Transforming Internal Medicine Training for Hospital and Community Care in the 2020s
Keywords:
internal medicine, hospitalist, residency curricula, ambulatory care, care transitions, competency-based training, multimorbidity, inpatient careAbstract
Internal medicine faces increasing complexity due to aging populations, multimorbidity, and expanding care transitions between hospital and community settings. This article reviews contemporary internal medicine residency curricula and the evolving interface between hospitalists and outpatient internists, highlighting implications for training and service design. Structured inpatient and ambulatory curricula now emphasize intensive exposure to general wards, critical care, geriatrics, oncology, and longitudinal continuity clinics, supported by formal teaching in communication, evidence-based medicine, and quality improvement. The rapid expansion of hospital medicine has created distinct roles: hospitalists focus on high-acuity, short-term inpatient management and care transitions, whereas clinic-based internists provide long-term, comprehensive care across settings. Aligning postgraduate training with these practice patterns requires clearer competency frameworks, explicit transition-of-care skills, and longitudinal ambulatory experience. This narrative review outlines current models and proposes practical directions for optimizing internal medicine education to support safe, efficient, and patient‑centered care across the continuum.
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