Médecine Interne

Department of Medicine


Mission of the Department of Medicine

Internal medicine is a specialty that is focused, as the name indicates, on the inside of the body and on the organs.

The overarching discipline has led to the creation, over the past three decades, of multiple sub-fields, in cardiology, rheumatology, nephrology, endocrinology, gastroenterology, pulmonology, infectious diseases, immunology, oncology, angiology, hematology, bone diseases and dermatology.

These sub-fields have become specialties in their own right over a number of years and have obtained the same status as internal medicine itself, which, in order to affirm its identity, is often seen as falling under the umbrella of “general” medicine.

Therefore, does this mean that internal medicine is the sum of cardiology, rheumatology, nephrology, etc.?

If this were the case, there would no longer be any internists, since no sensible physician would be able to claim such vast and in-depth knowledge across all these fields.

Consequently, general internal medicine covers most non-surgical organic diseases in adults... until the problem becomes too acute, too severe or too complicated for it to be treated by the general internist alone.

Does this mean that the general internist only plays an initial diagnostic role?

No, certainly not, since in addition to this crucial triage role, the general internist is still responsible for combining the opinions of the specialists in the context of the overall patient’s problems.

Indeed, as the patient becomes older, he/she presents with more and more simultaneous diseases (”comorbidities”) and for example an anticoagulant prescribed by the cardiologist could do more harm than good to a patient with a history of digestive problems, and similarly for an antihypertensive prescribed by a nephrologist to a patient with critical arterial insufficiency of the lower extremities or severe carotid artery stenosis

Besides this “combining” role, the internist is also, most often, responsible for locating an acute problem over the long-term.

The approach of the general internist is, therefore, not only a holistic one, but also a longitudinal one.

The role of the specialist internist is more oriented towards acute problems and technical issues, and such a specialist would not be able to master his/her own field of expertise and also that of his/her internist colleagues, both general internists and specialist internists specializing in other fields.

The specialist provides the latest knowledge of his/her area of specialty to help the patient, and at university centers, he/she is capable of developing sophisticated research programs, both clinically and/or laboratory oriented, which will make it possible to combine this knowledge via practical translational medicine.

This helps to create cutting-edge university centers where it is possible to recruit and treat patients who come from far away, attracted by university hospital centers that have been created for these purposes.

The internal medicine specialist not only responds to the generalist and to the internist, but also to other surgical or organ specialties.

He/she sees patients hospitalized in all the hospital divisions, and also in outpatient consultations where patients are referred by his/her colleagues.

He/she can follow up patients, using new techniques or treatments, over the long-term, when they require regular follow-up (for example, dialysis, regular transfusions, new and complex oncology treatments, rheumatology, infectious diseases, etc.).

Therefore, the specialist has multiple tasks, since he/she must develop cutting-edge research programs, obtain funding, teach new students and train new specialists, while treating his/her own patients.

The combination of these two approaches should lead, to the patient’s benefit, to collaborative care, during which generalist internists and specialist internists will debate and argue in a partnership of equals, in the context of an increasingly evidence-based approach to medicine.

Generalists often reproach specialists for not looking at the big picture.

Specialists think that generalists, because they are focused on the big picture, neglect specific disease issues.

These days however, the two have understood that there is no wrong perspective and that looking alternatively at the big picture and at the small detail makes it possible to take into account different and complementary perspectives!

From this symbiosis, a better future for internal medicine and its specialties is born.

The great strength of a university hospital is being able to bring together, at a single site, either in an outpatient setting or at the patient’s bedside, all of the expertise of the specialists, in order to provide the most sophisticated care, as well as research into the conditions of our patients.

Pre Laurence Genton Graf

Dre Laurence Genton Graf

Staff Physician


Physician in nutrition at the Geneva University Hospital, Switzerland. Specialist FMH in internal medicine. Consultations of nutrition for in- and outpatients. President elect of the Swiss Society for Clinical Nutrition since 2014.

Languages : French, English, German

Prof Claude Pichard

Prof Claude Pichard

Head, Nutrition unit


Professor of Nutrition at the Geneva University Hospital, Switzerland. Specialist in Internal medicine and Gastroenterology. Consultations of nutrition for hospitalized and out-patients.


The Beau-Séjour Division of Rehabilitation and  Internal Medicine (SMIR Beau-Séjour) has been recognized by the FMH as being Level A for training in general internal medicine.

Pre-graduate Education

Senior and university physicians at the Beau-Séjour SMIR are heavily involved in pre-graduate education and specifically in the following courses:

Division of internal medicine for the elderly - Trois-Chêne


Mission of the Trois-Chêne Rehabilitation and Internal Medicine

  • The SMIR-Trois-Chêne Division of Rehabilitation and Internal Medicine conducts clinical, education and research activities in the Department of Rehabilitation and Geriatrics. The Head of Division and two high level senior physicians in the division are Internal Medicine Specialists.
  • The SMI-R provides care for elderly patients who require acute care in rehabilitation and general internal medicine that most often involves complex comorbidities.
  • The SMI-R has a Continuing Care Unit (CCU) to closely monitor and provide treatments adapted to patients in the most acute situations. The SMI-R works very closely with the Bone Diseases Division within a care unit to provide post-fracture rehabilitation in the area of geriatric orthopedics.
  • In general, the rehabilitation framework at Trois-Chêne, which includes physiotherapy and occupational therapy, is available to patients in need in order to provide quality in a recovery and a return to independence.

General Internal Medicine


Mission of the General Internal Medicine Division

  • Provide care - in terms of diagnosis and therapy - for adult patients with a problem or disorder related to internal medicine, this is in collaboration with other divisions of the HUG, specifically the services of the department of medicine;
  • Provide care - a shared responsibility with senior physicians in relevant specialties - for patients with a problem or disorders requiring specialized care. The work is performed either by using the division's hospital beds or in the day hospital (UITB).



Clinical research activities of the Beau-Séjour Division of Rehabilitation and Internal Medicine (SMIR Beau-Séjour) are focused on optimizing the admissions and care processes.

It builds on a research group at the Geneva Faculty of Medicine. Research collaborations with other Swiss and foreign groups are part of their normal activities.