Specialty (medicine)

A specialty (or speciality) in medicine is a branch of medical practice. After completing medical school, physicians orsurgeons usually further their medical education in a specific specialty of medicine by completing a multiple year residencyto become a medical specialist.^[1]

§History of medical specialization[edit]

To a certain extent, medical practitioners have always been specialized. According to Galen, specialization was common among Roman physicians. The particular system of modern medical specialities evolved gradually during the 19th century. Informal social recognition of medical specialization evolved before the formal legal system. The particular subdivision of the practice of medicine into various specialities varies from country to country, and is somewhat arbitrary.^[2]

§Classification of medical specialization[edit]

Medical specialties can be classified along several axes. These are:

• Surgical or internal medicine
• Age range of patients
• Diagnostic or therapeutic
• Organ-based or technique-based

Throughout history, the most important has been the division into surgical and internal medicine specialties. The surgical specialties are the specialties in which an important part of diagnosis and treatment is achieved through major surgical techniques. The internal medicine specialties are the specialties in which the main diagnosis and treatment is never major surgery. In some countries Anesthesiology is classified as a surgical discipline, since it is vital in the surgical process, though anesthesiologists never perform major surgery themselves.

Many specialties are organ-based. Many symptoms and diseases come from a particular organ. Others are based mainly around a set of techniques, such as radiology, which was originally based around X-rays.

The age range of patients seen by any given specialist can be quite variable. Paediatricians handle most complaints and diseases in children that do not require surgery, and there are several subspecialties (formally or informally) in paediatrics that mimic the organ-based specialties in adults. Paediatric surgery may or may not be a separate specialty that handles some kinds of surgical complaints in children.

A further subdivision is the diagnostic versus therapeutic specialties. While the diagnostic process is of great importance in all specialties, some specialists perform mainly or only diagnostic examinations, such as pathology, clinical neurophysiology, and radiology. This line is becoming somewhat blurred with interventional radiology, an evolving field that uses image expertise to perform minimally invasive procedures.

§Specialties that are common world-wide[edit]

Specialty	Can be subspecialty of	Diagnostic (D) or therapeutic (T) specialty	Surgical (S) or internal medicine specialty (I)	Age range of patients	Organ-based (O) or technique-based (T)
Allergy and Immunology	Paediatrics or Internal medicine	Both	I	All	O
Adolescent Medicine	Paediatrics	Both	I	Paediatrics	T
Anaesthesiology	None	T	I or S	All	T
Pathology	None	D	Neither	All	T
Cardiology	Internal medicine	T	I	Adults	O
Paediatric cardiology	Paediatrics	T	I	Paediatric	O
Cardiothoracic surgery	General surgery	T	S	Adults	O
Child and adolescent psychiatry and psychotherapy	None	T	I	Paediatric	O
Clinical neurophysiology	Neurology	D	I	All	Both
Dermato-Venereology	None	T	I	All	O
Emergency Medicine	Anaesthetics	Both	I	All	Both
Endocrinology	Internal medicine	T	I	Adults	O
Gastroenterology	Internal medicine	T	I	Adults	O
General Practice	None	Both	Neither	All ages	Multidisciplinary
Geriatrics	Internal medicine or Family Medicine	T	I	Geriatric	Multidisciplinary
Obstetrics and Gynaecology	None	T	S	All	O
Health Informatics	None	Both	Neither	All	Multidisciplinary
Hospice and Palliative Medicine	Various	Both	Neither	All	Neither
Infectious diseases	Pediatrics or Internal medicine	Both	I	Variable	Neither
Internal Medicine	None	T	I	Adults	Neither
Interventional Radiology	Radiology	Both	Both	All	Multidisciplinary
Vascular medicine	Internal medicine	T	I	Adults	O
Microbiology	None	D	I	All	T
Nephrology	Internal medicine	T	I	Adults	O
Neurology	Internal medicine	T	I	Adults	O
Neurosurgery	Surgery	T	S	All	O
Nuclear medicine	None	Both	I	All	T
Occupational medicine	None	T	I	Working age	Multidisciplinary
Ophthalmology	None	T	S	All	O
Orthopaedics	General surgery	T	S	All	O
Oral and Maxillofacial Surgery	Several	T	S	All	O
Otorhinolaryngology	None	T	S	All	O
Paediatrics	None	T	I	Paediatric	Neither
Paediatric allergology	Paediatrics	T	I	Paediatric	O
Paediatric endocrinology and diabetes	Paediatrics	T	I	Paediatric	O
Paediatric gastroenterology, hepatology and nutrition	Paediatrics	T	I	Paediatric	O
Paediatric haematology and oncology	Paediatrics	T	I	Paediatric	O
Paediatric infectious diseases	Paediatrics	T	I	Paediatric	O
Neonatology	Paediatrics	T	I	Neonatal	Neither
Paediatric Nephrology	Paediatrics	T	I	Paediatric	O
Paediatric respiratory medicine	Paediatrics	T	I	Paediatric	O
Paediatric rheumatology	Paediatrics	T	I	Paediatric	O
Paediatric surgery	General Surgery	T	S	Paediatric	O
Physical and Rehabilitation Medicine	None	T	I	Adults	Multidisciplinary
Plastic, Reconstructive and Aesthetic Surgery	General surgery	T	S	All	O
Podiatric Medicine	Surgery	T	S	All	O
Pulmonology	Internal medicine	T	I	Adults	O
Psychiatry	Internal medicine	T	I	Adults	T
Public Health	None	Neither	Neither	All	T
Radiology	None	Both	I	All	T
Sports Medicine	Family Medicine	Both	Neither	All	Multidisciplinary
Neuroradiology	Radiology	Both	I	All	Both
Radiotherapy	(unknown)	T	Unknown	Unknown	T
General surgery	None	T	S	Variable	T
Urology	General surgery	T	S	All	O
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