Specialty_(medicine)

A specialty in medicine is a branch of medical science, other than general 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. Doctors who engage in a medical specialty are known as medical specialists.

Specialization

The process itself varies between countries. Before specializing in an area, one must have a basic medical degree from a university, which usually requires four to six years. After graduating, doctors may work as interns, where they rotate through different clinical specialties - not necessarily all in their intended field After the internship is completed, doctors complete residency training in a particular specialty or subspecialty.

In the broadest meaning of \'medicine\', there are many different specialties. However, within medical circles, there are two broad categories: "Medicine" and "Surgery." "Medicine" refers to the practice of non-operative medicine, and most subspecialties in this area require preliminary training in "Internal Medicine." "Surgery" refers to the practice of operative medicine, and most subspecialties in this area require preliminary training in "General Surgery." There are some specialties of medicine that do not fit into either of these categories, such as radiology, pathology, anaesthesia, etc.

In the U.S., all specialists must pass all three steps of the national medical board examinations (steps I and II during medical school and step III during intern year). After passing these exams, further board exams are given specific to each specialty, including both written and oral boards. After residency is completed and the doctor has been in practice for at least one year, and after all these exams have been passed, the doctor is considered to be board certified in that particular specialty. There are only a certain amount of training spots per specialty each year, and therefore some specialties can be very competitive. Some medical students do not obtain their first choice of specialty. Some specialties suffer from severe shortages of doctors (which can be due to a lack of applicants, an unanticipated need and therefore too few training spots, or high attrition rates), while other specialties suffer from an oversupply of practicing doctors.

Surgical training requires a minimum of five years of residency after medical school. Sub-specialties of surgery often require seven or more years. In addition, fellowships can last an additional one to three years. Because post-residency fellowships can be competitive, many trainees devote two additional years to research. Thus in some cases surgical training will not finish until more than a decade after medical school. Furthermore, surgical training can be very difficult and time-consuming. A surgical resident\'s average work week is approximately 75 hours. Some subspecialties of surgery, such as neurosurgery, require even longer hours, and utilize an extension to the 80 hour regulated work week, allowing up to 88 hours per week. Many surgical programs still exceed this work hour limit. Attempts to limit the amount of hours worked has been difficult because of the large volume of patients who require surgical care, the limited amount of resources (including a shortage of people willing to enter into surgery as a career), the need to perform long operations and still provide care to all pre- and post-operative patients, and the need to provide constant coverage in the OR, ICU, and ER.

Medical training, as opposed to surgical training, requires three years of residency training after medical school. This can then be followed by a one to two year fellowship in the subspecialties listed above. In general, resident work hours in medicine are much less than those in surgery.

Recently, in certain countries, such as Australia, programs have been designed whereby a candidate applies directly for subspecialty training, with the aim of making training more "streamlined". The college then provides whatever basic training it deems necessary.

Overlap

It is possible for two different specialties to perform the same or similar tasks. For example, the following types of surgical operations may be performed within multiple specialties:

• Amputation - orthopedics, trauma surgery, or vascular surgery
• Hand surgery - orthopedics, plastic surgery, or general surgery
• Craniofacial surgery - maxillofacial surgery or plastic surgery
• Nerve root decompression (spinal disc herniation repair) - neurosurgery or orthopedics
• Carpal tunnel repair - neurosurgery, general surgery, orthopedics, or plastic surgery

Salary

The mean annual salary of a medical specialist is $175,011 in the US, and $272,000 ibmdllc.com -Physician income not rising as fast as other professional pay for surgeons.

Although medical specialists in other countries on average make less than those in the U.S., they also go through fewer years of training, and most, if not all, of their educational tuition and living expenses are funded by the government during these years. In some countries (e.g., Austria, Netherlands)http://www.nao.org.uk/publications/nao_reports/06-07/0607335.pdf p. 38, specialty pay as a percentage of GDP per capita actually exceeds the U.S.

Specialties by country

Australia and New Zealand

Specialty training in Australia and New Zealand is overseen by the specialty colleges:

• Royal Australasian College of Surgeons
• Royal Australasian College of Physicians

Canada

Specialty training in Canada is overseen by the Royal College of Physicians and Surgeons of Canada

United States

There are three agencies or organizations in the United States which collectively oversee physician board certification of allopathic and osteopathic physicians in the 26 approved medical specialties recognized in the United States. These organizations are the American Board of Medical Specialties (ABMS) and the American Medical Association; the American Osteopathic Association Bureau of Osteopathic Specialists (AOABS) and the American Osteopathic Association; the American Board of Physician Specialties (ABPS) and the American Association of Physician Specialists. Each of these agencies and their associated national medical organization functions as an umbrella for its various specialty academies, colleges and societies.

All boards of certification now require that physicians demonstrate, by examination, continuing mastery of the core knowledge and skills for their chosen specialty. Recertification varies by specialty between every 7 and every 10 years.

Medical specialties

In this table, medical specialties are organized into the following groups:

• Surgical specialties - the use of manually operative and instrumental techniques to treat disorders.
• Internal medicine - concerns the diagnosis and nonsurgical treatment of diseases in adults, especially of internal organs.
• Diagnostic specialties, rather examines disorders etc. than directly attempts to cure.
• Neurology - focuses on the diagnosis, treatment, and management of patients with neurological disorders.

Other uses

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.

See also

• Interdisciplinary sub-specialties of medicine, including e.g.
  • General practice - family practice, family medicine or primary care is, in many countries, the first port-of-call for patients with non-emergency medical problems. By definition not a medical specialty, but a mix of all of them.
  • Occupational medicine - branch of clinical medicine which 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 andserves 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

References

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