The evolution of Medicine in the past several decades can be characterized by a recurring confrontation between the ideals of excellence and relevance. While excellence is often measured in a technologic sense, the people’s need can be the only yardstick for relevance. In effect, what physicians consider excellent may be outright irrelevant, while what the community considers relevant, may not require excellence at all. This conflict has confronted us in our daily activities, and has typified our struggles as a profession.

Internal Medicine has also grappled with the paradox of excellence and relevance for many years. A good example of how these ideals compete is the establishment of various subspecialties of Internal Medicine. This trend began in the seventies and since that time, our mother specialty has struggled to survive beside its very own offspring – unable to compete with the glamor and glitter of subspecialization. Until now, General IM only serves as a stepping-stone for aspiring students whose sights are already set on further training. While it is true that the number of internists has risen dramatically, the proportion who practice and teach General IM has dwindled. This imbalance has adversely affected not only the efficiency of healthcare in the country, but all over the world as well. It has already led to deterioration in the quality of training in Internal Medicine.

In a way, the excellence achieved through subspecialization poses a great challenge to the goal of relevance. The deeper we go into subspecialization – the less capable we became of providing wholistic care. Before this phenomenon of en masse subspecialization, internists were involved in personal relationships with their patients – probing not just their overall health, but also their social predicaments, their strife and their joys. That era is rapidly vanishing, as patients often become little more than an aggregate of malfunctioning organs going through an assembly line of specialty care.

A call to resuscitate General IM in the country first came out in the 1996 Annual Convention of the Philippine College of Physicians, with the theme “General IM: Back to the Future”. Little has happened since then, despite repeated proclamations. Finally, in May 3, 2011, 172 concerned internists finally decided to do something about the problem. In a meeting attended by 3 past presidents of the Philippine College of Physicians, a manifesto was signed calling for the formation of a new medical society – one that would advocate careers in General Internal Medicine, establish career paths for general internists, and develop innovations in the teaching and practice of General Internal Medicine. That dream is now a reality. On November 11, 2011, Internal Medicine was reborn in this country with the formal incorporation of the Philippine Society of General Internal Medicine (PSGIM).