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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 (paediatrics), cancer (oncology), laboratory medicine (pathology), or primary care (family medicine). 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.[1]
History of medical specialization
To a certain extent, medical practitioners have long been specialized. According to Galen, specialization was common among Roman physicians.[citation needed] 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.[2]
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 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 (formally or informally) 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
Specialty | May be subspecialty of | Age range of patients |
Diagnostic (D) or therapeutic (T) specialty |
Surgical (S) or internal medicine (I) specialty |
Organ-based (O) or technique-based (T) |
---|---|---|---|---|---|
Allergy and immunology | Internal medicine Pediatrics |
All | Both | I | O |
Adolescent medicine | Pediatrics Family medicine |
Pediatric | Both | I | T |
Anesthesiology | None | All | T | Both | Both |
Aerospace medicine | Family Medicine | All | Both | Neither | Both |
Bariatrics | Several | All | Both | Both | Both |
Cardiology | Internal medicine | Adults | T | I | O |
Cardiothoracic surgery | General surgery | Adults | T | S | O |
Child and adolescent psychiatry | Psychiatry | Pediatric | T | I | T |
Clinical neurophysiology | Neurology | All | D | I | Both |
Colorectal surgery | General Surgery | All | Both | S | O |
Dermatology | None | All | T | I | O |
Developmental pediatrics | Pediatrics | Pediatric | T | I | Neither |
Emergency medicine | Family Medicine | All | Both | Both | Both |
Endocrinology | Internal medicine | Adults | Both | I | Multidisciplinary |
Family Medicine | None | All | Both | Both | Multidisciplinary |
Forensic pathology | Pathology | All | D | Neither | T |
Forensic psychiatry | Psychiatry | All | D | I | T |
Gastroenterology | Internal medicine | Adults | T | I | O |
General surgery | None | Adults | T | S | T |
General surgical oncology | General surgery | Adults | T | S | T |
Geriatrics | Family medicine Internal medicine |
Geriatric | T | I | Multidisciplinary |
Geriatric psychiatry | Geriatrics Psychiatry |
Geriatric | T | I | Neither |
Gynecologic oncology | Obstetrics and gynecology | All | T | S | O |
Hematology | Internal medicine pathology |
Adults | D | I | Neither |
Hematologic pathology | Hematology Pathology |
All | D | Neither | T |
Infectious disease | Internal medicine Pediatrics |
All | Both | I | Neither |
Internal medicine | None | Adults | Both | I | Neither |
Interventional radiology | Radiology | All | Both | - | Multidisciplinary |
Intensive care medicine | Anesthesiology Emergency medicine Internal medicine |
All | T | Both | Both |
Maternal-fetal medicine | Obstetrics and gynecology | Adults | T | S | Both |
Medical biochemistry | Internal medicine | All | D | I | Neither |
Medical genetics | None | All | D | I | Neither |
Medical oncology | Internal medicine | Adults | D | I | Neither |
Neonatology | Pediatrics | Neonatal | T | I | Neither |
Nephrology | Internal medicine | All | T | I | O |
Neurology | Internal medicine | All | Both | I | O |
Neuropathology | Pathology | All | D | Neither | T |
Neurosurgery | None | All | T | S | O |
Nuclear medicine (Nucleology) | None | All | Both | I | T |
Obstetrics and gynecology | Family medicine | All | T | S | O |
Occupational medicine | Family medicine Internal medicine |
Adults | T | I | Multidisciplinary |
Ophthalmology | None | All | T | S | O |
Orthopedic surgery | None | All | T | S | O |
Oral and maxillofacial surgery | None | All | T | S | O |
Otorhinolaryngology | None | All | T | S | O |
Palliative care | Family Medicine Internal medicine Pediatrics |
All | Both | Neither | Neither |
Pathology | None | All | D | Neither | T |
Pediatrics | None | Pediatric | Both | I | Neither |
Pediatric allergy and immunology | Pediatrics | Pediatric | T | I | O |
Pediatric cardiology | Pediatrics | Pediatric | T | I | O |
Pediatric emergency medicine | Pediatrics | Pediatric | Both | Both | Both |
Pediatric endocrinology | Pediatrics | Pediatric | Both | I | Multidisciplinary |
Pediatric gastroenterology | Pediatrics | Pediatric | T | I | O |
Pediatric hematology and oncology | Pediatrics | Pediatric | T | I | O |
Pediatric infectious disease | Pediatrics | Pediatric | T | I | O |
Pediatric nephrology | Pediatrics | Pediatric | T | I | O |
Pediatric respiratory medicine | Pediatrics | Pediatric | T | I | O |
Pediatric rheumatology | Pediatrics | Pediatric | T | I | O |
Pediatric surgery | General surgery | Pediatric | T | S | O |
Physical medicine and rehabilitation | None | All | T | I | Multidisciplinary |
Plastic, reconstructive and aesthetic surgery | General surgery | All | T | S | O |
Psychiatry | Family medicine | All | Both | I | T |
Public health | Family medicine | All | Neither | Neither | T |
Radiation oncology | None | All | T | Neither | T |
Radiology | None | All | Both | I | T |
Reproductive endocrinology and infertility | Obstetrics and gynecology | Adults | T | S | T |
Pulmunology or Respiratory medicine | Internal medicine | Adults | T | I | O |
Rheumatology | Internal medicine | Adults | T | I | Neither |
Sports medicine | Family medicine | All | Both | Neither | Multidisciplinary |
Thoracic surgery | General surgery | Adults | T | S | T |
Toxicology | Emergency Medicine | All | Both | Neither | O |
Transfusion Medicine | None | All | Both | Neither | Both |
Neuroradiology | Radiology | All | Both | I | Both |
Urology | None | All | T | S | O |
Vascular surgery | General surgery | All | T | S | 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.[3] 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 Zdroj:https://en.wikipedia.org?pojem=Medical_specialty
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