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La grande majorit\u00e9 des programmes de m\u00e9decine interne g\u00e9n\u00e9rale au Canada sont devenus des entit\u00e9s distinctes offrant une formation qui d\u00e9passe le cadre de la formation dans la sp\u00e9cialit\u00e9 de la m\u00e9decine interne tant sur le plan des comp\u00e9tences que du leadership. En d\u00e9cembre 2010, le Coll\u00e8ge royal des m\u00e9decins et chirurgiens du Canada est venu couronner des ann\u00e9es d\u2019efforts en d\u00e9cr\u00e9tant que la m\u00e9decine interne g\u00e9n\u00e9rale \u00e9tait bel et bien une sursp\u00e9cialit\u00e9 \u00e0 part enti\u00e8re. Le Coll\u00e8ge royal a approuv\u00e9 les objectifs et les exigences de la formation et les normes pr\u00e9cises d\u2019agr\u00e9ment de ce \u00ab nouveau \u00bb programme de deux ans en m\u00e9decine interne g\u00e9n\u00e9rale.<\/p>\n
En 2013, les facult\u00e9s de m\u00e9decine pourront pr\u00e9senter la demande d\u2019agr\u00e9ment de leur programme de formation en m\u00e9decine interne g\u00e9n\u00e9rale au Coll\u00e8ge royal. Nous pr\u00e9voyons que 80 % des universit\u00e9s canadiennes offriront un programme agr\u00e9\u00e9 de formation de deux ans dans la sursp\u00e9cialit\u00e9 de la m\u00e9decine interne g\u00e9n\u00e9rale aux r\u00e9sidents de 4e ann\u00e9e en juillet 2014. Ces programmes formeront des m\u00e9decins chefs de file, aptes \u00e0 relever les grands d\u00e9fis de l\u2019avenir dans le secteur de la sant\u00e9, notamment le vieillissement de la population, les multiples maladies concomitantes et la n\u00e9cessit\u00e9 d\u2019innover. Le passage ci-dessous, tir\u00e9 de l\u2019\u00e9nonc\u00e9 des objectifs de la formation en m\u00e9decine interne g\u00e9n\u00e9rale qui para\u00eet sur le site Web<\/a> du Coll\u00e8ge royal des m\u00e9decins et chirurgiens du Canada, r\u00e9sume ce mandat.<\/p>\n La m\u00e9decine interne g\u00e9n\u00e9rale est une sursp\u00e9cialit\u00e9 de la m\u00e9decine interne qui int\u00e8gre les valeurs du g\u00e9n\u00e9ralisme, est sensible aux besoins de la population et pr\u00e9conise l\u2019adaptation du mode de pratique du m\u00e9decin lorsque les besoins de la population changent. Les internistes g\u00e9n\u00e9ralistes sont pr\u00e9par\u00e9s \u00e0 diagnostiquer et \u00e0 prendre en charge les probl\u00e8mes de sant\u00e9 courants ou \u00e9mergents qui rel\u00e8vent de la m\u00e9decine interne, que le probl\u00e8me se pr\u00e9sente seul ou en compagnie d\u2019autres troubles de sant\u00e9 et lorsque l\u2019acc\u00e8s aux autres sursp\u00e9cialit\u00e9s est limit\u00e9. Les internistes g\u00e9n\u00e9ralistes prodiguent des soins complets \u00e0 des patients adultes dans une perspective globale par opposition \u00e0 la d\u00e9marche diagnostique et th\u00e9rapeutique ax\u00e9e sur un organe ou une maladie. Ils sont en mesure de maintenir la stabilit\u00e9 des patients pr\u00e9sentant des troubles multiples \u00e0 long terme ou durant une p\u00e9riode de stress physiologique, telles la grossesse ou la p\u00e9riode p\u00e9riop\u00e9ratoire. Les internistes g\u00e9n\u00e9ralistes se portent \u00e0 la d\u00e9fense de leurs patients et de tous les patients au sein des syst\u00e8mes complexes de prestation de soins de sant\u00e9, dans l\u2019optique d\u2019optimiser les soins plut\u00f4t que de les maximiser et de pr\u00e9venir d\u2019autres maladies. Ils savent que l\u2019exercice de la m\u00e9decine est intimement li\u00e9 \u00e0 l\u2019art et \u00e0 la science de la prestation de soins de sant\u00e9 et que, en raison de leur r\u00f4le central, ils occupent une place distinctive dans l\u2019am\u00e9lioration de la qualit\u00e9 des services de sant\u00e9, la promotion de la s\u00e9curit\u00e9 des patients et l\u2019innovation dans les syst\u00e8mes de sant\u00e9.<\/em><\/p>\n The vast majority of General Internal Medicine (GIM) programs in Canada have become distinct entities that provide training in additional competencies and leadership above and beyond those required for the specialty of Internal Medicine. In December 2010, after many years of effort, General Internal Medicine finally achieved recognition as a distinct subspecialty by the Royal College of Physicians and Surgeons of Canada. All documentation (objectives of training, specialty training requirements, specific standards of accreditation) for the \u201cnew\u201d two year training program in GIM has now been approved by the Royal College.<\/p>\n Starting in 2013, programs are applying to the Royal College to become accredited GIM subspecialty training programs. Currently it is anticipated that 80 % of Canadian Universities will have an accredited two-year GIM subspecialty training program for the entry class of PGY4\u2019s in July 2014. GIM subspecialty programs are poised to train physician-leaders who will address the health care challenges of the future, including an aging population, patients with multiple comorbidities and simultaneous health care issues, and the need for health care innovation. This mandate is summarized in the following excerpt from the Objectives of Training in General Internal Medicine (Royal College of Physicians and Surgeons of Canada website<\/a>).<\/p>\n General Internal Medicine is a subspecialty of Internal Medicine which embraces the values of generalism, is aligned with population needs, and promotes the practitioner\u2019s ability to adapt their practice profile when population needs change. General Internists are prepared to diagnose and manage patients with common and emergency internal medicine conditions, and are able to do so when the individual has multiple conditions and with limited access to other subspecialists. General Internists provide comprehensive care of the adult patient in an integrated fashion as opposed to an organ-centred or disease-centred approach. They are prepared to maintain stability of patients with multisystem disorders over the long-term or during physiological stresses such as during pregnancy or the peri-operative period. General Internists advocate for their individual patients as well as for all patients within complex healthcare delivery systems, by aiming to optimize and not maximize care, including prevention of other conditions. General Internists recognize that the practice of medicine is tightly linked to the art and science of health care delivery and, by virtue of their pivotal role are uniquely placed to engage in quality improvement, patient safety, and healthcare systems initiatives.<\/p>\n Les programmes peuvent \u00eatre trouv\u00e9s au site Wed de CARMS<\/a> et\/ou du Coll\u00e8ge Royal.<\/a> Le point sur la formation dans la sursp\u00e9cialit\u00e9 de la m\u00e9decine interne g\u00e9n\u00e9rale La grande majorit\u00e9 des programmes de m\u00e9decine interne g\u00e9n\u00e9rale au Canada sont devenus des entit\u00e9s distinctes offrant une formation qui d\u00e9passe le cadre de la formation dans la sp\u00e9cialit\u00e9 de la m\u00e9decine interne tant sur le plan des comp\u00e9tences que du leadership. 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