A SPECIALTY (or SPECIALITY) in medicine is a branch of medical practice. After completing medical school , physicians or surgeons usually further their medical education in a specific specialty of medicine by completing a multiple year residency to become a MEDICAL SPECIALIST.
* 1 History of medical specialization
* 2 Classification of medical specialization
* 3 Specialties that are common worldwide
* 4 List of specialties recognized in the European Union and
European Economic Area
* 5 List of North American medical specialties and others
* 7 Specialties by country
* 7.1 Australia and New Zealand
* 7.2 Canada
* 7.3 Germany
* 7.4 India
* 8 Other uses * 9 Training * 10 Satisfaction * 11 See also * 12 Notes * 13 References
HISTORY OF MEDICAL SPECIALIZATION
To a certain extent, medical practitioners have always been
specialized. According to
CLASSIFICATION OF MEDICAL SPECIALIZATION
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 WORLDWIDE
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)
Adolescent medicine Paediatrics Both I Paediatric T
Anaesthesiology None T Unknown All Both
Aerospace medicine None Both Neither All Both
Pathology None D Neither All T
Cardiothoracic surgery General surgery T S Adults O
Clinical neurophysiology Neurology D I All Both
Colon and Rectal
Dermatology-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 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
Internal medicine None T I Adults Neither
Interventional radiology Radiology Both Unknown All Multidisciplinary
Vascular medicine Internal medicine T I Adults O
Microbiology None D I All T
Nephrology Internal medicine T I All O
Neurology Internal medicine T I All O
Neurosurgery Surgery T S All O
Occupational medicine None T I Adults Multidisciplinary
Ophthalmology None T S All O
Orthodontics None T S All O
Orthopaedics General surgery T S All O
Oral and maxillofacial surgery Surgery T S All O
Otorhinolaryngology None T S All O
Paediatrics None T I Paediatric Neither
Paediatric allergology Paediatrics T I Paediatric O
Paediatric cardiology 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 medicine and rehabilitation None T I All Multidisciplinary
Plastic, reconstructive and aesthetic surgery General surgery T S All O
Pulmonology Internal medicine T I Adults O
Radiation Oncology None T Neither All T
Sports medicine Family medicine Both Neither All Multidisciplinary
Neuroradiology Radiology Both I All Both
General surgery None T S Adults T
Urology General surgery T S All O
Vascular surgery General surgery T S All O
LIST OF SPECIALTIES RECOGNIZED IN THE EUROPEAN UNION AND EUROPEAN ECONOMIC AREA
The European Union publishes a list of specialties recognized in the European Union, and by extension, the European Economic Area. Note that there is substantial overlap between some of the specialties and it is likely that for example "Clinical radiology" and "Radiology" refer to a large degree to the same pattern of practice across Europe.
* Accident and emergency medicine
* Biological hematology
LIST OF NORTH AMERICAN MEDICAL SPECIALTIES AND OTHERS
In this table, as in many healthcare arenas, medical specialties are organized into the following groups:
* Surgical specialties focus on manually operative and instrumental techniques to treat disease. * Medical specialties that focus on the diagnosis and non-surgical treatment of disease. * Diagnostic specialties focus more purely on diagnosis of disorders.
SPECIALTY CODE GROUP SUB-SPECIALTIES FOCUS
Allergic reactions, asthma, and the immune system
* Pediatric anesthesia * Pain management * Intensive care * Critical care * Obstetrics and gynaecology * Cardiothoracic anesthesiology * Trauma care * Pre- and Post-Operative Assessment and Care * Generalist (covers all the sub-specialties)
Disease of the cardiovascular system
The operation of heart and major blood vessels of the chest .
Clinical laboratory sciences
* Transfusion medicine is concerned with the transfusion of blood and blood component , including the maintenance of a "blood bank ". * Cellular pathology is concerned with diagnosis using samples from patients taken as tissues and cells using histology and cytology . * Clinical chemistry is concerned with diagnosis by making biochemical analysis of blood, body fluids, and tissues. * Hematology is concerned with diagnosis by looking at changes in the cellular composition of the blood and bone marrow as well as the coagulation system in the blood. * Clinical microbiology is concerned with the in vitro diagnosis of diseases caused by bacteria , viruses , fungi , and parasites . * Clinical immunology is concerned with disorders of the immune system and related body defenses. It also deals with diagnosis of allergy .
Application of diagnostic techniques in medical laboratories such as assays , microscope analysis.
Food and nutrition
Emergency medicine EM Medicine
* Disaster medicine
* Emergency medical services
* Hospice and palliative medicine
* International Emergency
The initial management of emergent medical conditions, often in hospital emergency departments or the field.
The endocrine system (i.e., endocrine glands and hormones ) and its diseases, including diabetes and thyroid diseases.
Family medicine FM Medicine
* Adolescent medicine * Geriatric medicine * Hospice and palliative medicine * Sleep medicine * Sports medicine
Continuing, comprehensive healthcare for the individual and family, integrating the biological, clinical and behavioral sciences to treat patients of all ages, sexes, organ systems, and diseases.
Gastroenterology GI Medicine
The alimentary tract
General surgery GS Surgery
* Colorectal surgery * Gastrointestinal surgery * Transplant surgery * Trauma surgery
Female reproductive health
The liver and biliary tract , usually a part of gastroenterology.
Infectious disease ID Medicine
Diseases caused by biological agents
Intensive care medicine
Neurology N Medicine
* Behavioral neurology * Clinical neurophysiology * Geriatric neurology * Headache medicine * Neuromuscular medicine * Neurodevelopmental disabilities * Neuro-oncology * Neuroradiology * Vascular neurology * Hospice and palliative medicine * Pain medicine * Sleep medicine
Diseases involving the central, peripheral, and autonomic nervous systems
Neurosurgery NS Surgery
Disease of the central nervous system , peripheral nervous system , and spinal column .
Oncology ON Medicine
* Radiation oncology – pertains to the use of radiation therapy (the medical use of ionizing radiation ) as part of cancer treatment to control malignant cells (not to be confused with radiology ).
Ophthalmology OPH Surgery Retina, Cornea Diseases of the visual pathways, including the eyes, brain, etc.
Oral and maxillofacial surgery Maxfacs, OMS Surgery
* Oral and Craniofacial surgery (Head and neck) * Facial cosmetic surgery * Craniomaxillofacial trauma
Disease of the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region.
Orthopedic surgery ORS Surgery Hand surgery , surgical sports medicine , adult reconstruction, spine surgery, foot and ankle, musculoskeletal oncology, orthopedic trauma surgery, pediatric orthopedic surgery Injury and disease of the musculoskeletal system .
Otorhinolaryngology , or ENT ORL, ENT Surgery Head and neck, facial cosmetic surgery, Neurotology , Laryngology Treatment of ear, nose, and throat disorders. The term head and neck surgery defines a closely related specialty that is concerned mainly with the surgical management of cancer of the same anatomical structures.
Palliative care PLM Medicine
A relatively modern branch of clinical medicine that deals with pain and symptom relief and emotional support in patients with terminal illnesses including cancer and heart failure .
Pathology PTH Diagnostic
Understanding disease through examination of molecules , cells , tissues and organs . The term encompasses both the medical specialty that uses tissues and body fluids to obtain clinically useful information and the related scientific study of disease processes.
Pediatrics PD Medicine Children. Like internal medicine, pediatrics has many sub-specialties for specific age ranges, organ systems, disease classes, and sites of care delivery. Most sub-specialties of adult medicine have a pediatric equivalent such as pediatric cardiology , pediatric emergency medicine , pediatric endocrinology , pediatric gastroenterology , pediatric hematology , pediatric oncology , pediatric ophthalmology , and neonatology . deals with the medical care of infants , children , and adolescents (from newborn to age 16-21, depending on the country).
Surgery Treats a wide variety of thoracic and abdominal (and sometimes urologic ) diseases of childhood.
Physical medicine and rehabilitation Or Physiatry PM&R Medicine
Concerned with functional improvement after injury, illness, or congenital disorders .
Plastic surgery PS Surgery
* Cosmetic surgery * Burn * Microsurgery * Hand surgery * Craniofacial surgery
Elective cosmetic surgery as well as reconstructive surgery after traumatic or operative mutilation.
Podiatry POD Surgery
* Forefoot surgery * Midfoot surgery * Rearfoot surgery * Ankle surgery * Soft tissue leg surgery
Elective podiatric surgery of the foot and ankle, lower limb diabetic wound and salvation, peripheral vascular disease limb preservation, lower limb mononeuropathy conditions. Reconstructive foot & ankle surgery .
Proctology PRO Medicine
The bio-psycho-social study of the etiology , diagnosis , treatment and prevention of cognitive , perceptual , emotional and behavioral disorders. Related non-medical fields include psychotherapy and clinical psychology .
The lungs and respiratory system . Pulmonology is generally considered a branch of internal medicine , although it is closely related to intensive care medicine when dealing with patients requiring mechanical ventilation .
* Interventional radiology is concerned with using expert imaging of the human body, usually via CT, ultrasound, fluoroscopy , or MRI to perform a breadth of intravascular procedures (angioplasty, arterial stenting, thrombolysis, uterine fibroid embolization), biopsies and minimally invasive oncologic procedures (radiofrequency and cryoablation of tumors "> in the US, and $272,000 for surgeons. However, because of commodity inflation , increasing negligent costs, steep price rise of rental, the annual salary range of a medical specialist varies and is not rising as fast as other professional pay. Often, especially in the United States, physicians practice in groups of specialists within a particular medical specialty. These practice groups are often formed to help reach economies of scales in rental, insurance and staff costs as well as other benefits of practicing with other professionals and are typically governed by various legal documents.
The table below details the average range of salaries for physicians of selected specialties as of July 2010. Also given in the average number of hours worked per week for full-time physicians (numbers are from 2003).
SPECIALTY MEDIAN SALARY (USD) Average hours
work/week AVERAGE SALARY/HOUR (USD)
Emergency medicine 239,000 to $316,296 46 87
Family medicine 175,000 to $220,196 52.5 58
Internal medicine 184,200 to $231,691 57 58
Neurology 213,000 to $301,327 55.5 93
Ophthalmology 150,000 to $351,000 47
Orthopedic surgery 397,879 to $600,000 58
Otolaryngology 191,000 to $393,000 53.5
Oral and Maxillofacial
Pediatrics 160,111 to $228,750 54 69
Podiatry 170,800 to $315,150 45 80
Urology 331,192 to $443,518 60.5
Neurological surgery 350,000 to $705,000
Plastic surgery 265,000 to $500,000
Gastroenterology 251,026 to $396,450
Pulmonology 165,000 to $365,875
According to a 2010 study, physician and surgeon median annual income was $166,400.
SPECIALTIES BY COUNTRY
AUSTRALIA AND NEW ZEALAND
Specialty training in Australia and New Zealand is overseen by the specialty colleges:
* Australasian College for Emergency
Specialty training in Canada is overseen by the Royal College of Physicians and Surgeons of Canada , the College of Family Physicians of Canada , and by Collège des médecins du Québec .
In Germany these doctors use the term Facharzt.
Specialty training in India is overseen by the Medical Council of
India , which is responsible for recognition of post graduate training
and by the
National Board of Examinations . And education of Ayurveda
in overseen by Central Council of Indian
There are three agencies or organizations in the
CERTIFYING BOARD NATIONAL ORGANIZATION PHYSICIAN TYPE
ABMS AMA MD and DO
AOABOS AOA DO only
ABPS AAPS MD and DO
All boards of certification now require that medical practitioners demonstrate, by examination, continuing mastery of the core knowledge and skills for a chosen specialty. Recertification varies by particular specialty between every seven and every ten years.
SPECIALTY AND PHYSICIAN LOCATION
There are hierarchies of medical specialties in the cities of a region. Small towns and cities have primary care, middle sized cities offer secondary care, and metropolitan cities have tertiary care. Income, size of population, population demographics, distance to the doctor, all influence the numbers and kinds of specialists and physicians located in a city. (Smith, 1977, 1979)
Economic demand influences the location of particular specialties. For example, more orthopedic surgeons are found in ski areas, obstetricians in the suburbs, and boutique specialties such as hypnosis, plastic surgery, psychiatry are more likely to practice in high income areas. Small populations can usually only support primary care. A large population is needed to support specialists who treat rare diseases. Some specialties need to cooperate and thus locate near each other, such as hematology, oncology, and pathology, or cardiology, thoracic surgery and pulmonology.
A population's income level determines whether sufficient physicians can practice in an area and whether public subsidy is needed to maintain the health of the population. Developing countries and poor areas usually have shortages of physicians and specialties, and those in practice usually locate in larger cities. For some underlying theory regarding physician location, see Central Place Theory. (Smith, 1977, 1979)
In the U.S. Army , the term "medical specialist" refers to occupational therapists, physical therapists, dietitians and physician assistants, also known as allied health professionals. Also included in the term "medical specialist", but not in the term "allied health professional" are EMT/combat medics.
A survey of physicians in the
SPECIALTY OVERALL SATISFACTION FEELING OF ENOUGH COMPENSATION WOULD HAVE CHOSEN SAME SPECIALTY AGAIN
Dermatologist 80% 71% 93%
Radiologist 72% 69% 82%
Oncologist 70% 55% 79%
Gastroenterologist 69% 52% 80%
Ophthalmologist 67% 55% 79%
Infectious disease/HIV physician 66% 54% 73%
Plastic surgeon 66% 53% 82%
Anesthesiologist 65% 63% 70%
Orthopedic surgeon 65% 47% 83%
Psychiatrist 65% 58% 67%
Rheumatologist 65% 53% 66%
Podiatrist 64% 51% 75%
Emergency medicine physician 63% 65% 56%
Urologist 63% 47% 78%
Cardiologist 62% 46% 75%
Pediatrician 62% 51% 61%
Diabetes specialist/Endocrinologist 61% 45% 68%
Neurologist 60% 49% 63%
General surgeon 58% 44% 60%
Nephrologist 57% 45% 55%
Obstetrician/Gynecologist 57% 50% 53%
Pulmonologist 57% 45% 52%
Primary care physician 54% 48% 43%
* Interdisciplinary sub-specialties of medicine , including
* Occupational medicine – branch of clinical medicine that provides health advice to organizations and individuals concerning work-related health and safety issues and standards. See occupational safety and health . * Disaster medicine – branch of medicine that provides healthcare services to disaster survivors; guides medically related disaster preparation , disaster planning , disaster response and disaster recovery throughout the disaster life cycle and serves as a liaison between and partner to the medical contingency planner , the emergency management professional, the incident command system , government and policy makers. * Preventive medicine – part of medicine engaged with preventing disease rather than curing it. It can be contrasted not only with curative medicine, but also with public health methods (which work at the level of population health rather than individual health). * Medical genetics – the application of genetics to medicine . Medical genetics is a broad and varied field. It encompasses many different individual fields, including clinical genetics , biochemical genetics , cytogenetics , molecular genetics , the genetics of common diseases (such as neural tube defects ), and genetic counseling .
* Specialty Registrar
Federation of National Specialty Societies of Canada
* Society of General Internal
* ^ Weisz G (Fall 2003). "The Emergence of Medical Specialization
in the Nineteenth Century". Bull Hist Med. 77 (3): 536–574. PMID
14523260 . doi :10.1353/bhm.2003.0150 .
* ^ "Directive 2005/36/EC of the European Parliament and of the
Council of 7 September 2005 on the recognition of professional
qualifications". European Parliament and Council. Retrieved 19 April
* ^ A B C Regeringen.se – new grouping of the medical specialties
Archived April 10, 2008, at the
* Smith, Margot W. "Physician's Specialties and Medical Trade Areas:
An Application of Central Place Theory." Papers and Proceedings of
Applied Geography Conferences, Vol. 9, West Point NY 1986.
* Smith Margot W (1979). "A Guide to the Delineation of Medical Care
Regions, Medical Trade Areas and
* v * t * e
* Outline * History
Specialties and subspecialties
* Physical medicine and rehabilitation (PMborder-left-width:2px;border-left-style:solid;width:100%;padding:0px">
* Bachelor of Medicine, Bachelor of