Between the 1960s and the early 1990s, the evolution of subspecialty divisions in academic departments of internal medicine was characterized by an impressive blend of research, clinical and technological development, and educational growth. The subspecialties that developed highly specific bases of cognitive information, plus technically sophisticated procedural capabilities, became better defined and began to drift away from the parent specialty1–5. The glue that held departments of medicine together in the past was a unified definition of their academic mission. Now we face, for the first time, the loss of this sense of identity. This loss is not a.
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