General Internal Medicine Subspecialty Training
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 “new” two year training program in GIM has now been approved by the Royal College.
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).
General Internal Medicine is a subspecialty of Internal Medicine which embraces the values of generalism, is aligned with population needs, and promotes the practitioner’s 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.