When the Board of Internal Medicine was originally established, the primary emphasis was on General Internal Medicine as a specialty. The rules were simple. Following his internship the trainee completed three years of training in a qualified residency, one year of which could be spent in a subspecialty. These three years of residency training, plus two years of practice (total of five years) qualified the internist for his examination. After he completed his certification in General Internal Medicine he could go on to take his subspecialty board examinations if he had taken two years of approved training in that subspecialty, one of which may also have been used for his general internal medicine qualifications.
About four years ago, after following this training pattern for many years, a group of internists who were board members recommended that (1) all systems specialties establish certifying examinations, and (2) the specialty of General Internal