Medical specialty


A medical specialty is a branch of medical practice that is focused on a defined group of patients, diseases, skills, or philosophy. Examples include those branches of medicine that deal exclusively with children, cancer, laboratory medicine, or primary care. After completing medical school or other basic training, physicians or surgeons and other clinicians usually further their medical education in a specific specialty of medicine by completing a multiple-year residency to become a specialist.

History

To a certain extent, medical practitioners have long been specialized. According to Galen, specialization was common among Roman physicians. The particular system of modern medical specialties 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 specialties varies from country to country, and is somewhat arbitrary.

Classification

Medical specialties can be classified along several axes. These are:
Throughout history, the most important has been the division into surgical and internal medicine specialties. The surgical specialties are those 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. Pediatricians handle most complaints and diseases in children that do not require surgery, and there are several subspecialties in pediatrics that mimic the organ-based specialties in adults. Pediatric 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

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. 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.
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.
SpecialtyCodeGroupSub-specialtiesFocus
Allergy and immunologyAllergic reactions, asthma, and the immune system.
AnesthesiologyAN, PANSurgery
  • Pediatric anesthesia
  • Pain management
  • Intensive care
  • Critical care
  • Obstetrics and gynaecology
  • Cardiothoracic anesthesiology
  • Trauma care
  • Pre- and Post-Operative Assessment and Care
  • Generalist
Anesthesia
BariatricsDeals with the causes, prevention, and treatment of obesity.
CardiologyMedicine
  • Interventional cardiology
  • Echocardiography
  • Electrocardiography
  • Sports cardiology
  • Cardiogeriatrics
  • Preventive cardiology and Cardiac Rehabilitation
  • Pediatric cardiology
    		• Disease of the cardiovascular system.
    Cardiovascular surgerySurgeryThe operation of heart and major blood vessels of the chest.
    Clinical laboratory sciencesDiagnostic
  • 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.
    DermatologyD, DSMedicineDermatology, Mohs surgerySkin and its appendages.
    DieteticsRDFood and nutrition
    Emergency medicineEMMedicine
  • Disaster medicine
  • Emergency medical services
  • Hospice and palliative medicine
  • International Emergency Medicine and Global Health
  • Medical toxicology
  • Pediatric emergency medicine
  • Research
  • Simulation
  • Sports medicine
  • Toxicology
  • Ultrasound
  • Undersea and hyperbaric medicine
  • Wilderness medicine
    		• The initial management of emergent medical conditions, often in hospital emergency departments or the field.
    EndocrinologyMedicineThe endocrine system and its diseases, including diabetes and thyroid diseases.
    Family medicineFMMedicine
  • Addiction medicine
  • Adolescent medicine
  • Anesthesia
  • Emergency medicine
  • Care of the elderly
  • Clinical environmental health
  • Global health
  • HIV care
  • Hospital medicine
  • Indigenous health
  • Low-risk obstetrics
  • Medical education
  • Medical oncology
  • Medical simulation
  • Pain medicine
  • Palliative care
  • Point of Care Ultrasound
  • Research
  • Sleep medicine
  • Sports and exercise medicine
  • Women's health
    		• 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.
    Forensic medicineMedicine
    GastroenterologyGIMedicineThe alimentary tract
    General surgeryGSSurgery
  • Colorectal surgery
  • Gastrointestinal surgery
  • Transplant surgery
  • Trauma surgery
    • GeriatricsIMGMedicineElderly patients
    GynecologyFemale reproductive health
    HepatologyMedicineThe liver and biliary tract, usually a part of gastroenterology.
    Hospital medicineMedicine
    Infectious diseaseIDMedicineDiseases caused by biological agents.
    Intensive care medicineMedicineLife support and management of critically ill patients, often in an ICU.
    Internal medicineMedicine
    Medical researchAnatomy, Biochemistry, Embryology, Genetics, Pharmacology, ToxicologyCare of hospitalized patients
    NephrologyMedicineKidney diseases
    NeurologyNMedicine
  • 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.
    NeurosurgeryNSSurgery
  • Cerebrovascular
  • Neurosurgical oncology
  • Stereotactic and functional
  • Spine
  • Neurotrauma
  • Skull base
  • Peripheral nerve
  • Pediatric neurosurgery
    		• Disease of the central nervous system, peripheral nervous system, and spinal column.
    Obstetrics and gynecologyOB/GYNSurgery
  • Maternal-fetal medicine
  • Reproductive medicine
  • Fertility medicine
  • Gynecologic oncology
    • OncologyONMedicine
  • Radiation oncology – pertains to the use of radiation therapy as part of cancer treatment to control malignant cells.
    		• Cancer and other malignant diseases, often grouped with hematology.
    OphthalmologyOPHSurgery
  • Anterior segment surgery
  • Cornea
  • Glaucoma
  • Neuro-ophthalmology
  • Ocular oncology
  • Oculoplastics and Orbital surgery
  • Ophthalmic pathology
  • Pediatric ophthalmology/strabismus
  • Refractive surgery
  • Medical retina
  • Uveitis
  • Vitreo-retinal surgery
    		• Diseases of the visual pathways, including the eyes, brain, etc.
    Oral and maxillofacial surgeryMaxfacs, OMSSurgery
  • Oral and Craniofacial surgery
  • 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 surgeryORSSurgeryHand surgery, surgical sports medicine, adult reconstruction, spine surgery, foot and ankle, musculoskeletal oncology, orthopedic trauma surgery, pediatric orthopedic surgeryInjury and disease of the musculoskeletal system.
    Otorhinolaryngology, or ENTORL, ENTSurgeryHead and neck, facial cosmetic surgery, Neurotology, LaryngologyTreatment 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 carePLMMedicineA 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.
    PathologyPTHDiagnosticUnderstanding 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.
    PediatricsPDMedicineChildren. 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.
    Pediatric surgerySurgeryTreats a wide variety of thoracic and abdominal diseases of childhood.
    Physical medicine and rehabilitation Or PhysiatryPM&RMedicine
  • Cancer Rehabilitation
  • Pain Management
  • Traumatic Brain Injury
  • Spinal Cord Injury
  • Sports Medicine
  • Pediatrics
  • Hospice & Palliative Medicine
    		• Concerned with functional improvement after injury, illness, or congenital disorders.
    Plastic surgeryPSSurgery
  • Cosmetic surgery
  • Burn
  • Microsurgery
  • Hand surgery
  • Craniofacial surgery
    		• Elective cosmetic surgery as well as reconstructive surgery after traumatic or operative mutilation.
    PodiatryPODSurgery
  • 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.
    ProctologyPROMedicine treats disease in the rectum, anus, and colon.
    PsychiatryPMedicine
  • Addiction psychiatry focuses on substance abuse and its treatment.
  • Child and adolescent psychiatry focuses on the care of children and adolescents with mental, emotional, and learning problems including ADHD, autism, and family conflicts.
  • Consultation-Liaison psychiatry focuses on the interface between general medicine and psychiatry.
  • Forensic psychiatry focuses on the interface of psychiatry and law.
  • Geriatric psychiatry focuses on the care of elderly people with mental illnesses including dementias, post-stroke cognitive changes, and depression.
  • Neuropsychiatry focuses on affective, cognitive and behavioral disorders attributable to diseases of the nervous system
  • Sleep medicine focuses on the diagnosis and treatment of sleep disorders.
  • Hospice and Palliative Medicine
  • Pain medicine
    		• The bio-psycho-social study of the etiology, diagnosis, treatment and prevention of cognitive, perceptual, emotional and behavioral disorders. Related fields include psychotherapy and clinical psychology.
    PulmonologyMedicineThe 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.
    Public HealthPublic health focuses on the health of populations. Physicians employed in this field work in policy, research or health promotion, taking a broad view of health that encompasses the social determinants of health.
    RadiologyR, DRDiagnostic and Therapeutic
  • 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, biopsies and minimally invasive oncologic procedures
  • Nuclear medicine uses radioactive substances for in vivo and in vitro diagnosis either using imaging of the location of radioactive substances placed into a patient or using in vitro diagnostic tests utilizing radioactive substances.
    		• The use of expertise in radiation in the context of medical imaging for diagnosis or image guided minimally invasive therapy. X-rays, etc.
    RheumatologyRHUMedicineAutoimmune and inflammatory diseases of the joints and other organ systems, such as arthritis and other rheumatic diseases.
    Surgical oncologySOSurgeryCurative and palliative surgical approaches to cancer treatment.
    Thoracic surgeryTSSurgerySurgery of the organs of the thoracic cavity: the heart, lungs, and great vessels.
    Transplant surgeryTTSSurgeryTransplantation of organs from one body to another.
    ToxicologyDiagnostic and Therapeutic
  • Environmental
  • Forensic
  • Occupational
  • Pediatric
    		• Poisonings, Overdoses; Environmental, and Occupational Exposures
    Urgent Care MedicineUCMMedicineImmediate medical care offering outpatient care for the treatment of acute and chronic illness and injury.
    UrologyUSurgeryUrinary tracts of males and females, and the male reproductive system. It is often practiced together with andrology.
    Vascular surgeryVSSurgeryThe peripheral blood vessels – those outside the chest and outside the central nervous system.