How to Become an Internist: Training, Salary, and Career Guide

Internal medicine is one of the broadest and most essential fields in modern healthcare. Internists, or physicians specializing in internal medicine, focus on the prevention, diagnosis, and non-surgical treatment of adult diseases that often involve multiple organ systems. From managing chronic conditions like diabetes and hypertension to solving puzzling diagnostic cases, internists play a central role in long-term patient care.

If you’re considering a career as an internist, this guide will walk you through the educational path, skills needed, job outlook, and reasons why internal medicine could be the right specialty for you.

Looking for a Premed, Medical or PA internship abroad? Inquire here.

What Does an Internist Do?

Internists are often described as “doctor’s doctors” because of their ability to see the bigger picture in complex health cases. Their responsibilities include:

• Diagnosing and managing diseases affecting the heart, lungs, kidneys, digestive system, and other internal organs.
• Providing preventive care and promoting wellness throughout adulthood.
• Coordinating with specialists when patients face overlapping or complicated health concerns.
• Building long-term relationships with patients, often caring for them for decades.

Beyond general internal medicine, many internists choose to subspecialize in fields like cardiology, endocrinology, gastroenterology, or oncology.

Why Choose Internal Medicine?

• Problem-solving: 

Internists are known for tackling challenging and unusual cases involving multiple organ systems.

• Patient relationships: 

Many internists care for the same patients throughout adulthood, building trust over time.

• Variety: 

On any given day, an internist might treat asthma, manage diabetes, and evaluate a rare infectious disease.

• Flexibility: 

Internists can work in hospitals, clinics, private practice, rehabilitation centers, or academic settings.

• High demand: 

Internal medicine is consistently one of the most in-demand specialties worldwide.

Step-by-Step Path to Becoming an Internist

Step 1: Earn a Bachelor’s Degree

Most future physicians complete a 4-year undergraduate degree. While your major does not need to be in the sciences, you must complete pre-med prerequisites in biology, chemistry, physics, and math. Maintaining a strong GPA and gaining extracurricular healthcare experience are critical. Shadowing doctors or joining pre-med internships abroad can also strengthen your application.

Step 2: Take the MCAT

The Medical College Admission Test (MCAT) assesses your critical thinking and knowledge of scientific principles. High scores improve your chances of admission to medical school.

Step 3: Complete Medical School

Medical school takes four years. The first half focuses on foundational science courses, while the latter half includes clinical rotations across specialties. During this time, you’ll also take the United States Medical Licensing Examination (USMLE) Step 1 and Step 2.

Step 4: Residency in Internal Medicine

After earning your MD or DO, you’ll enter a 3-year internal medicine residency. Here, you’ll refine your diagnostic skills, manage a wide range of adult illnesses, and prepare for independent practice.

Step 5: Optional Subspecialty Fellowship

Many internists choose to pursue fellowships in areas such as cardiology, oncology, infectious diseases, or endocrinology. These take an additional 1–3 years depending on the specialty.

Step 6: Licensure and Board Certification

To practice, you’ll need to secure state licensure and pass the American Board of Internal Medicine (ABIM) certification exam.

How Long Does It Take to Become an Internist?

The full process generally takes about 11 years after high school:

• 4 years — Bachelor’s degree
• 4 years — Medical school
• 3 years — Residency
• +1–3 years — Fellowship (if subspecializing

Skills Needed to Succeed in Internal Medicine

• Strong problem-solving and analytical abilities
• Compassion and empathy for long-term patient relationships
• Excellent communication for explaining complex health issues
• A broad medical knowledge base across organ systems

Internist Salary and Career Outlook

According to the U.S. Bureau of Labor Statistics, internists earn an average annual salary of about $225,000. Salaries vary depending on state, institution type, and subspecialty. Demand for internists remains high, with internal medicine consistently ranking as one of the most sought-after specialties by healthcare employers.

Gaining Early Experience in Internal Medicine

Before you commit to medical school, it’s important to gain firsthand exposure to patient care. Programs like Go Elective’s medical internships in Kenya and Tanzania allow students to shadow internists and other specialists in busy hospitals. You’ll see a wide range of conditions, from chronic illnesses to acute emergencies, while learning how physicians in resource-limited settings approach diagnosis and treatment.

This kind of clinical exposure not only strengthens your medical school application but also gives you clarity on whether internal medicine aligns with your interests and skills.

Final Thoughts

A career in internal medicine offers variety, intellectual challenge, and the chance to build lasting relationships with patients. While the journey is long, the rewards are significant for those passionate about adult medicine and problem-solving across complex cases.

If you’re considering this path, start early with shadowing and clinical internships abroad to prepare yourself for medical school and beyond. With the right dedication, you could be the internist patients trust to guide them through every stage of adulthood.

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Author: Go-Elective Abroad

Date Published: Sep 12, 2025