{"schemaVersion":"1.0","exportedAt":"2026-05-15T12:39:54.246Z","occupation":{"soc":"29-1216.00","title":"General Internal Medicine Physicians","group":"Healthcare Practitioners & Technical","sector":"62","jobZone":5,"jobZoneInferred":false},"framework":{"version":"v.26.05","description":"","contextCovered":"This framework covers the full practice continuum of General Internal Medicine Physicians — from supervised early clinical encounters in ambulatory and inpatient settings through autonomous expert practice and organizational leadership in academic medical centers and health systems.","levels":{"emerging":{"label":"Emerging","statements":["Patient medical records, laboratory reports, and test results — review and organize under attending physician supervision to support initial diagnostic workup in an inpatient or outpatient setting.","Common acute conditions such as infections, influenza, and pneumonia — recognize presenting signs and symptoms and formulate a preliminary differential diagnosis under direct clinical supervision.","Prescribed medications and standard treatment protocols — administer and document under supervision, following established formulary guidelines in a hospital or clinic environment.","Patient histories and physical examination findings — collect and record systematically using electronic health record software during supervised clinical encounters.","Routine health problems in adult patients — assist in managing under attending oversight, applying evidence-based protocols for conditions such as hypertension and uncomplicated diabetes.","Diagnostic procedures and test results — explain to patients in clear, accessible language under supervision, ensuring informed understanding prior to and following clinical investigations.","Preventive health guidance on diet, physical activity, and hygiene — deliver to individual patients following established clinical guidelines during supervised office visits.","Medical literature and clinical guidelines — read and synthesize to support differential diagnosis and treatment planning under the direction of a supervising internist.","Electronic medical record and scheduling software — navigate and utilize to document patient encounters, order tests, and coordinate care within a structured clinical workflow.","Interprofessional care team communications — participate in under supervision, conveying patient status and treatment updates accurately during rounds or case conferences."]},"developing":{"label":"Developing","statements":["Laboratory findings, imaging reports, and clinical examination data — analyze independently to formulate and refine diagnoses for adult patients presenting with common internal medicine conditions in an ambulatory or hospital setting.","Chronic diseases including hypertension, type 2 diabetes, and heart disease — manage longitudinally with reduced oversight, adjusting treatment plans based on patient response and evolving clinical data.","Medication regimens and non-pharmacologic therapies — prescribe and titrate for patients across the adult age spectrum, applying current evidence-based guidelines in an outpatient practice.","Comorbid conditions occurring simultaneously in adult and elderly patients — evaluate and coordinate treatment for, recognizing interactions between diagnoses in a complex clinical panel.","Diagnostic reasoning in cases with overlapping or atypical presentations — apply inductive and deductive reasoning to reach working diagnoses with moderate case complexity and routine follow-up.","Patient education sessions on disease management, prevention, and lifestyle modification — conduct independently, tailoring communication style to individual health literacy levels.","Serious and chronic illnesses such as chronic obstructive pulmonary disease and chronic kidney disease — provide ongoing, comprehensive management including monitoring for disease progression in an office or inpatient context.","Care plans for long-term patients — document and update in electronic health record systems, ensuring continuity and accuracy across multiple visits and care settings.","Community health guidance on disease prevention and screening — deliver during patient encounters and health education events, applying public health principles to individual and population-level needs.","Referral decisions and specialist coordination — initiate and manage for patients requiring subspecialty input, communicating clinical reasoning clearly in written referral documentation."]},"proficient":{"label":"Proficient","statements":["Complex, multi-system diagnostic workups involving ambiguous or overlapping presentations — conduct autonomously, integrating clinical history, physical findings, and advanced diagnostics to reach accurate diagnoses across the full scope of internal medicine.","Rare and obscure internal disorders including atypical endocrine, autoimmune, and neurological conditions — identify and treat independently, applying deep biomedical knowledge and category flexibility in challenging inpatient or outpatient scenarios.","Comprehensive long-term medical care for high-complexity adult patients with multiple chronic conditions — provide and oversee autonomously, coordinating pharmacologic and non-pharmacologic treatment plans across organ systems.","Critical clinical judgment in high-stakes, time-sensitive situations — exercise to prioritize differential diagnoses and initiate management for acutely decompensating patients in emergency or hospital settings.","Patient-centered treatment plans integrating psychological, social, and physiological factors — design and implement, drawing on therapy, counseling, and behavioral science knowledge to optimize adherence and outcomes.","Systems-level analysis of patient outcomes and care quality metrics — perform using clinical data and health informatics tools, identifying gaps in care delivery and recommending practice improvements.","Interprofessional care coordination for patients with serious, chronic, and complex illnesses — lead across nursing, pharmacy, social work, and subspecialty teams, ensuring integrated and coherent care planning.","Advanced pharmacotherapeutic decisions involving polypharmacy, drug interactions, and individualized dosing — make for elderly and medically complex patients, balancing efficacy and safety in a comprehensive practice setting.","Clinical documentation and medical writing for complex cases — produce at a high standard, including detailed consultations, discharge summaries, and evidence-based treatment rationales in electronic health record platforms.","Preventive medicine strategies for high-risk adult populations — design and implement at the individual patient level, integrating risk stratification, screening protocols, and targeted lifestyle interventions."]},"advanced":{"label":"Advanced","statements":["Clinical practice standards and internal medicine care pathways — develop and implement at an organizational level, translating evidence-based research into institutional protocols that improve patient outcomes across a health system.","Residency and fellowship training programs — design, oversee, and continuously improve, mentoring emerging physicians in diagnostic reasoning, patient management, and professional competency development.","Diagnostic and therapeutic strategy for the most complex and refractory internal medicine cases — set and guide, serving as the definitive clinical authority in multidisciplinary case conferences and institutional tumor or complex care boards.","Quality improvement and patient safety initiatives — lead across department or system scale, using systems evaluation and outcomes data to drive measurable reductions in diagnostic error and preventable complications.","Institutional policies on chronic disease management, medication stewardship, and care coordination — author and champion, aligning internal medicine practice with national guidelines and regulatory standards.","Community and public health programs targeting disease prevention and health equity — design and lead, translating clinical expertise into population-level interventions addressing high-prevalence conditions such as diabetes and cardiovascular disease.","Research agendas and clinical scholarship in general internal medicine — direct, fostering a culture of inquiry and evidence generation within academic medical centers or large health systems.","Interprofessional and interdepartmental collaboration at executive level — facilitate, aligning internal medicine, subspecialties, and administrative leadership to achieve integrated, patient-centered organizational goals.","Clinical performance and professional development of attending physicians — evaluate and guide through formal review processes, structured feedback, and individualized development planning in a hospital or academic practice setting.","Strategic resource allocation and care delivery innovation — advise senior healthcare leadership on, leveraging expertise in systems analysis, health informatics, and complex problem solving to shape the organization's long-term clinical direction."]}}},"sources":{"onet":"v30.2 (CC BY 4.0)","crosswalk":"https://skillscrosswalk.com","generator":"LER.me"},"attribution":"© EBSCOed"}