An Internal Medicine Doctor Explains Internal Medicine

Added: 2026-05-31

[00:00:00]Mr. Doctor Siken, what is your medical specialty? All right, take notes. I'm explaining internal medicine. So, internal medicine deals with the clinical diagnosis and medical care of adults across the entire spectrum of health, ranging from the office to the intensive care unit. I practice a non-surgical specialty that specializes in the diagnostic workup, medical treatment, and coordination of care.

[00:00:24]Internal medicine deals with knowing a little about a lot and utilizing my diagnostic acumen in order to determine what a patient's problem is. And if I can't treat the patient medically, I need to know who to get on board to fix it. No patient gets scoped, cut open, or irradiated unless I'm able to complete my investigation and refer the patient to a gastroenterologist, surgeon, radiation oncologist, et cetera. In the United States, internal medicine is a 3-year residency that follows 4 years of undergraduate, 4 years of med school, and can be optionally followed up with 1 to 3 years of fellowship in the various subspecialties dedicated to adult medical care. These include cardiology, allergy, endocrinology, sports medicine, sleep medicine, and whatnot. Internists who elect to practice general internal medicine straight out of residency will usually work in a clinic as a primary care physician or in the hospital as a hospitalist. I'm the latter, but also I'm special and I'm doing an administration fellowship and halfway done with my MBA and gunning for a C-suite position as a physician executive. And as a hospitalist, I practice acute care medicine as part of a hospital system on the general medical wards. I take care of sick patients who are too ill to be seen in the office, but not sick enough to deserve intensive care in an ICU, trauma unit, or burn unit. When I admit a patient under my name, I become their primary physician for that hospitalization, and it's my job to figure out why they landed in the hospital and how I can get them better.

[00:01:50]My name goes on the top of their chart and I accept full medical legal responsibility for everything that happens to them under my roof. I handle everything from admission to discharge.

[00:01:59]And a significant amount of time is also spent on discharge planning and follow-up, where working with my case managers also helps me get a deeper insight into the American healthcare system and how I can help my patients the best. I like the responsibility of being the quarterback for my patients and directly making the decisions that lead to them getting better. I also prefer working in a hospital setting because I know I'll have quick turnaround time on labs and imaging, nurses caring for my patients 24/7, and some specialty support on call. I'm responsible for some basic procedures in hospitalized patients like arterial lines, central lines, intubations, LPs, etc. But, the hospitalist model seems to be moving away from that in favor of dedicated APP procedural teams. In the US, a regular hospitalist job is usually working 7:00 a.m. to 7:00 p.m. for 7 days in a row followed by 7 days off.

[00:02:46]This is considered a full-time equivalent, and average yearly compensation is about 275 to 325k depending on your area. You can of course go higher working in a smaller, more rural hospital, or go lower working for a bigger academic center in a big city. Formally, we only get a week or so of vacation a year, but since you're really only working 26 weeks of the year, you don't actually need to take extra time off to go travel, spend time with family, set up a side gig, or do this Vtubing thing. Hello. Hello everybody. What what is up? Depending on how busy understaffed your hospital or a sister hospital is, you can also take shifts on your off days doing something called moonlighting. This is a great way to make some extra cash in residency, and now as an attending, it's very nice to have the option to clear a couple thousand in a weekend. There are also hospitalists who only work night shifts from 7:00 p.m. to 7:00 a.m. called nocturnists. Some people prefer this lifestyle because it's less about dealing with social or hospital issues and more focused on the medicine, or because they're total night owls.

[00:03:49]Obviously, they You a pretty nice pay bump for that, too. One of my friends who graduated with me last year signed on for 450k a year as a nocturnist, but also she's in West Virginia in the middle of nowhere and she's like a 4'11 Hijabi. Anyway, get get that bag girl.

[00:04:04]We've got loans to pay off. All right, TLDR, how is it different from pediatrics? I don't see patients under 18 years old. Family medicine? I have significantly less outpatient clinic based training with a much more inpatient hospital based focus. I also don't have adequate training or exposure in pediatrics, OB/GYN, or psychiatry that family medicine doctors would see regularly in their offices as PCPs. I deal with a lot more acute conditions that can kill you in 6 days than chronic conditions that can kill you if you don't follow up with every 6 months.

[00:04:35]Emergency medicine? I deal with acute conditions that can kill you in 6 days and they deal with acute conditions that can kill you in 6 minutes. Also, there is much more of a focus on ruling out diseases, doing immediate procedures, and stabilizing the patient rather than actually diagnosing, managing, or coordinating their health care. House?

[00:04:53]Well, I don't break into people's houses.

[00:04:56]I'm sure it looked easier on YouTube.

[00:04:57]>> Also, I don't want to bang my chief of medicine.