Training programmes in internal medicine: Germany.

Despite differences from one country to another, training programmes for an internal medicine specialist have several common denominators, starting with real hospital responsibilities, a feature which is a fundamental necessity. These responsibilities are guaranteed by institutions which are called, depending on the country, "internat des h6pitaux, assistanat, or clinicat." This training must be full time, supervised by a specialist in internal medicine, and last for at least five years. Active participation in the teaching, group discussions, and frequent clinical or clinicopathological conferences will help the student to acquire deeper and wider views on the whole of internal medicine and its techniques. Other important features of this training include studying a particular subject in depth, and clinical research. Not only will this broaden his views on other aspects of human and general biology, but it will inculcate the human qualities required for team work, so essential to all aspects of the practice of medicine. The educational influences of internal medicine have a particularly important place in general-practitioner training. Together with the paediatrician the specialist in internal medicine should take an active part in keeping him up to date with the new investigatory and therapeutic techniques. Also the specialist must ensure that the general practitioner does not become isolated and that he is given open access to the teaching centres.