Baylor University and Baylor Alumni Association Announce New Era of Partnership. DALLAS, Texas (Feb. 22, 2016. Internal Audit. Internal Medicine Residency Program. Internal Medicine residents at Baylor University Medical Center at Dallas are entirely selected through the National. The history of internal medicine at Baylor University Medical Center, part 1. DEVELOPMENT OF INTERNAL MEDICINE IN THE USAInternal medicine in the USA had its roots in the Association of American Physicians (AAP) (1, 2), which was founded in 1. East Coast (1, 3). An overview of the Internal Medicine Residency program at Baylor College of Medicine. The Internal Medicine. 2016 Baylor College of Medicine® One Baylor. Residency Navigator / Internal Medicine. Baylor University Medical Center. Internal Medicine Residency Program · Dallas, TX ·. Already on Doximity? Physician & Location Finder. Baylor Outpatient Therapy and Sports Medicine Clinic at. Baylor Health Care System and Baylor University Medical Center at Dallas. . this means that the “internal” in internal medicine does. of internal medicine at Baylor. program in internal medicine at Baylor. Baylor College of Medicine. The school was formed in Dallas. The School currently offers a Diploma in Tropical Medicine program as well as several non. The Internal Medicine Residency program at Baylor University Medical Center at Dallas accepts 16 to 17 residents each year. Nine categorical Internal Medicine. These founding members had taken foreign postgraduate study, had interests in clinical research as well as private practice, were skilled in pathology, and were part- time teachers in medical schools (2). The AAP was designed to be a scholarly society in which members could report and discuss experiences and new concepts, but medical ethics and medical politics were excluded (4). At its first meeting, Reginald Fitz gave the first description of appendicitis, and many other major discoveries were first presented at AAP meetings. A sister organization, the American Society for Clinical Investigation (ASCI), was formed in 1. Dr. Samuel Meltzer (5). Its purpose was to develop and promote clinical research. The yearly joint meetings in May of the AAP and ASCI in Atlantic City were, for many years, the highlight of academic medicine in the USA and, indeed, in the world. Osler and the development of internal medicine. Dr. William Osler (Figure 1) was president of the AAP in 1. His remarks are significant because this was the first recorded time that the term “internal medicine” was used in the USA and because he specified his views on the training necessary to practice this specialty that he envisioned: Dr. William Osler in 1. Montreal, Quebec, Canada. Image II- 6. 25. 56 (detail), Mc. Cord Museum of Canadian History, Montreal. The time has come when able young men should be encouraged to devote themselves to internal medicine as a specialty. Content to labor and wait during the first 1. The opportunity for such a career is in every city with a hospital of 5. He elaborated on these concepts in a subsequent essay (6). A reading of Osler strongly suggests that he considered internal medicine to be composed of consultants to general physicians. Osler was thus proposing that practitioners of internal medicine would spend 1. Of course, much time should also be spent with patients in outpatient dispensaries and on the wards. Osler considered hospitals to be the college in which medicine could be learned, primarily by practical experience rather than by lectures (6). To a student, he said, “Let the old man read new books; you read the journals and the old books” and, “beware the Delilah of the press, sooner or later she is sure to play the harlot, and has left many a man shorn of his strength, viz., the confidence of his professional brethren.” By his prescription, there would be little or no time for love or marriage during the first 1. The meaning of “internal medicine”Osler apparently borrowed the term “internal medicine” from the Germans, who began to use it in the 1. The innere in the German innere Medizin is said to have been used to correct the misconception that these special physicians were dealing only with clinical matters, and more specifically was to denote a basis in experimental science (7). If true, this means that the “internal” in internal medicine does not refer to the interior of the body, as usually thought, but rather refers to a physician who gets to the inside of a clinical problem by using knowledge that comes from experimental science. In other words, internal medicine means getting to the underlying basis of the signs and symptoms of an illness, using the experimental method rather than dogma. Although this proposed origin of “internal medicine” is appealing, the name is less clear than those of other specialties, and in some ways, it is unsatisfactory. It often requires an explanation, which is awkward. Even today, it is defined more in negative terms (no pediatrics, no obstetrics, no surgery) than in positive terms. There is confusion between “intern” (from the French interne) and “internist.” Many have tried to find a better name, without success. Diagnostician (dia, through; gnosis, knowledge), physician (physikos, natural), clinician (klinikos, pertaining to a bed), and consultant are other terms that have been suggested or used for physicians in this specialty, but they did not take hold. Considering the evolution of the practice of internal medicine over the past 1. A name that clearly emphasizes strong ties to medical science and to scholarship would be better, but no such name has been invented. Despite its uninspiring and confusing name, internal medicine in the USA became powerful in medical schools because of its focus on science, clinical research, and teaching. The identification of internal medicine with the AAP and the ASCI gave the field a lasting academic tone (2). The laboratory and scientific aspects of early internal medicine made the field much more than just a group of doctors who did not do surgery, obstetrics, or pediatrics, and it gave internal medicine a hospital base, such as surgery had. The American College of Physicians. Internal medicine also became powerful as a practice specialty primarily because of the organizational success of the American College of Physicians (ACP) (2), which was formed in 1. It was patterned after the Royal College of Physicians of London, which was founded in 1. King Henry VIII. The Royal College's chief purpose, in 1. The purpose of the ACP is to recognize the skills of internists and to advance the field of internal medicine. In 1. 92. 0, the ACP established a journal called the Annals of Medicine, which later changed its name to the Annals of Clinical Medicine. In 1. 92. 7, the journal was renamed the Annals of Internal Medicine and today is the most prestigious medical journal devoted specifically to internal medicine. Board certification. The ACP, in conjunction with the American Medical Association, formed the American Board of Internal Medicine (ABIM) in 1. The purpose of the board was to establish more definite criteria for the title of specialist in internal medicine, so that the public would know whom to trust. To be certified by the board, an applicant needed to pass rigorous written and oral examinations. Because a sound knowledge of physiology, biochemistry, pathology, and other basic sciences was considered essential for the practice of internal medicine, a portion of the written examination covered these topics in detail. It was decided that no internist would be eligible for fellowship in the college unless he or she had been certified by the examining board. The aim of the college in making this rule was to elevate standards until ACP fellowship had the same connotation as fellowship in the Royal College of Physicians. Several points are noteworthy about the development of the ABIM. First, the ACP asked the AAP for cooperation in the formation of the board, but the AAP decided that the proposed board was outside the scope of its activity (9). By this decision, academic medicine declined to participate in the certification of internists, perhaps because of its prohibition of medical politics. Second, the board decided that foreign postgraduate training was not a prerequisite for eligibility to take the board examination. Apparently, it felt training in the USA was now on a par with training in Germany, England, and France. Third, the board did not specify where training in the USA should be done prior to taking the board examination. This made it possible for nonuniversity hospitals to offer such training. Finally, as shown in Table 1, the ABIM was somewhat of a latecomer to the world of board certification. Medical specialty boards established by 1. In 1. 94. 0, the ABIM decided to certify candidates as subspecialists in 4 fields—cardiology, gastroenterology, tuberculosis, and allergy—but only if those candidates were first board certified in general internal medicine. Dermatology and neurology had formed their own boards several years before the ABIM was formed, so dermatologists and neurologists could not be compelled to obtain prior certification in internal medicine. Thus, the ABIM was formed in time to include all but 2 medical subspecialties under the umbrella of internal medicine. By contrast, even though the American Board of Surgery was formed only 1 year later than the ABIM, most surgical subspecialties already had their own boards. Therefore, surgery (or general surgery) did not gain control over its subspecialties. Table 2 provides an additional comparison of the boards of internal medicine and surgery (1. In contrast to surgery, the ABIM had no desire that every practitioner of internal medicine should be board certified and was designed to recognize only a few outstanding internists—a special breed, an outstanding consultant. Therefore, the examination tested not acceptable standards of practice but whether the candidate had “superb knowledge of the practice of medicine.”Comparisons of the boards of internal medicine and surgery*By the time World War II started, the armed services had an easy way to define specialists, i. A boardcertified internist became an army captain rather than a first lieutenant (1. While young army doctors might have intended to be general practitioners before the war, afterward many of them quite naturally sought specialty training and certification, often in internal medicine (1. The trend toward subspecialization. Scientific developments (such as radar, penicillin, and the atom bomb) had made a decisive impact on the outcome of World War II, and it was clear that science would play a similar role in future wars. This mind- set led to the development of the National Science Foundation and the National Institutes of Health (NIH). Through its extramural programs, the NIH poured enormous amounts of money into the internal medicine departments of medical schools (because that's where the best clinical scientists were) (1. The NIH also organized itself into categories based on specific organs and diseases, and this stimulated the trend toward subspecialization.
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