Medical Education in Internal Medicine The postgraduate training in the specialty
Roberto M. Cataldi Amatriain - Ramón Pujol Farriols - Pierre Bou Khalil
Oficios
INTRODUCTION
Prof. RobertoM. Cataldi Amatriain
?The profile of the specialist in Internal Medicine
shall never be finished and shall never be perfect?.
There are many opinions either about the profile of the internist or his training, and
not all of them have a solid base. The evolution of Internal Medicine through time
took place at different speeds and with different characteristics, according to the
times. Profile and training were different in the Ancient Times, the Middle Age, the
Modern Age, and even in our days. The speed of the change increased and became
vertiginous in the twentieth century and at the present time. Nowadays doctors have
to make great efforts to be updated with the bulky existing information, procedures,
and other aspects inherent to the specialty. It is likely that in the next decades the
circumstances will force to implement deeper changes suitable to the level of
knowledge and the requirements of the society at that time. It is very important to
pay close attention to the evolution of the professional profile through the years,
since you cannot innovate in an intelligent way if you do not thoroughly know the
past of the profession.
In Medicine, like in any other discipline, it is necessary to differentiate what is
essential from what is accessory. Some authors have tried to explicitly state a new
model suitable to the passing of time favoring the digital culture and management, to
the detriment of a solid base training in the specialty, indispensable for a correct
practice. Others pretend to modify the professional profile giving preference to
research and the handling of statistics, blurring in turn the daily task of the practical
doctor. Both positions would seem to ignore that within Medicine there are
specialists in management, in computing, in (basic and clinical) research, in
statistics. Anyway, everyday there are more specialties and ultra-specialties as
consequence of these new forms of knowledge. The challenge relies in elucidating
how much of each one of these disciplines must be included into the training of the
internist in order to change his profile with common sense and conforming to the
new reality.