Physicians have many specializations and subspecializations into certain branches of medicine, which are listed below.
There are variations from country to country regarding which specialties certain subspecialties are in. In the broadest meaning of "medicine", there are many different specialties. In the UK, most specialities have their own body or college, which have its own entrance examination. These are collectively known as the Royal Colleges, although not all currently use the term "Royal".
The development of a speciality is often driven by new technology such as the development of effective anaesthetics or ways of working such as emergency departments ; the new specialty leads to the formation of a unifying body of doctors and the prestige of administering their own examination. Within medical circles, specialities usually fit into one of two broad categories: "Medicine" and "Surgery.
At present, some specialties of medicine do not fit easily into either of these categories, such as radiology, pathology, or anesthesia. Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate or treat a pathological condition such as disease or injury , to help improve bodily function or appearance or to repair unwanted ruptured areas for example, a perforated ear drum.
Surgeons must also manage pre-operative, post-operative, and potential surgical candidates on the hospital wards. Surgery has many sub-specialties, including general surgery , ophthalmic surgery , cardiovascular surgery , colorectal surgery , neurosurgery , oral and maxillofacial surgery , oncologic surgery , orthopedic surgery , otolaryngology , plastic surgery , podiatric surgery , transplant surgery , trauma surgery , urology , vascular surgery , and pediatric surgery. In some centers, anesthesiology is part of the division of surgery for historical and logistical reasons , although it is not a surgical discipline.
Other medical specialties may employ surgical procedures, such as ophthalmology and dermatology , but are not considered surgical sub-specialties per se. Surgical training in the U.
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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. Internal medicine is the medical specialty dealing with the prevention, diagnosis, and treatment of adult diseases. According to some sources, an emphasis on internal structures is implied.
Because their patients are often seriously ill or require complex investigations, internists do much of their work in hospitals. Formerly, many internists were not subspecialized; such general physicians would see any complex nonsurgical problem; this style of practice has become much less common. In modern urban practice, most internists are subspecialists: that is, they generally limit their medical practice to problems of one organ system or to one particular area of medical knowledge.
For example, gastroenterologists and nephrologists specialize respectively in diseases of the gut and the kidneys.
In the Commonwealth of Nations and some other countries, specialist pediatricians and geriatricians are also described as specialist physicians or internists who have subspecialized by age of patient rather than by organ system. Elsewhere, especially in North America, general pediatrics is often a form of primary care.
There are many subspecialities or subdisciplines of internal medicine :. Training in internal medicine as opposed to surgical training , varies considerably across the world: see the articles on medical education and physician for more details. In North America, it requires at least three years of residency training after medical school, which can then be followed by a one- to three-year fellowship in the subspecialties listed above.
In general, resident work hours in medicine are less than those in surgery, averaging about 60 hours per week in the US. This difference does not apply in the UK where all doctors are now required by law to work less than 48 hours per week on average. The following are some major medical specialties that do not directly fit into any of the above-mentioned groups:.
Medical education and training varies around the world. It typically involves entry level education at a university medical school , followed by a period of supervised practice or internship , or residency. This can be followed by postgraduate vocational training. A variety of teaching methods have been employed in medical education, still itself a focus of active research.
Since knowledge, techniques, and medical technology continue to evolve at a rapid rate, many regulatory authorities require continuing medical education. Medical practitioners upgrade their knowledge in various ways, including medical journals , seminars, conferences, and online programs. In most countries, it is a legal requirement for a medical doctor to be licensed or registered. In general, this entails a medical degree from a university and accreditation by a medical board or an equivalent national organization, which may ask the applicant to pass exams.
This restricts the considerable legal authority of the medical profession to physicians that are trained and qualified by national standards. It is also intended as an assurance to patients and as a safeguard against charlatans that practice inadequate medicine for personal gain. While the laws generally require medical doctors to be trained in "evidence based", Western, or Hippocratic Medicine, they are not intended to discourage different paradigms of health. In the European Union, the profession of doctor of medicine is regulated.
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A profession is said to be regulated when access and exercise is subject to the possession of a specific professional qualification. The regulated professions database contains a list of regulated professions for doctor of medicine in the EU member states, EEA countries and Switzerland. Doctors who are negligent or intentionally harmful in their care of patients can face charges of medical malpractice and be subject to civil, criminal, or professional sanctions.
Medical ethics is a system of moral principles that apply values and judgments to the practice of medicine. As a scholarly discipline, medical ethics encompasses its practical application in clinical settings as well as work on its history, philosophy, theology, and sociology.
Six of the values that commonly apply to medical ethics discussions are:. Values such as these do not give answers as to how to handle a particular situation, but provide a useful framework for understanding conflicts. When moral values are in conflict, the result may be an ethical dilemma or crisis. Sometimes, no good solution to a dilemma in medical ethics exists, and occasionally, the values of the medical community i.
Conflicts can also arise between health care providers, or among family members. For example, some argue that the principles of autonomy and beneficence clash when patients refuse blood transfusions , considering them life-saving; and truth-telling was not emphasized to a large extent before the HIV era.see
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Prehistoric medicine incorporated plants herbalism , animal parts, and minerals. In many cases these materials were used ritually as magical substances by priests, shamans , or medicine men.
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Well-known spiritual systems include animism the notion of inanimate objects having spirits , spiritualism an appeal to gods or communion with ancestor spirits ; shamanism the vesting of an individual with mystic powers ; and divination magically obtaining the truth. The field of medical anthropology examines the ways in which culture and society are organized around or impacted by issues of health, health care and related issues.
Early records on medicine have been discovered from ancient Egyptian medicine , Babylonian Medicine , Ayurvedic medicine in the Indian subcontinent , classical Chinese medicine predecessor to the modern traditional Chinese medicine , and ancient Greek medicine and Roman medicine. In China, archaeological evidence of medicine in Chinese dates back to the Bronze Age Shang Dynasty , based on seeds for herbalism and tools presumed to have been used for surgery. In India, the surgeon Sushruta described numerous surgical operations, including the earliest forms of plastic surgery.
In Greece, the Greek physician Hippocrates , the "father of modern medicine",   laid the foundation for a rational approach to medicine. Hippocrates introduced the Hippocratic Oath for physicians, which is still relevant and in use today, and was the first to categorize illnesses as acute , chronic , endemic and epidemic, and use terms such as, "exacerbation, relapse , resolution, crisis, paroxysm , peak, and convalescence ". The Hebrew contribution to the development of modern medicine started in the Byzantine Era , with the physician Asaph the Jew.
The concept of hospital as institution to offer medical care and possibility of a cure for the patients due to the ideals of Christian charity, rather than just merely a place to die, appeared in the Byzantine Empire. Although the concept of uroscopy was known to Galen, he did not see the importance of using it to localize the disease.
It was under the Byzantines with physicians such of Theophilus Protospatharius that they realized the potential in uroscopy to determine disease in a time when no microscope or stethoscope existed. That practice eventually spread to the rest of Europe. After CE, the Muslim world had the works of Hippocrates, Galen and Sushruta translated into Arabic , and Islamic physicians engaged in some significant medical research. Notable Islamic medical pioneers include the Persian polymath , Avicenna , who, along with Imhotep and Hippocrates, has also been called the "father of medicine".
For example, he was the first to recognize the reaction of the eye's pupil to light. In Europe, Charlemagne decreed that a hospital should be attached to each cathedral and monastery and the historian Geoffrey Blainey likened the activities of the Catholic Church in health care during the Middle Ages to an early version of a welfare state: "It conducted hospitals for the old and orphanages for the young; hospices for the sick of all ages; places for the lepers; and hostels or inns where pilgrims could buy a cheap bed and meal".
It supplied food to the population during famine and distributed food to the poor. This welfare system the church funded through collecting taxes on a large scale and possessing large farmlands and estates.
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The Benedictine order was noted for setting up hospitals and infirmaries in their monasteries, growing medical herbs and becoming the chief medical care givers of their districts, as at the great Abbey of Cluny. The Church also established a network of cathedral schools and universities where medicine was studied. The Schola Medica Salernitana in Salerno, looking to the learning of Greek and Arab physicians, grew to be the finest medical school in Medieval Europe.
However, the fourteenth and fifteenth century Black Death devastated both the Middle East and Europe, and it has even been argued that Western Europe was generally more effective in recovering from the pandemic than the Middle East. The major shift in medical thinking was the gradual rejection, especially during the Black Death in the 14th and 15th centuries, of what may be called the 'traditional authority' approach to science and medicine.
This was the notion that because some prominent person in the past said something must be so, then that was the way it was, and anything one observed to the contrary was an anomaly which was paralleled by a similar shift in European society in general — see Copernicus 's rejection of Ptolemy 's theories on astronomy. Physicians like Vesalius improved upon or disproved some of the theories from the past. The main tomes used both by medicine students and expert physicians were Materia Medica and Pharmacopoeia.
Andreas Vesalius was the author of De humani corporis fabrica , an important book on human anatomy. Later this was described by Renaldus Columbus and Andrea Cesalpino. Herman Boerhaave is sometimes referred to as a "father of physiology" due to his exemplary teaching in Leiden and textbook 'Institutiones medicae' Pierre Fauchard has been called "the father of modern dentistry". Veterinary medicine was, for the first time, truly separated from human medicine in , when the French veterinarian Claude Bourgelat founded the world's first veterinary school in Lyon, France.
Before this, medical doctors treated both humans and other animals. Modern scientific biomedical research where results are testable and reproducible began to replace early Western traditions based on herbalism, the Greek " four humours " and other such pre-modern notions.