By Subhasree Nag
Internal medicine is an umbrella division with a general focus on diagnosing, treating, and preventing a broad spectrum of diseases in patients (adults).
Undergoing clinical rotations in the internal medicine department will commonly involve taking patient history thoroughly and physical examination of multiple organ systems, all by employing innovative diagnostic tools.
This article will provide you with a deeper insight into why Caribbean medical school rotations include internal medicine as part of the course curriculum.
Internal medicine makes room for better decision-making and clinical reasoning based on evidence.
This is crucial for providing a complete assessment of the level of relationship between the patient and physician.
Internal medicine residency training program can take a minimum of 3 years to complete.
Once you have completed the clinical rotations period at a Caribbean medical school, you will gain the eligibility to earn national board certification.
How can you actually use this?
When being a resident here in the Caribbean, you will be trained in a wide variety of subspecialty medical areas ꟷ cardiology, pulmonology and critical care, gastroenterology, rheumatology, hematology, oncology, nephrology, infectious diseases.
So, on completion of the clinical rotation program, you can continue practicing in any of the above-mentioned medical genres, thanks to the immense scope that internal medicine has in store for you!
What will you typically do during clinical rotations focused on internal medicine?
Well, to begin with, your primary goal will be to provide care for your patients.
You will have to acquire a ton of clinical skills, which can range from managing acute illnesses to chronic conditions.
Treating a Broad Range of Internal Medicine Conditions
Internal medicine doctors diagnose, manage, and treat a very wide variety of conditions — from the common and simple to the rare and complex.
They include diseases, infections, injuries, and other conditions affecting the heart, blood, kidneys, joints, and the digestive, respiratory, and vascular systems, such as:
- Allergies, including allergic rhinitis; angioedema (“hives”), and food allergies
- Birth control, including emergency contraception
- Bleeding and clotting disorders, including hemophilia, sickle cell disease, thrombotic thrombocytopenic purpura (TTP), intravascular coagulation, and von Willebrand disease
- Cardiac (heart) issues, including coronary artery disease; angina; pericarditis; heart defects; heart failure; arrhythmias such as atrial fibrillation and tachycardia; complications of heart attack, stroke, and transient ischemic attack (TIA)
- Cognitive concerns, including cognitive impairment and dementia
- Dermatologic (skin) issues, including abscesses; cysts; cellulitis; skin cancer; and acne
- Ear, nose, and throat problems, including sinusitis; pharyngitis (sore throat); rhinitis; strep throat; otitis; and vertigo
- Endocrine conditions, including thyroid disease; electrolyte disorders; Cushing’s syndrome; adrenal insufficiency; and diabetes and related complications, such as ketoacidosis and hyperglycemic state
- Gastrointestinal problems, including infections; bleeding; inflammatory bowel disease; colitis and Crohn’s disease; gastroenteritis; esophageal disease; ingested foreign bodies; food impaction; narrowing (stenosis) and blockages (ischemia); difficulty swallowing (dysphagia); anal fissure; acid peptic disease; diverticulitis and diverticulosis; peptic ulcers; pancreatitis; liver disease; cholecystitis; and cholangitis
- Hypertension (high blood pressure) and related complications, including hypertensive retinopathy and hypertensive encephalopathy
- Infections, including Lyme disease; infections of shunts and other implanted devices; soft-tissue infections; bacterial peritonitis; staphylococcal and streptococcal infections; toxic shock syndrome; non-HIV viral infections; and clostridioides difficile (“c. diff”)
- Kidney conditions, including chronic kidney disease; acute kidney injury; pre-renal disease; kidney stones; tubular necrosis; and hydronephrosis
- Liver disease, including cirrhosis; fatty liver; hepatitis; and hepatic encephalopathy
- Men’s health, including prostate disease and erectile dysfunction
- Metabolic conditions such as metabolic alkalosis; metabolic acidosis; and metabolic mineral and bone disease
- Neurologic conditions, including headaches; migraine; Bell’s palsy; meningitis; encephalitis; epilepsy; neuromuscular disease; and peripheral nerve and muscle diseases, such as neuropathies
- Non-surgical orthopedic issues, including strains, sprains, minor breaks, and other injuries; and joint pain and inflammation
- Pain, including acute pain; chronic pain; pain related to cancer, and other conditions
- Pulmonary (lung and respiratory) issues, including bronchitis and other infections; asthma; pneumonia; trouble breathing; foreign bodies in the airway; chronic obstructive pulmonary disease (COPD); pneumothorax; and pulmonary embolism (blood clot)
- Urinary health, including urinary stones; bladder issues; and urinary tract infections
- Vascular (blood flow) conditions, including venous thrombosis; peripheral vascular disease; and syncope (fainting)
- Women’s health, including well-woman care and care for obstetric and gynecologic (OB/GYN) issues
The best part?
On a daily basis you will engage in conducting:
- Comprehensive physical examination, mainly as observation;
- Detailed history taking;
- Palpationand percussion;
Not to mention, the task of confirming diagnoses, using various tests, such as:
- Laboratory tests
- Echocardiography (ECG)
- Pulmonary function tests
- Ultrasound
- Biopsies
That’s not all…
Internal medicine rotations also expect you to be good with providing physical therapy, as well as managing patients with minor interventional procedures or those undergoing treatments such as medications.
Now, don’t get the wrong idea and start thinking of these as a tiresome procedure.
Look: as a subspecialty-trained resident, you will have the option to explore as many medical departments as you feel like.
Of course, you need to execute extensive procedures with precision, including central venous catheter insertions, coronary angiographies, endoscopies (e.g., bronchoscopy ERCP), and catheter-based protocols.
But don’t let this scare you!
Your professional journey relying on internal medicine is likely to be based on the practice setting.
So, take your time and choose what is best for you!
If you are still unsure about the career path that you should follow right after you have graduated from medical school, then reach out to us for further guidance.
Caribbean medical colleges host world-class mentors in internal medicine, who would be happy to help support you throughout your professional journey.
Sign up for a course now!
