there is neither a risk nor benefit to interviewing early or late), but we do not recommend doing all interviews in January, as some programs are offering fewer dates.

Does your specialty recommend that all letters of recommendation be written by members of your specialty?

The most important letter is the chair of medicine letter. There are specialty-wide guidelines for how to write these, as they are looked at carefully. Northwestern faculty were involved in creating these guidelines. It is best to have the chair of medicine letter and two other internal medicine letters. A single, strong non-medicine letter speaks to good performance across disciplines. You should not have more than one letter from outside of internal medicine unless it is from a research adviser. If you plan to have more than one, run this by your adviser or Dr. Neely.

If letters can come from other disciplines, do you have a recommendation as to which disciplines are more highly valued?

All are okay. Pick the person who will write the strongest letter.

Does the academic rank of the letter writer matter?

This matters less than in other specialties. The chair letter is automatically the most senior person in the department and is usually consigned by the clerkship director. Pick three other people who know you the best. Strong letters from people with experience supervising and grading students are the best.

Does your specialty require a letter from the chairman?

The vast majority of programs require this. It would be very unusual for a Feinberg student to apply without a department letter, and it might be very hard to match without it. Feinberg students from all levels of the class have matched well in internal medicine. Use your adviser and Dr. Neely to map out a strategy. We want everyone to be successful in the match and have a lot of experience doing this. We are excited about every student applying and will do our best to help you. It's a great field and an excellent career choice.

Internal Medicine Specialty Session - Winter / Residency Application Information

During the winter of the M3 year, students should attend specialty sessions sponsored by the Department of Internal Medicine for the opportunity to learn more about the specialty as well as to meet attendings and residents in the field.

Internal Medicine Resources

Request an Internal Medicine Advisor

Contact our Internal Medicine Team:

Stefanie Reiff, MD
M3 Clerkship Director

Michelle Fletcher, MD
M4 Sub-I Director

For More Information

Department of Medicine
Feinberg School of Medicine
Northwestern University
201 E. Huron, Suite Galter 3-150
Chicago, IL 60611

Website
Advising website (email your netID to bridget.murdoch@northwestern.edu for access)