Medical specialty

Lore & Background

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 subdivision of medicine into various specialties varies from country to country and is somewhat arbitrary.

Reader's Guide

Medical specialties are classified along several axes, the most important historically being the division into surgical and internal medicine specialties. Surgical specialties involve major surgical techniques for diagnosis and treatment; internal medicine specialties never involve major surgery. Many specialties are organ-based, while others are technique-based, such as radiology. The age range of patients varies; pediatricians handle most non-surgical complaints in children. A further subdivision is diagnostic versus therapeutic specialties; some specialists, like pathologists and radiologists, perform mainly diagnostic examinations. The line is blurring with interventional radiology, which uses image expertise for minimally invasive procedures. In the United States, hierarchies of medical specialties exist in cities: small towns have primary care, middle-sized cities offer secondary care, and metropolitan cities have tertiary care. Income, population size, demographics, and distance to the doctor influence the numbers and kinds of specialists in a location. A population's income level determines whether sufficient physicians can practice in an area. Developing countries and poor areas usually have shortages of physicians and specialties.

Did You Know?

• The modern system of medical specialties evolved gradually during the 19th century.
• In some countries, anesthesiology is classified as a surgical discipline because it is vital in the surgical process, though anesthesiologists never perform major surgery themselves.
• A 2022 survey found that dermatologists were most satisfied with their choice of specialty, followed by radiologists, oncologists, plastic surgeons, and gastroenterologists.