Discover your future in Internal Medicine

The General Internist Career Path

Internal Medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness.

More About Internal Medicine Careers

The Subspecialist Career Path

Subspecialists in internal medicine have chosen to receive additional, more in-depth training and board certification in the diagnosis and management of diseases of a specific type or diseases affecting a single organ system.

More About Subspecialty Careers

The Hospitalist Career Path

Hospitalists are providers who dedicate most of their career to the care of hospitalized patients. They focus on clinical management, with an added eye to quality, safety, and utilization.

More About Hospitalist Careers

My Kind of Medicine:
Real Stories of ACP Internists

Susan L. Turney, MD, MS, FACMPE, FACP

Dr. Susan L. Turney

CEO, Marshfield Clinic Health System

Farzanna S. Haffizulla, MD, FACP

Dr. Farzanna S. Haffizulla

Internist in Private Practice

Saad Z. Usmani

Dr. Saad Z. Usmani

Director of Clinical Research

Joshua M. Liao, MD

Dr. Joshua M. Liao

Internal Medicine Resident

Dr. Valerie J. Lang

Dr. Valerie J. Lang

Associate Professor of Medicine

Dr. David Fleming

Dr. David Fleming

ACP President with Dr. Robert Centor, ACP Chair, Board of Regents

Dr. Kent J. DeZee

Dr. Kent DeZee

Program Director, General Medicine Fellowship

Dr. Erik Wallace

Dr. Erik Wallace

Associate Dean

Dr. Suchitra Behl

Dr. Suchitra Behl

Consultant for FORTIS C-DOC

Take Action
Join us on the Hill

  1. Join the Advocates for Internal Medicine Network and make a difference on Capitol Hill.
  2. Login to the Legislative Action Center and be heard by policy makers.
  3. Follow The Advocacy Blog and get the latest news and opinions on health care reform.
Challenge your mind…

HEADLINES from ACP:

MORE NEWS
MKSAP 5 - Question of the Week

A 27-year-old woman with an 8-year history of ulcerative colitis is evaluated during a follow-up examination. The initial colonoscopy after diagnosis showed pancolitis. She has been treated with mesalamine since diagnosis and has had episodes of bloody diarrhea two or three times a year but has otherwise been well. Her most recent colonoscopy 1 year ago when she had increased diarrhea and bleeding showed no progression of disease. Since then, she has been clinically stable. The patient's medical history is otherwise unremarkable, and her only medications are low-dose mesalamine and a multivitamin. There is no family history of colorectal cancer.

On physical examination, vital signs are normal. There is mild abdominal tenderness in the right lower quadrant without rebound or guarding. The rest of the physical examination is normal.

Laboratory studies reveal a normal complete blood count, including leukocyte differential, and a normal serum C-reactive protein level.

The most appropriate management for this patient is annual colonoscopy beginning now. This patient has pancolitis of 8 years' duration. The inflammation involves the ileum and proximal colon. The colon cancer risk in patients with ulcerative colitis or Crohn disease reaches a significant level (estimate annual cancer risk of 1% to 2% per year) after 8 years of inflammation. The cancer risk is slightly delayed for patients with inflammation limited to the distal colon. The recommendation is to initiate a surveillance program with colonoscopy 8 years after onset of disease, with follow-up colonoscopy every 1 to 2 years thereafter. Random biopsies are performed in four-quadrant fashion throughout the entire colon. Colectomy is recommended for patients with dysplastic findings on biopsy.

In wireless capsule endoscopy, a patient swallows a video capsule that by intestinal motility passes through the stomach and into the small intestine. The video capsule transmits images to a recording device worn by the patient. The images are downloaded onto a computer where they can be reviewed. With capsule endoscopy, the small bowel can be visualized in its entirety. There is no recommendation for standard screening for small-bowel carcinoma in the setting of ulcerative colitis or Crohn disease, and therefore, capsule endoscopy is not indicated. Furthermore, capsule endoscopy has no ability to biopsy the bowel wall and assess for dysplasia. Flexible sigmoidoscopy would not reach the at-risk colonic mucosa in the proximal colon beyond the reach of the sigmoidoscope, and annual fecal occult blood testing is insensitive to the diagnosis of colonic dysplasia, the earliest precursor of colon cancer.

Key Point

  • Patients with inflammatory bowel disease should initiate screening for colorectal cancer after 8 years' disease duration.
Q.Which of the following is the most appropriate management for this patient?
Abstract Competition

Abstract Competition

The College sponsors local and national abstract competitions especially for student members that offer monetary awards and the chance to win recognition.

Doctor's Dilemma

Doctor's Dilemma™

ACP's national medical jeopardy competition, held each year at ACP’s annual meeting, allows dozens of teams of residents and medical students from around the nation to compete for the coveted title of national champion.

Member Benefits

Discover the benefits of ACP membership that are waiting for you.

Shop ACP Online

MKSAP for Students 5 Digital

MKSAP for Students 5 Digital

List: $69.95
Student Member: $59.95

Internal Medicine Essentials

Internal Medicine Essentials for Students

List: $54.95
Student Member: $44.95

MKSAP for Students 5 Book

MKSAP for Students 5 Book

List: $54.95
Student Member: $44.95

On Being a Doctor 3

On Being a Doctor 3

List: $29.95
Member: $24.95

Ethics Manual, Sixth Edition

Ethics Manual, Sixth Edition

List: $12.95
Member: $10.95

Breaking the Cycle

Breaking the Cycle

List: $29.95
Member: $24.95