Internal medicine
The internal medicine concerned with the prevention, diagnosis, conservative and interventional treatment as well as rehabilitation and aftercare of health disorders and diseases of the respiratory system ( Pneumology ), the heart and circulation (Cardiology), the digestive organs ( Gastroenterology and Hepatology ), kidneys ( nephrology ), of the blood and blood-forming organs (hematology ), the vascular system ( Angiology ), metabolism and internal secretion ( Endocrinology and Diabetes ), the immune system ( immunology ), the supporting and connective tissue ( Rheumatology ) and infectious diseases ( infectious Diseases and tropical Medicine ), poisoning ( Clinical Toxicology ), solid tumors and hematologic malignancies (oncology ), the monitoring and treatment of seriously ill patients ( intensive Care ) and the influence of exercise and sports on the healthy and ill people ( Internistische sports medicine).
The training regulations and the supplementary qualifications in internal medicine are different in different countries.
Most important methods of investigation of internal medicine
- Case history
- Physical examination
- Electrocardiogram ( ECG)
- Langzeit-EKG/Event-Recorder
- Long-term blood pressure measurement
- Sonography ( ultrasound scans ) B-mode
- Doppler sonography
- Echocardiography
- Transesophageal echocardiography ( TEE)
- Endosonography
- Contrast-
- Esophagogastroduodenoscopy ( EGD, gastroscopy )
- Sigmoidoscope, sigmoidoscopy, Ileocoloskopie ( colonoscopy )
- Endoscopic retrograde cholangiopancreatography ( ERCP)
- Balloon enteroscopy (thin colonoscopy )
- Capsule endoscopy ( colonoscopy thin )
Current Development Trends
As a result of the rapid increase of knowledge in their territories is part of the internal medicine of increasing sub-specialization. The fact that the classical, well -trained general internist is displaced more and more by the representatives of individual subareas in many industrialized nations, met with criticism. So on the 110th German Medical Assembly reintroduction of postgraduate training in Internal Medicine was decided without focus designation in 2007. For several years, the general medicine is used as part of internal medicine teaching (5 years training).
In addition to the progressive independence of the organ-related disciplines, the following trends are evident:
- In Germany, established a cash technically induced splitting into a specialist and a general practitioner's domain, which is accompanied by severe restrictions of the competence area family physicians active internists.
- The methods of internal medicine are becoming invasive at least in the specialized areas, so you can compare the complication rates with minor surgical procedures. This is particularly true in the field of cardiology and gastroenterology.
- In some areas, the internal medicine overlaps among others with radiology, neurology and laboratory medicine. Since smaller hospitals do not always have their own specialist of these areas, these tasks are performed by internists.
Specialist title Internist
When a doctor is called an internist who has completed specialist training in the field of Internal Medicine and completed a certification examination.
Germany
The official name in Germany is a specialist in internal medicine ( or optionally "intern "). In order to be able to carry that title, a physician must complete at an accredited institution of higher education with a set by the state medical boards further education regulations, a training of at least 60 months ( 5 years). In addition, there is the option to choose where to focus. The training time is then at least 72 months ( 6 years). At the end of the training we have an oral examination in both cases. The further education regulations may vary according to district chamber, since the sovereignty education in Germany is subject to the respective area-based medical associations.
According to the current CPE regulations exist for the internal medicine specialist following designations:
- Consultant / Specialist in internal medicine - including the primary care internists
- Consultant / Specialist in internal medicine and angiology: angiologist
- Consultant / Specialist in Internal Medicine and Endocrinology and Diabetology: endocrinologist / diabetologist
- Consultant / Specialist in Internal Medicine and Gastroenterology: Gastroenterologist
- Consultant / Specialist in internal medicine and hematology and oncology: Hematologist / Oncologist
- Consultant / Specialist in Internal Medicine and Cardiology: Cardiologist
- Consultant / Specialist in Internal Medicine and Nephrology: Nephrologist
- Consultant / Specialist in Internal Medicine and Pulmonology: Pulmonary Specialist
- Consultant / Specialist in internal medicine and rheumatology: Rheumatologist
Besides choosing a center of gravity, it is possible to acquire several additional qualifications in Germany. These include, for example, Infectious Diseases and Emergency Medicine.