Walk into any major teaching hospital in India and look at the signage. You’ll likely find departments of cardiology, neurology, nephrology, gastroenterology, endocrinology and, somewhere among them, a department of general medicine. Now travel outside India and ask for the relevant specialty. In most countries and most of the international medical literature, you will be referred to an internal medicine department. Are these two different specialties? No.
An Indian general medicine physician and an international internal medicine physician belong to essentially the same broad specialty: a discipline primarily concerned with the diagnosis and non-surgical treatment of diseases in adults. So the question is not whether Indian general medicine is different from internal medicine; the question is whether India should continue to use a name that is becoming increasingly ambiguous when a more accurate and internationally understandable name becomes available.
A name that underestimates
The first problem is the word “general”. To the average patient, “general practitioner” may sound like a doctor who treats common illnesses—the doctor someone sees before being referred to a specialist. But this is not what an MD or DNB in general medicine is. An internist (one who practices general medicine or internal medicine) has received intensive, specialized training in diagnosing and treating complex illnesses in adults. The physician is expected to integrate information from multiple organ systems, recognize patterns that may not fit within a single specialty, and manage patients with multiple concurrent medical conditions.
Consider an elderly patient with shortness of breath, anemia, renal dysfunction, diabetes, weight loss, and abnormal liver tests. Which specialist should he be treated by? His condition falls under the subspecialties of hematology, nephrology, endocrinology and gastroenterology/hepatology, which are subspecialties of internal medicine in most other parts of the world. But in India they continue to be called superspecialties.
For our patient with shortness of breath, a specialist trained to look at the whole patient and ask if the abnormalities are related is the right specialist: a consultant in internal medicine. Integrative function is at the core of internal medicine, and the word “general” does not adequately capture it.
General medicine also creates confusion with family medicine. India recognizes family medicine as a distinct medical specialty. Family medicine and internal medicine are not the same thing. Family medicine deals with comprehensive and ongoing health care across the lifespan—from children to older adults—and for a wide range of health problems. Internal medicine, in contrast, is essentially a specialized discipline of health care for adults.
There is also a common misconception about the word “internal.” This does not simply mean “treating organs within the body.” The modern concept of internal medicine has deep roots in 19th-century European medicine, especially German medicine, when advances in physiology, pathology, and bacteriology transformed clinical practice. Physicians increasingly used scientific knowledge to diagnose and treat diseases that were treated with medication rather than surgery. The term “Internal Medicine” arose from this tradition. Thus, internal medicine describes the method and discipline of medical practice for adults, rather than simply a list of internal organs.
Why “general” medicine?
Why then in India they say “general medicine”? The answer lies partly in history. British medicine has developed a strong tradition of general clinical medicine. Even as specialization expanded, general practitioners retained an important role in British hospitals, and broad clinical knowledge remained highly valued. Britain was an important source of medical terminology inherited by India. Thus, there is a historical explanation for Indian terminology.
Subsequently, this terminology became part of Indian medical law and was strengthened by Indian institutions. The Indian Medical Council Act, 1956 officially recognized Doctor of Medicine (General Medicine) as a postgraduate medical qualification. By the 1990s, the nomenclature became even more standardized. The Medical Council of India Rules, 1993 expressly state that the nomenclature of postgraduate courses shall be uniformly adopted and the degree of MD in General Medicine shall be prescribed. Thus, what may have originated as part of the British medical tradition became ingrained in India’s own normative system.
Why nomenclature matters
The word “general” in an era of narrow specialization is increasingly misleading. When the term “general medicine” took root, medicine was much less specialized than it is today. Today, internal medicine is the mother discipline from which numerous specializations have emerged: cardiology, gastroenterology, nephrology, endocrinology, rheumatology, pulmonology, infectious diseases, hematology, medical oncology and others. The existence of these narrow specialties does not make the therapist a non-specialist: quite the contrary. The therapist’s expertise lies in understanding the patient when the disease does not respect these boundaries. This is a separate specialty.
Indian medicine no longer operates in a language-isolated environment. Indian doctors train abroad; foreign doctors train in India. The qualifications of Indian PhD students are assessed internationally. Medical journals, conferences, guidelines and clinical studies operate across national borders. A doctor who presents himself internationally as a specialist in internal medicine is immediately understood. The title “General Medicine” may require some explanation. This may seem trivial. It’s not. Specialty names communicate to patients, colleagues, hospitals, universities, regulatory bodies, and international institutions the scope of a physician’s knowledge. A clear professional vocabulary matters.
Formalizing the use of an existing term
The proposed change will not introduce an alien concept into Indian medicine. The term “internal medicine” is already widely used in Indian hospitals, medical departments, academic literature and postgraduate training. For example, the Indian Armed Forces Medical College has a department of internal medicine. And in Indian postgraduate education programs, the term “internal medicine” is usually used to describe the discipline taught. Even India’s medical regulatory system is not entirely uniform in terminology. The National Medical Commission’s own records list doctors in general medicine departments whose qualifications are listed as Doctor of Medicine, Internal Medicine. The transition, therefore, will not occur from an unfamiliar term to a new one. This would be a formal recognition of terminology that is already partially in use.
What needs to change? The proposal doesn’t have to be complicated. India could gradually adopt: MD (internal medicine) instead of MD (general medicine); DNB (internal medicine) instead of DNB (general medicine); Department of Internal Medicine instead of Department of General Medicine and Internal Medicine Specialist or Internist instead of the ambiguous description “General Practitioner”. Existing degrees will, of course, remain fully valid. There is no need to change the training, scope of practice or professional status of existing physicians. Only the nomenclature will change. Change of name, not change of specialty. Thus, this proposal is not associated with prestige. It’s about precision. This is not about abandoning India’s medical history; it is about allowing medical terminology to evolve with medical practice.
Looking to the future
Every profession periodically has to wonder whether the language it has inherited accurately describes what it does. Indian medicine has changed a lot since the terminology of postgraduate specialties was first codified. We now practice medicine in an era of molecular diagnostics, precision medicine, artificial intelligence, genomics, transplantation, complex multisystem diseases and unprecedented subspecialization. However, one of our major adult medical specialties still goes by a name that essentially means: general. Perhaps it’s time to be more specific.
(Dr. Abraham Itthiachen M. is Professor of Medicine, MOSC Medical College, Kolenchery and Chairman, Indian Doctors Association, Kerala Chapter. abyliz@rediffmail.com)
Published – September 9, 2026 01:10 pm EST.