It may be helpful to understand what it means to be an internist and a rheumatologist before you choose a physician to help you with your RA.
An internist is a person who has completed four years of college, four years of medical school, and at least three years of a medical residency. During that residency, the internist studies the diagnosis and medical treatment of a wide variety of diseases affecting the human body, with emphasis on the heart, lungs, digestive track, neurological system (brain and nerves), and endocrine system (which includes the thyroid, pancreas, and pituitary glands). During the residency, the physician's performance is assessed by the residency training director through oral and written examinations and direct observation of the resident during his or her patient care activities.
After completing the residency, the physician is invited by the American Board of Internal Medicine to take an examination that will demonstrate his or her understanding of the skills and knowledge required to practice internal medicine. This board certification exam is a grueling two-day experience. The successful completion of this examination entitles the physician to be called “board certified” or “a diplomate of the American Board of Internal Medicine.”
The American Board of Internal Medicine created this certification process to assure the public that a physician is competent to provide a high quality of patient care. Certification requirements include the following:
- Completion of a course of study leading to the M.D. or D.O. (Doctor of Osteopathy) degree from a recognized school of medicine or school of osteopathy
- Completion of a minimum of three years of required training in an accredited internal medicine residency program
- Documentation of the individual's successful performance during the residence program
- An unrestricted license to practice medicine
- Passing the American Board of Internal Medicine's certification examination
A board-certified internist is capable of rendering excellent care to patients with RA.
The rheumatologist's role is primarily to diagnose and treat individuals with arthritis and musculoskeletal diseases. These diseases include the many forms of arthritis, diffuse connective tissue diseases, autoimmune and immunologic disorders, metabolic bone diseases, and diffuse or localized musculoskeletal pain problems. These diseases are often complex, involve multiple organ systems, and are difficult to diagnose. Their treatments can be complicated and may entail specific requirements for monitoring therapy to assure its effectiveness and avoid unwanted side effects.
Side effects
A term associated with medical treatments; problems that occur when a treatment has consequences that go beyond the desired effect, or when the patient develops problems that occur in addition to the desired therapeutic effect.
An internist can become a rheumatologist by undertaking a rheumatology fellowship—an extra two to three years of medical training that focuses on the immune system and diseases of the muscles, bones, and joints. The rheumatologist spends years of in-depth study learning about arthritis and related diseases. After successfully completing the fellowship, the rheumatologist is invited to sit for a full-day examination by the American Board of Internal Medicine in rheumatological diseases. If the physician passes the test, he or she is referred to as being a “board-certified rheumatologist” or “diplomate of the American Board of Internal Medicine, Rheumatology.” As a general rule, the rheumatologist will have more training and experience in the area of RA than an internist will.
Rheumatology
The branch of medicine devoted to the study and treatment of connective tissue diseases.