From Wikipedia the free encyclopedia
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.
History of medical specialization
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 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. 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||May be subspecialty of||Age range |
|Diagnostic (D) or |
|Surgical (S) or |
internal medicine (I)
or technique-based (T)
|Allergy and immunology||Internal medicine |
|Adolescent medicine||Pediatrics |
|Aerospace medicine||Family Medicine||All||Both||Neither||Both|
|Cardiothoracic surgery||General surgery||Adults||T||S||O|
|Child and adolescent psychiatry||Psychiatry||Pediatric||T||I||T|
|Colorectal surgery||General Surgery||All||Both||S||O|
|Emergency medicine||Family Medicine||All||Both||Both||Both|
|General surgical oncology||General surgery||Adults||T||S||T|
|Geriatrics||Family medicine |
|Geriatric psychiatry||Geriatrics |
|Gynecologic oncology||Obstetrics and gynecology||All||T||S||O|
|Hematology||Internal medicine |
|Hematologic pathology||Hematology |
|Infectious disease||Internal medicine |
|Intensive care medicine||Anesthesiology |
|Maternal-fetal medicine||Obstetrics and gynecology||Adults||T||S||Both|
|Medical biochemistry||Internal medicine||All||D||I||Neither|
|Medical oncology||Internal medicine||Adults||D||I||Neither|
|Nuclear medicine (Nucleology)||None||All||Both||I||T|
|Obstetrics and gynecology||Family medicine||All||T||S||O|
|Occupational medicine||Family medicine |
|Oral and maxillofacial surgery||None||All||T||S||O|
|Palliative care||Family Medicine |
|Pediatric allergy and immunology||Pediatrics||Pediatric||T||I||O|
|Pediatric emergency medicine||Pediatrics||Pediatric||Both||Both||Both|
|Pediatric hematology and oncology||Pediatrics||Pediatric||T||I||O|
|Pediatric infectious disease||Pediatrics||Pediatric||T||I||O|
|Pediatric respiratory medicine||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|
|Public health||Family medicine||All||Neither||Neither||T|
|Reproductive endocrinology and infertility||Obstetrics and gynecology||Adults||T||S||T|
|Pulmunology or Respiratory medicine||Internal medicine||Adults||T||I||O|
|Sports medicine||Family medicine||All||Both||Neither||Multidisciplinary|
|Thoracic surgery||General surgery||Adults||T||S||T|
|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. 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
- Child psychiatry
- Clinical biology
- Clinical chemistry
- Clinical microbiology
- Clinical neurophysiology
- Craniofacial surgery
- Family and General Medicine
- Gastroenterologic surgery
- General Practice
- General surgery
- Infectious diseases
- Internal medicine
- Laboratory medicine
- Nuclear medicine
- Obstetrics and gynaecology
- Occupational medicine
- Oral and maxillofacial surgery
- Paediatric surgery
- Physical medicine and rehabilitation
- Plastic surgery
- Podiatric surgery
- Preventive medicine
- Public health
- Radiation Oncology
- Respiratory medicine
- Thoracic surgery
- Tropical medicine
- Vascular surgery
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.
|Allergy and immunology||Allergic reactions, asthma, and the immune system.|
|Anesthesiology||AN, PAN||Surgery||Anesthesia|
|Bariatrics||Deals with the causes, prevention, and treatment of obesity.|
|Cardiology||Medicine||Disease of the cardiovascular system.|
|Cardiovascular surgery||Surgery||The operation of heart and major blood vessels of the chest.|
|Clinical laboratory sciences||Diagnostic|| ||Application of diagnostic techniques in medical laboratories such as assays, microscope analysis.|
|Dermatology||D, DS||Medicine||Dermatology, Mohs surgery||Skin and its appendages (hair, nails, sweat glands etc.).|
|Dietetics||RD||Food and nutrition|
|Emergency medicine||EM||Medicine||The initial management of emergent medical conditions, often in hospital emergency departments or the field.|
|Endocrinology||Medicine||The endocrine system (i.e., endocrine glands and hormones) and its diseases, including diabetes and thyroid diseases.|
|Family medicine||FM||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|| |
|Geriatrics||IMG||Medicine||Elderly patients|
|Gynecology||Female reproductive health|
|Hepatology||Medicine||The liver and biliary tract, usually a part of gastroenterology.|
|Infectious disease||ID||Medicine||Diseases caused by biological agents.|
|Intensive care medicine||Medicine||Life support and management of critically ill patients, often in an ICU.|
|Medical research||Anatomy, Biochemistry, Embryology, Genetics, Pharmacology, Toxicology||Care of hospitalized patients|
|Neurology||N||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.|
|Obstetrics and gynecology||OB/GYN||Surgery|
|Oncology||ON||Medicine||Cancer and other malignant diseases, often grouped with hematology.|
|Ophthalmology||OPH||Surgery||Diseases of the visual pathways, including the eyes, brain, etc.|
|Oral and maxillofacial surgery||Maxfacs, OMS||Surgery|| ||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).|
|Pediatric surgery||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|| ||Elective cosmetic surgery as well as reconstructive surgery after traumatic or operative mutilation.|
|Podiatry||POD||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||(or Colorectal Surgery) Treats disease in the rectum, anus, and colon.|
|Psychiatry||P||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.|
|Pulmonology||Medicine||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.|
|Public Health||Public 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.|
|Radiology||R, DR||Diagnostic and Therapeutic|| ||The use of expertise in radiation in the context of medical imaging for diagnosis or image guided minimally invasive therapy. X-rays, etc.|
|Rheumatology||RHU||Medicine||Autoimmune and inflammatory diseases of the joints and other organ systems, such as arthritis and other rheumatic diseases.|
|Surgical oncology||SO||Surgery||Curative and palliative surgical approaches to cancer treatment.|
|Thoracic surgery||TS||Surgery||Surgery of the organs of the thoracic cavity: the heart, lungs, and great vessels.|
|Transplant surgery||TTS||Surgery||Transplantation of organs from one body to another.|
|Toxicology||Diagnostic and Therapeutic|| ||Poisonings, Overdoses; Environmental, and Occupational Exposures|
|Urgent Care Medicine||UCM||Medicine||Immediate medical care offering outpatient care for the treatment of acute and chronic illness and injury.|
|Urology||U||Surgery||Urinary tracts of males and females, and the male reproductive system. It is often practiced together with andrology ("men's health").|
|Vascular surgery||VS||Surgery||The peripheral blood vessels – those outside the chest (usually operated on by cardiovascular surgeons) and outside the central nervous system (treated by neurosurgery).|
According to the 2022 Medscape Physician Compensation Report, physicians on average earn $339K annually. Primary care physicians earn $260K annually while specialists earned $368K annually.
|Specialty||Average salary (USD)||Average hours |
|Average salary/hour (USD)|
|Allergy & Immunology||$298K|
|Cardiac Surgery||218,684 to $500,000|
|Obstetrics and Gynecology||$336K||59||83|
|Oral and Maxillofacial Surgery||360,000 to $625,210||53|
|Physical Medicine & Rehabiliation||$322K|
|Podiatry||170,800 to $315,150||45||80|
|Neurosurgery||350,000 to $705,000||132|
Specialties by country
Australia and New Zealand
There are 15 recognised specialty medical Colleges in Australia. The majority of these are Australasian Colleges and therefore also oversee New Zealand specialist doctors. These Colleges are:
|Specialist College||Major Subspecialties||Approximate number of specialist doctors/trainees|
|Australasian College for Emergency Medicine||Paediatric emergency medicine||5,000|
|Australasian College of Dermatologists||700|
|Australasian College of Sport and Exercise Physicians||Exercise medicine||350|
|Australian and New Zealand College of Anaesthetists||Pain medicine||7,000|
|Australian College of Rural and Remote Medicine||4,500|
|College of Intensive Care Medicine||Paediatric Intensive care||1,200|
|Royal Australasian College of Medical Administrators||800|
|Royal Australasian College of Physicians||Addiction medicine, Adolescent and young adult medicine, Cardiology, Clinical Genetics, Clinical haematology, Clinical pharmacology, Community child health, Endocrinology, Gastroenterology, General and acute care medicine, General paediatrics Geriatric medicine, Haematology, Infectious diseases, Immunology and allergy, Neonatal and perinatal medicine, Nephrology, Neurology, Nuclear medicine, Occupational medicine, Oncology, Paediatric emergency medicine, Palliative medicine, Public health, Rehabilitation, Respiratory and sleep medicine, Rheumatology, Sexual Health||28,000|
|Royal Australasian College of Surgeons||Cardiothoracic, General surgery, Head & neck, Neurosurgery, Orthopaedics, Paediatric surgery, Plastics, Urology, Vascular||9,000|
|Royal Australian and New Zealand College of Obstetricians and Gynaecologists||Obstetrics, Gynaecology, Fertility medicine, Obstetric ultrasound, Gynaecological oncology, Urogynaecology||2,500|
|Royal Australian and New Zealand College of Ophthalmologists||1,100|
|Royal Australian and New Zealand College of Psychiatrists||5,000|
|Royal Australian and New Zealand College of Radiologists||Diagnostic, Interventional, Ultrasound, Nuclear medicine||3,500|
|Royal Australian College of General Practitioners||40,000|
|Royal College of Pathologists of Australasia||Anatomical, Chemical, Clinical, Forensic, Genetic, Haematological, Immunological, Microbiological Pathology||1,000|
In addition, the Royal Australasian College of Dental Surgeons supervises training of specialist medical practitioners specializing in Oral and Maxillofacial Surgery in addition to its role in the training of dentists. There are approximately 260 faciomaxillary surgeons in Australia.
The Royal New Zealand College of General Practitioners is a distinct body from the Australian Royal Australian College of General Practitioners. There are approximately 5100 members of the RNZCGP.
Within some of the larger Colleges, there are sub-faculties, such as: Australasian Faculty of Rehabilitation Medicine Archived 2014-12-11 at the Wayback Machine within the Royal Australasian College of Physicians
There are some collegiate bodies in Australia that are not officially recognised as specialities by the Australian Medical Council but have a college structure for members, such as: Australasian College of Physical Medicine
There are some collegiate bodies in Australia of Allied Health non-medical practitioners with specialisation. They are not recognised as medical specialists, but can be treated as such by private health insurers, such as: Australasian College of Podiatric Surgeons
Specialty training in Canada is overseen by the Royal College of Physicians and Surgeons of Canada and the College of Family Physicians of Canada. For specialists working in the province of Quebec, the Collège des médecins du Québec also oversees the process.
In Germany these doctors use the term Facharzt.
Specialty training in India is overseen by the Medical Council of India, responsible for recognition of post graduate training and by the National Board of Examinations. Education of Ayurveda in overseen by Central Council of Indian Medicine (CCIM), the council conducts UG and PG courses all over India, while Central Council of Homoeopathy does the same in the field of Homeopathy.
In Sweden, a medical license is required before commencing specialty training. Those graduating from Swedish medical schools are first required to do a rotational internship of about 1.5 to 2 years in various specialties before attaining a medical license. The specialist training lasts 5 years.
There are three agencies or organizations in the United States that collectively oversee physician board certification of MD and DO physicians in the United States in the 26 approved medical specialties recognized in the country. These organizations are the American Board of Medical Specialties (ABMS) and the American Medical Association (AMA); the American Osteopathic Association Bureau of Osteopathic Specialists (AOABOS) and the American Osteopathic Association; the American Board of Physician Specialties (ABPS) and the American Association of Physician Specialists (AAPS). Each of these agencies and their associated national medical organization functions as its various specialty academies, colleges and societies.
|Certifying board||National organization||Physician type|
|ABMS||AMA||MD and DO|
|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.
In the United States 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.
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.
Satisfaction and burnout
A survey of physicians in the United States came to the result that dermatologists are most satisfied with their choice of specialty followed by radiologists, oncologists, plastic surgeons, and gastroenterologists. In contrast, primary care physicians were the least satisfied, followed by nephrologists, obstetricians/gynecologists, and pulmonologists. Surveys have also revealed high levels of depression among medical students (25 - 30%) as well as among physicians in training (22 - 43%), which for many specialties, continue into regular practice. A UK survey conducted of cancer-related specialties in 1994 and 2002 found higher job satisfaction in those specialties with more patient contact. Rates of burnout also varied by specialty.
- Branches of medicine
- 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 Medicine
- "Different Types of Doctors: Find the Specialist You Need". webmd.com. Retrieved 17 March 2018.
- Weisz G (Fall 2003). "The Emergence of Medical Specialization in the Nineteenth Century". Bull Hist Med. 77 (3): 536–574. doi:10.1353/bhm.2003.0150. PMID 14523260. S2CID 23694173.
- "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 2011.
- Regeringen.se – new grouping of the medical specialties Archived April 10, 2008, at the Wayback Machine
- "Becoming a Registered Dietitian". Department of Food Science and Human Nutrition. University of Illinois at Urbana-Champaign. Retrieved 21 April 2016.
- "Medscape Physician Compensation Report 2022: Incomes Gain, Pay Gaps Remain". Medscape. Retrieved 2022-07-23.
- "Medscape Physician Compensation Report 2022: Incomes Gain, Pay Gaps Remain". Medscape. Retrieved 2022-07-23.
- Katzowitz, Josh (2022-02-02). "How Much Do Doctors Make? [Salary by Specialty 2022] | White Coat Investor". The White Coat Investor - Investing & Personal Finance for Doctors. Retrieved 2022-07-23.
- Council of Presidents of Medical Colleges, https://cpmc.edu.au/
- Medical Board of Australia, https://www.medicalboard.gov.au/registration/types/specialist-registration/medical-specialties-and-specialty-fields.aspx
- "What sort of doctor do you want to be? Medical specialties in Australia". 15 May 2014.
- "What is ANZAOMS? - ANZAOMS".
- "Specialty training / residency". Lund University, Faculty of Medicine. 2015-05-20. Retrieved 2016-11-26.
- Smith, Margot Wiesinger (1979). "A guide to the delineation of medical care regions, medical trade areas, and hospital service areas". Public Health Reports. 94 (3): 248–254. JSTOR 4596085. PMC 1431844. PMID 582210.
- "These medical specialties have the biggest gender imbalances". American Medical Association. Retrieved 17 July 2020.
- Woolf, Katherine; Jayaweera, Hirosha; Unwin, Emily; Keshwani, Karim; Valerio, Christopher; Potts, Henry (2019). "Effect of sex on specialty training application outcomes: A longitudinal administrative data study of UK medical graduates". BMJ Open. 9 (3): e025004. doi:10.1136/bmjopen-2018-025004. PMC 6429837. PMID 30837254.
- "Medscape: Medscape Access".
- Rotenstein, Lisa S.; Ramos, Marco A.; Torre, Matthew; Segal, J. Bradley; Peluso, Michael J.; Guille, Constance; Sen, Srijan; Mata, Douglas A. (2016-12-06). "Prevalence of Depression, Depressive Symptoms, and Suicidal Ideation Among Medical Students: A Systematic Review and Meta-Analysis". JAMA. 316 (21): 2214–2236. doi:10.1001/jama.2016.17324. ISSN 1538-3598. PMC 5613659. PMID 27923088.
- Mata, Douglas A.; Ramos, Marco A.; Bansal, Narinder; Khan, Rida; Guille, Constance; Angelantonio, Emanuele Di; Sen, Srijan (2015). "Prevalence of Depression and Depressive Symptoms Among Resident Physicians: A Systematic Review and Meta-analysis". JAMA. 314 (22): 2373–2383. doi:10.1001/jama.2015.15845. PMC 4866499. PMID 26647259.
- Taylor, Cath; Graham, Jill; Potts, Henry WW; Richards, Michael A.; Ramirez, Amanda J. (2005). "Changes in mental health of UK hospital consultants since the mid-1990s". The Lancet. 366 (9487): 742–744. doi:10.1016/S0140-6736(05)67178-4. PMID 16125591. S2CID 11391979.