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-the document explains the powers that all European internist must reach, regardless of the place and healthcare organization that works

-publication will help to develop programmes of training, assessment and personal development of specialists

-La SEMI has a working group dedicated to complex chronic patients he has done research and measures to mitigate the effect of the economic crisishardship and the pandemic of chronic diseases to not delay the necessary care reorganization and that the health care system is sustainable

Pamplona, September of 2011- the European Federation of internal medicine (European Federation of Internal Medicine [EFIM]) and the section of internal medicine of the European Union of medical specialists (UEMS) have tried in recent times define the core competencies that all internist European should purchase, regardless of the operation of every national health system.

However, is an expensive task because the function of the internist is heterogeneous in European countries and internal medicine is a specialty of very broad content, the most extensive of all, since it is all the ailments and medical pathologies. Hence the importance of the map of core competencies that the Spanish society of internal medicine (SEMI) presents now and that concentrates, in a single document, required competencies to all internist in Spain and that will help to develop programmes for training, evaluation and continuous personal development. The Coordinator of the work is Dr. José Manuel Porcel service medicine internal of the Hospital Universitario Arnau of Vilanova from Lleida.

The end of this publication, as pointed out by the DRA. Pilar Román, first Vice-President of the SEMI, “ is to define the knowledge, skills and abilities that all internal medicine specialist must possess, irrespective of the place where work and age and type of training that count, tackling excellently the needs of patients and society in the 21st century ”.

The internal medicine crisis

The current economic crisis affects all sectors of society and very especially to the health system, due to the increase in the number of patients with chronic diseases. “ The advancement of medicine and the best living conditions have led many people to reach the elderly with illnesses or chronic conditions that account for over 60% of expenditure on health, situation that will continue to grow in the coming years, in such a way can be unworkable the survival of the system in a short time ”, according to the Vice President of the SEMI.

“ Western health systems are very well prepared for acute diseases, but not to provide adequate care to patients with several chronic diseases, which are currently handled in way reactive due to the existing multitude of specialists, with the consequent lack of coordination in diagnostic tests and treatments and the existence of an unnecessary expense ”says the expert. Why a new organizational model, in which teams of primary care physicians, internists and nurses will be fundamental, without forgetting the necessary support from other specialties or disciplines such as social work, pharmacists or public health etc. considers urgent “ everyone must be prepared for the new powers that will be necessary in order to adopt a proactive approach to prevent diseases and the decompensation while we help patients to be knowledgeable, responsible for his State of health and its care auto ”, concludes the DRA. Román

thus, the SEMI has a working group dedicated to complex chronic patients, who has made research relevant for its treatment and he is carrying out multiple actions to mitigate the effect of the economic crisis and chronic diseases so that the health care system is sustainable and contribute actively to change organizational.

In the same vein, a large number of service of all Spain chiefs gathered in Pamplona on 23 and 24 September at the eleventh meeting of Heads of service to discuss both issues, seeking the commitment of leaders of the internal medicine services Spanish. “ Are aware that our specialty is best suited to efficiently accommodate the large number of patients with multiple complex chronic diseases ”, said the expert.

An unequal in European health systems specialty

The objective of the plan of skills is not to enumerate the long list of diseases you need to know the internist in the different areas in which exercises (district hospitals, third level or reference, hospitalization at home, emergency etc.), but “ the number of nuclear powers due to the degree of knowledge or training for each may be different depending on the area where development assistance activity ”, as pointed out by the DRA. Román.

For this reason, the publication is divided into 6 parts: clinical care of the patient, clinical knowledge, technical skills and interpretation, communication, professional responsibility and academic activities – teaching and research skills.

Without prejudice to the deep specialization that many internists have acquired in third level hospitals in pathologies of diagnosis or treatment specific (systemic autoimmune diseases, rare diseases, infections such as HIV, etc.), which the paper picks up are “ a series of knowledge and skills that are the essence of the specialty, the added value with respect to other specialties must provide patients ”, according to the expert of the SEMI.

The differences in internal medicine services are notorious; “ in some countries, for example, the internists have an important role in the lash level ”, drew the DRA. Román. Furthermore, its relevance is uneven in various European health systems, being far more influential as specialty independent countries of the South, between those who Spain occupies a privileged place (the SEMI has an important role in the European Federation of Internal Medicine and, therefore, their positions significantly influencing measures at European level). “ In United States are also collecting various initiatives with the same objective ”, concludes the DRA. Román.