The Rebirth of General, ‘Acute’ Medicine: will the baby survive?
During the 1980s and 1990s general medicine was progressively displaced by medical specialties as the major focus of a consultant physician’s career. Fewer and fewer people were appointed as ‘general physicians with a specialist interest’, which had been the norm prior to this. Specialists whose main focus was their ‘ology’ were continuing to be expected to take their share of acute medical “takes”. Training for most medical specialties still encompassed training in General Internal Medicine (GIM). However, this often was truncated in favour of the main specialty and was even resented, by some, as interfering with their “proper” training. None of this was surprising: medical specialties were becoming more complex & many more treatments, interventions and diagnostic tools were becoming available. Simultaneously, working hours were decreasing, and training was taking place within a much more formalised structure.
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