[The practice of internal medicine at the dawn of the 21st century].

Since it's birth as specialty, back more than a century ago, internal medicine profile has been sui generis, sometimes hard to understand to the Mexican medicine professional, on the contrary to our American colleague. The transformation of the professional role of this specialty to meet the needs that civil society demands is so imperative, that we can no longer avoid our responsibility without facing the risk of vanishing. An analysis of the changes occurring in the USA, and the side effects in our environment was made. We propose a model for the specialty performance that keeping it's traditional role as a second level specialty, spread it's influence to the primary care, instead of the actual trend toward the third level subspecialties.