Medicine

Medicine

Overview
Medicine is the science
Science
Science is a systematic enterprise that builds and organizes knowledge in the form of testable explanations and predictions about the universe...

 and art of healing
Healing
Physiological healing is the restoration of damaged living tissue, organs and biological system to normal function. It is the process by which the cells in the body regenerate and repair to reduce the size of a damaged or necrotic area....

. It encompasses a variety of health care
Health care
Health care is the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. Health care is delivered by practitioners in medicine, chiropractic, dentistry, nursing, pharmacy, allied health, and other care providers...

 practices evolved to maintain and restore health
Health
Health is the level of functional or metabolic efficiency of a living being. In humans, it is the general condition of a person's mind, body and spirit, usually meaning to be free from illness, injury or pain...

 by the prevention and treatment
Therapy
This is a list of types of therapy .* Adventure therapy* Animal-assisted therapy* Aquatic therapy* Aromatherapy* Art and dementia* Art therapy* Authentic Movement* Behavioral therapy* Bibliotherapy* Buteyko Method* Chemotherapy...

 of illness
Illness
Illness is a state of poor health. Illness is sometimes considered another word for disease. Others maintain that fine distinctions exist...

.

Contemporary medicine applies health science, biomedical research
Biomedical research
Biomedical research , in general simply known as medical research, is the basic research, applied research, or translational research conducted to aid and support the body of knowledge in the field of medicine...

, and medical technology
Medical technology
Medical Technology encompasses a wide range of healthcare products and is used to diagnose, monitor or treat diseases or medical conditions affecting humans. Such technologies are intended to improve the quality of healthcare delivered through earlier diagnosis, less invasive treatment options and...

 to diagnose and treat injury and disease, typically through medication or surgery
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...

, but also through therapies as diverse as psychotherapy
Psychotherapy
Psychotherapy is a general term referring to any form of therapeutic interaction or treatment contracted between a trained professional and a client or patient; family, couple or group...

, external splints & traction
Splint (medicine)
A splint is a device used for support or immobilization of limbs or of the spine.It can be used:* By the emergency medical services or by volunteer first responders, to immobilize a fractured limb before the transportation; it is then a temporary immobilization;* By allied health professionals such...

, prostheses, biologics
Biologics
A biologic is a medicinal product such as a vaccine, blood or blood component, allergenic, somatic cell, gene therapy, tissue, recombinant therapeutic protein, or living cells that are used as therapeutics to treat diseases...

, ionizing radiation and others.
Discussion
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Unanswered Questions
Quotations

"If you know neither the terminology nor the concepts, you're ignorant. If you know the terminology, but you don't know the concepts, you're dangerous."

Jacob M. Appel, Arborophilia|Arborophilia (2005)

"The unbiased opinion of most medical men of sound judgment and long experience...[holds that] the amount of death and disaster in the world would be less, if all disease were left to itself."

Harvard professor Jacob Bigelow, 1835.

"Cured yesterday of my disease, I died last night of my physician."

Matthew Prior (1664-1721)

"Our diseases are so old fashioned, they can't keep up with the new medicines."

Leonid S. Sukhorukov All About Everything

"I firmly believe that if the whole material medica, as now used, could be sunk to the bottom of the sea, it would be better for mankind-and all the worse for the fishes."

Oliver Wendell Holmes, Sr., 19th century physician

"The college-birs are threeLaw, Physic and DivinityAnd while these three remain combined,They keep the world oppressed and blind...Now is the time to be set free,From priests' and Doctors' slavery.

19th century rhyme associated with the Thomsonian movement

"We should not encourage the medical student to while away his time in the labyrinths of Chemistry and Physiology."

Harvard Medical School professor, 1871.

"History is replete with examples of what happens when any group of authorities do not have to answer to empirical evidence but are free to define truth as they see fit. None of the examples has a happy ending. Why should it be otherwise with therapy?"

Robert Todd Carroll, The Skeptic's Dictionary, entry on "repressed memory therapy (RMT)"
Encyclopedia
Medicine is the science
Science
Science is a systematic enterprise that builds and organizes knowledge in the form of testable explanations and predictions about the universe...

 and art of healing
Healing
Physiological healing is the restoration of damaged living tissue, organs and biological system to normal function. It is the process by which the cells in the body regenerate and repair to reduce the size of a damaged or necrotic area....

. It encompasses a variety of health care
Health care
Health care is the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. Health care is delivered by practitioners in medicine, chiropractic, dentistry, nursing, pharmacy, allied health, and other care providers...

 practices evolved to maintain and restore health
Health
Health is the level of functional or metabolic efficiency of a living being. In humans, it is the general condition of a person's mind, body and spirit, usually meaning to be free from illness, injury or pain...

 by the prevention and treatment
Therapy
This is a list of types of therapy .* Adventure therapy* Animal-assisted therapy* Aquatic therapy* Aromatherapy* Art and dementia* Art therapy* Authentic Movement* Behavioral therapy* Bibliotherapy* Buteyko Method* Chemotherapy...

 of illness
Illness
Illness is a state of poor health. Illness is sometimes considered another word for disease. Others maintain that fine distinctions exist...

.

Contemporary medicine applies health science, biomedical research
Biomedical research
Biomedical research , in general simply known as medical research, is the basic research, applied research, or translational research conducted to aid and support the body of knowledge in the field of medicine...

, and medical technology
Medical technology
Medical Technology encompasses a wide range of healthcare products and is used to diagnose, monitor or treat diseases or medical conditions affecting humans. Such technologies are intended to improve the quality of healthcare delivered through earlier diagnosis, less invasive treatment options and...

 to diagnose and treat injury and disease, typically through medication or surgery
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...

, but also through therapies as diverse as psychotherapy
Psychotherapy
Psychotherapy is a general term referring to any form of therapeutic interaction or treatment contracted between a trained professional and a client or patient; family, couple or group...

, external splints & traction
Splint (medicine)
A splint is a device used for support or immobilization of limbs or of the spine.It can be used:* By the emergency medical services or by volunteer first responders, to immobilize a fractured limb before the transportation; it is then a temporary immobilization;* By allied health professionals such...

, prostheses, biologics
Biologics
A biologic is a medicinal product such as a vaccine, blood or blood component, allergenic, somatic cell, gene therapy, tissue, recombinant therapeutic protein, or living cells that are used as therapeutics to treat diseases...

, ionizing radiation and others. The word medicine is derived from the Latin
Latin
Latin is an Italic language originally spoken in Latium and Ancient Rome. It, along with most European languages, is a descendant of the ancient Proto-Indo-European language. Although it is considered a dead language, a number of scholars and members of the Christian clergy speak it fluently, and...

 ars medicina, meaning the art of healing.

History


Prehistoric medicine
Prehistoric medicine
Prehistoric medicine is a term used to describe the use of medicine before the invention of writing. As the timing of the invention of writing varies per culture and region, the term "prehistoric medicine" encompasses a wide range of time periods and dates....

 incorporated plants (herbalism
Herbalism
Herbalism is a traditional medicinal or folk medicine practice based on the use of plants and plant extracts. Herbalism is also known as botanical medicine, medical herbalism, herbal medicine, herbology, herblore, and phytotherapy...

), animal parts and minerals. In many cases these materials were used ritually as magical substances by priests, shamans, or medicine men
Medicine man
"Medicine man" or "Medicine woman" are English terms used to describe traditional healers and spiritual leaders among Native American and other indigenous or aboriginal peoples...

. Well-known spiritual systems include animism
Animism
Animism refers to the belief that non-human entities are spiritual beings, or at least embody some kind of life-principle....

 (the notion of inanimate objects having spirits), spiritualism
Spiritualism
Spiritualism is a belief system or religion, postulating the belief that spirits of the dead residing in the spirit world have both the ability and the inclination to communicate with the living...

 (an appeal to gods or communion with ancestor spirits); shamanism
Shamanism
Shamanism is an anthropological term referencing a range of beliefs and practices regarding communication with the spiritual world. To quote Eliade: "A first definition of this complex phenomenon, and perhaps the least hazardous, will be: shamanism = technique of ecstasy." Shamanism encompasses the...

 (the vesting of an individual with mystic powers); and divination
Divination
Divination is the attempt to gain insight into a question or situation by way of an occultic standardized process or ritual...

 (magically obtaining the truth). The field of medical anthropology
Medical anthropology
Medical anthropology is an interdisciplinary field which studies "human health and disease, health care systems, and biocultural adaptation". It views humans from multidimensional and ecological perspectives...

 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
Ancient Egyptian medicine
The medicine of the ancient Egyptians is some of the oldest documented. From the beginnings of the civilization in the until the Persian invasion of 525 BC, Egyptian medical practice went largely unchanged and was highly advanced for its time, including simple non-invasive surgery, setting of...

, Babylonian medicine, Ayurvedic
Ayurveda
Ayurveda or ayurvedic medicine is a system of traditional medicine native to India and a form of alternative medicine. In Sanskrit, words , meaning "longevity", and , meaning "knowledge" or "science". The earliest literature on Indian medical practice appeared during the Vedic period in India,...

 medicine (in the Indian subcontinent
Indian subcontinent
The Indian subcontinent, also Indian Subcontinent, Indo-Pak Subcontinent or South Asian Subcontinent is a region of the Asian continent on the Indian tectonic plate from the Hindu Kush or Hindu Koh, Himalayas and including the Kuen Lun and Karakoram ranges, forming a land mass which extends...

), classical Chinese medicine (predecessor to the modern traditional Chinese Medicine
Traditional Chinese medicine
Traditional Chinese Medicine refers to a broad range of medicine practices sharing common theoretical concepts which have been developed in China and are based on a tradition of more than 2,000 years, including various forms of herbal medicine, acupuncture, massage , exercise , and dietary therapy...

), and ancient Greek medicine and Roman medicine
Medicine in ancient Rome
Medicine in ancient Rome combined various techniques using different tools and rituals. Ancient Roman medicine included a number of specializations such as internal medicine, ophthalmology and urology...

. The Egyptian Imhotep
Imhotep
Imhotep , fl. 27th century BC was an Egyptian polymath, who served under the Third Dynasty king Djoser as chancellor to the pharaoh and high priest of the sun god Ra at Heliopolis...

 (3rd millennium BC) is the first physician in history known by name. Earliest records of dedicated hospitals come from Mihintale in Sri Lanka
Sri Lanka
Sri Lanka, officially the Democratic Socialist Republic of Sri Lanka is a country off the southern coast of the Indian subcontinent. Known until 1972 as Ceylon , Sri Lanka is an island surrounded by the Indian Ocean, the Gulf of Mannar and the Palk Strait, and lies in the vicinity of India and the...

 where evidence of dedicated medicinal treatment facilities for patients are found. The Indian surgeon Sushruta described numerous surgical operations, including the earliest forms of plastic surgery
Plastic surgery
Plastic surgery is a medical specialty concerned with the correction or restoration of form and function. Though cosmetic or aesthetic surgery is the best-known kind of plastic surgery, most plastic surgery is not cosmetic: plastic surgery includes many types of reconstructive surgery, hand...

.

The Greek physician Hippocrates
Hippocrates
Hippocrates of Cos or Hippokrates of Kos was an ancient Greek physician of the Age of Pericles , and is considered one of the most outstanding figures in the history of medicine...

, the "father of medicine", laid the foundation for a rational approach to medicine. Hippocrates introduced the Hippocratic Oath
Hippocratic Oath
The Hippocratic Oath is an oath historically taken by physicians and other healthcare professionals swearing to practice medicine ethically. It is widely believed to have been written by Hippocrates, often regarded as the father of western medicine, or by one of his students. The oath is written in...

 for physicians, which is still relevant and in use today, and was the first to categorize illnesses as acute, chronic
Chronic (medicine)
A chronic disease is a disease or other human health condition that is persistent or long-lasting in nature. The term chronic is usually applied when the course of the disease lasts for more than three months. Common chronic diseases include asthma, cancer, diabetes and HIV/AIDS.In medicine, the...

, endemic
Endemic (epidemiology)
In epidemiology, an infection is said to be endemic in a population when that infection is maintained in the population without the need for external inputs. For example, chickenpox is endemic in the UK, but malaria is not...

 and epidemic, and use terms such as, "exacerbation, relapse
Relapse
Relapse, in relation to drug misuse, is resuming the use of a drug or a dependent substance after one or more periods of abstinence. The term is a landmark feature of both substance dependence and substance abuse, which are learned behaviors, and is maintained by neuronal adaptations that mediate...

, resolution, crisis, paroxysm, peak, and convalescence
Convalescence
Convalescence is the gradual recovery and of health and strength after illness. It refers to the later stage of an infectious disease or illness when the patient recovers and returns to normal, but may continue to be a source of infection even if feeling better...

".

The Greek physician Galen
Galen
Aelius Galenus or Claudius Galenus , better known as Galen of Pergamon , was a prominent Roman physician, surgeon and philosopher...

 was also one of the greatest surgeons of the ancient world and performed many audacious operations, including brain and eye surgeries. After the fall of the Western Roman Empire
Western Roman Empire
The Western Roman Empire was the western half of the Roman Empire after its division by Diocletian in 285; the other half of the Roman Empire was the Eastern Roman Empire, commonly referred to today as the Byzantine Empire....

 and the onset of the Early Middle Ages
Early Middle Ages
The Early Middle Ages was the period of European history lasting from the 5th century to approximately 1000. The Early Middle Ages followed the decline of the Western Roman Empire and preceded the High Middle Ages...

, the Greek tradition of medicine went into decline in Western Europe, although it continued uninterrupted in the Eastern Roman (Byzantine) Empire.

After 750 CE, the Muslim world had the works of Hippocrates, Galen and Sushruta translated into Arabic, and Islamic physicians
Islamic medicine
In the history of medicine, Islamic medicine, Arabic medicine or Arabian medicine refers to medicine developed in the Islamic Golden Age, and written in Arabic, the lingua franca of Islamic civilization....

 engaged in some significant medical research. Notable Islamic medical pioneers include the polymath
Polymath
A polymath is a person whose expertise spans a significant number of different subject areas. In less formal terms, a polymath may simply be someone who is very knowledgeable...

, Avicenna
Avicenna
Abū ʿAlī al-Ḥusayn ibn ʿAbd Allāh ibn Sīnā , commonly known as Ibn Sīnā or by his Latinized name Avicenna, was a Persian polymath, who wrote almost 450 treatises on a wide range of subjects, of which around 240 have survived...

, who, along with Imhotep and Hippocrates, has also been called the "father of medicine". He wrote The Canon of Medicine
The Canon of Medicine
The Canon of Medicine is an encyclopedia of Galenic medicine in five books compiled by Ibn Sīnā and completed in 1025. It presents a clear and organized summary of all the medical knowledge of the time...

, considered one of the most famous books in the history of medicine. Others include Abulcasis, Avenzoar
Ibn Zuhr
Abū Merwān ’Abdal-Malik ibn Zuhr was a Muslim physician, surgeon and teacher in Al-Andalus.He was born at Seville...

, Ibn al-Nafis, and Averroes
Averroes
' , better known just as Ibn Rushd , and in European literature as Averroes , was a Muslim polymath; a master of Aristotelian philosophy, Islamic philosophy, Islamic theology, Maliki law and jurisprudence, logic, psychology, politics, Arabic music theory, and the sciences of medicine, astronomy,...

. Rhazes was one of first to question the Greek theory of humorism
Humorism
Humorism, or humoralism, is a now discredited theory of the makeup and workings of the human body, adopted by Greek and Roman physicians and philosophers, positing that an excess or deficiency of any of four distinct bodily fluids in a person directly influences their temperament and health...

, which nevertheless remained influential in both medieval Western and medieval Islamic medicine
Islamic medicine
In the history of medicine, Islamic medicine, Arabic medicine or Arabian medicine refers to medicine developed in the Islamic Golden Age, and written in Arabic, the lingua franca of Islamic civilization....

. The Islamic Bimaristan
Bimaristan
Bimaristan is a Persian word meaning hospital, with Bimar- from Middle Persian of vīmār or vemār, meaning "sick" plus -stan as location and place suffix...

 hospitals were an early example of public hospital
Public hospital
A public hospital or government hospital is a hospital which is owned by a government and receives government funding. This type of hospital provides medical care free of charge, the cost of which is covered by the funding the hospital receives....

s.

However, the fourteenth and fifteenth century Black Death
Black Death
The Black Death was one of the most devastating pandemics in human history, peaking in Europe between 1348 and 1350. Of several competing theories, the dominant explanation for the Black Death is the plague theory, which attributes the outbreak to the bacterium Yersinia pestis. Thought to have...

 was just as devastating to the Middle East as to Europe, and it has even been argued that Western Europe was generally more effective in recovering from the pandemic than the Middle East. In the early modern period, important early figures in medicine and anatomy emerged in Europe, including Gabriele Falloppio
Gabriele Falloppio
Gabriele Falloppio , often known by his Latin name Fallopius, was one of the most important anatomists and physicians of the sixteenth century....

 and William Harvey
William Harvey
William Harvey was an English physician who was the first person to describe completely and in detail the systemic circulation and properties of blood being pumped to the body by the heart...

.

The major shift in medical thinking was the gradual rejection, especially during the Black Death
Black Death
The Black Death was one of the most devastating pandemics in human history, peaking in Europe between 1348 and 1350. Of several competing theories, the dominant explanation for the Black Death is the plague theory, which attributes the outbreak to the bacterium Yersinia pestis. Thought to have...

 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
Nicolaus Copernicus
Nicolaus Copernicus was a Renaissance astronomer and the first person to formulate a comprehensive heliocentric cosmology which displaced the Earth from the center of the universe....

's rejection of Ptolemy
Ptolemy
Claudius Ptolemy , was a Roman citizen of Egypt who wrote in Greek. He was a mathematician, astronomer, geographer, astrologer, and poet of a single epigram in the Greek Anthology. He lived in Egypt under Roman rule, and is believed to have been born in the town of Ptolemais Hermiou in the...

's theories on astronomy). Physicians like Vesalius
Vesalius
Andreas Vesalius was a Flemish anatomist, physician, and author of one of the most influential books on human anatomy, De humani corporis fabrica . Vesalius is often referred to as the founder of modern human anatomy. Vesalius is the Latinized form of Andries van Wesel...

 improved upon or disproved some of the theories from the past.

Andreas Vesalius was an author of one of the most influential books on human anatomy
Human anatomy
Human anatomy is primarily the scientific study of the morphology of the human body. Anatomy is subdivided into gross anatomy and microscopic anatomy. Gross anatomy is the study of anatomical structures that can be seen by the naked eye...

, De humani corporis fabrica
De humani corporis fabrica
De humani corporis fabrica libri septem is a textbook of human anatomy written by Andreas Vesalius in 1543....

. French surgeon Ambroise Paré
Ambroise Paré
Ambroise Paré was a French surgeon. He was the great official royal surgeon for kings Henry II, Francis II, Charles IX and Henry III and is considered as one of the fathers of surgery and modern forensic pathology. He was a leader in surgical techniques and battlefield medicine, especially the...

 is considered as one of the fathers of surgery
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...

. Bacteria and microorganisms were first observed with a microscope by Antonie van Leeuwenhoek in 1676, initiating the scientific field microbiology
Microbiology
Microbiology is the study of microorganisms, which are defined as any microscopic organism that comprises either a single cell , cell clusters or no cell at all . This includes eukaryotes, such as fungi and protists, and prokaryotes...

. Partly based on the works by the Italian surgeon and anatomist Matteo Realdo Colombo the English physician William Harvey
William Harvey
William Harvey was an English physician who was the first person to describe completely and in detail the systemic circulation and properties of blood being pumped to the body by the heart...

 described the circulatory system
Circulatory system
The circulatory system is an organ system that passes nutrients , gases, hormones, blood cells, etc...

. Herman Boerhaave
Herman Boerhaave
Herman Boerhaave was a Dutch botanist, humanist and physician of European fame. He is regarded as the founder of clinical teaching and of the modern academic hospital. His main achievement was to demonstrate the relation of symptoms to lesions...

 is sometimes referred to as a "father of physiology" due to his exemplary teaching in Leiden and textbook 'Institutiones medicae' (1708). It is said that the 17th century French physician Pierre Fauchard
Pierre Fauchard
Pierre Fauchard was a significant French physician, credited as being the "father of modern dentistry". He is widely known for his book, Le chirurgien dentiste, "The Surgeon Dentist" 1728, where he described the basic oral anatomy and function, signs and symptoms of oral pathology, operative...

 started dentistry
Dentistry
Dentistry is the branch of medicine that is involved in the study, diagnosis, prevention, and treatment of diseases, disorders and conditions of the oral cavity, maxillofacial area and the adjacent and associated structures and their impact on the human body. Dentistry is widely considered...

 science as we know it today, and he has been named "the father of modern dentistry".

Veterinary medicine was for the first time truly separated from human medicine in 1761, when the french veterinarian Claude Bourgelat founded the world's first veterinary school in Lyon, France. Before this, medical doctors treated both humans and animals.

Modern scientific biomedical research
Biomedical research
Biomedical research , in general simply known as medical research, is the basic research, applied research, or translational research conducted to aid and support the body of knowledge in the field of medicine...

 (where results are testable and reproducible) began to replace early Western traditions based on herbalism, the Greek "four humours
Humorism
Humorism, or humoralism, is a now discredited theory of the makeup and workings of the human body, adopted by Greek and Roman physicians and philosophers, positing that an excess or deficiency of any of four distinct bodily fluids in a person directly influences their temperament and health...

" and other such pre-modern notions. The modern era really began with Edward Jenner
Edward Jenner
Edward Anthony Jenner was an English scientist who studied his natural surroundings in Berkeley, Gloucestershire...

's discovery of the smallpox vaccine
Smallpox vaccine
The smallpox vaccine was the first successful vaccine to be developed. The process of vaccination was discovered by Edward Jenner in 1796, who acted upon his observation that milkmaids who caught the cowpox virus did not catch smallpox...

 at the end of the 18th century (inspired by the method of inoculation
Inoculation
Inoculation is the placement of something that will grow or reproduce, and is most commonly used in respect of the introduction of a serum, vaccine, or antigenic substance into the body of a human or animal, especially to produce or boost immunity to a specific disease...

 earlier practiced in Asia), Robert Koch
Robert Koch
Heinrich Hermann Robert Koch was a German physician. He became famous for isolating Bacillus anthracis , the Tuberculosis bacillus and the Vibrio cholerae and for his development of Koch's postulates....

's discoveries around 1880 of the transmission of disease by bacteria, and then the discovery of antibiotic
Antibiotic
An antibacterial is a compound or substance that kills or slows down the growth of bacteria.The term is often used synonymously with the term antibiotic; today, however, with increased knowledge of the causative agents of various infectious diseases, antibiotic has come to denote a broader range of...

s around 1900.

The post-18th century modernity
Modernity
Modernity typically refers to a post-traditional, post-medieval historical period, one marked by the move from feudalism toward capitalism, industrialization, secularization, rationalization, the nation-state and its constituent institutions and forms of surveillance...

 period brought more groundbreaking researchers from Europe. From Germany
Germany
Germany , officially the Federal Republic of Germany , is a federal parliamentary republic in Europe. The country consists of 16 states while the capital and largest city is Berlin. Germany covers an area of 357,021 km2 and has a largely temperate seasonal climate...

 and Austria, doctors Rudolf Virchow
Rudolf Virchow
Rudolph Carl Virchow was a German doctor, anthropologist, pathologist, prehistorian, biologist and politician, known for his advancement of public health...

, Wilhelm Conrad Röntgen
Wilhelm Conrad Röntgen
Wilhelm Conrad Röntgen was a German physicist, who, on 8 November 1895, produced and detected electromagnetic radiation in a wavelength range today known as X-rays or Röntgen rays, an achievement that earned him the first Nobel Prize in Physics in 1901....

, Karl Landsteiner
Karl Landsteiner
Karl Landsteiner , was an Austrian-born American biologist and physician of Jewish origin. He is noted for having first distinguished the main blood groups in 1900, having developed the modern system of classification of blood groups from his identification of the presence of agglutinins in the...

 and Otto Loewi
Otto Loewi
Otto Loewi was a German born pharmacologist whose discovery of acetylcholine helped enhance medical therapy. The discovery earned for him the Nobel Prize in Physiology or Medicine in 1936 which he shared with Sir Henry Dale, whom he met in 1902 when spending some months in Ernest Starling's...

 made notable contributions. In the United Kingdom, Alexander Fleming
Alexander Fleming
Sir Alexander Fleming was a Scottish biologist and pharmacologist. He wrote many articles on bacteriology, immunology, and chemotherapy...

, Joseph Lister
Joseph Lister, 1st Baron Lister
Joseph Lister, 1st Baron Lister OM, FRS, PC , known as Sir Joseph Lister, Bt., between 1883 and 1897, was a British surgeon and a pioneer of antiseptic surgery, who promoted the idea of sterile surgery while working at the Glasgow Royal Infirmary...

, Francis Crick
Francis Crick
Francis Harry Compton Crick OM FRS was an English molecular biologist, biophysicist, and neuroscientist, and most noted for being one of two co-discoverers of the structure of the DNA molecule in 1953, together with James D. Watson...

 and Florence Nightingale
Florence Nightingale
Florence Nightingale OM, RRC was a celebrated English nurse, writer and statistician. She came to prominence for her pioneering work in nursing during the Crimean War, where she tended to wounded soldiers. She was dubbed "The Lady with the Lamp" after her habit of making rounds at night...

 are considered important. Spanish
Spain
Spain , officially the Kingdom of Spain languages]] under the European Charter for Regional or Minority Languages. In each of these, Spain's official name is as follows:;;;;;;), is a country and member state of the European Union located in southwestern Europe on the Iberian Peninsula...

 doctor Santiago Ramón y Cajal
Santiago Ramón y Cajal
Santiago Ramón y Cajal ForMemRS was a Spanish pathologist, histologist, neuroscientist, and Nobel laureate. His pioneering investigations of the microscopic structure of the brain were original: he is considered by many to be the father of modern neuroscience...

 is considered the father of modern neuroscience
Neuroscience
Neuroscience is the scientific study of the nervous system. Traditionally, neuroscience has been seen as a branch of biology. However, it is currently an interdisciplinary science that collaborates with other fields such as chemistry, computer science, engineering, linguistics, mathematics,...

.

From New Zealand and Australia came Maurice Wilkins
Maurice Wilkins
Maurice Hugh Frederick Wilkins CBE FRS was a New Zealand-born English physicist and molecular biologist, and Nobel Laureate whose research contributed to the scientific understanding of phosphorescence, isotope separation, optical microscopy and X-ray diffraction, and to the development of radar...

, Howard Florey, and Frank Macfarlane Burnet
Frank Macfarlane Burnet
Sir Frank Macfarlane Burnet, , usually known as Macfarlane or Mac Burnet, was an Australian virologist best known for his contributions to immunology....

.

In the United States, William Williams Keen
William Williams Keen
William Williams Keen was the first brain surgeon in the United States. He also saw Franklin Delano Roosevelt when his paralytic illness struck, and worked closely with six American presidents.-Biography:...

, William Coley
William Coley
William Bradley Coley was an American bone surgeon and cancer researcher, pioneer of cancer immunotherapy. He developed a treatment based on provoking an immune response to bacteria...

, James D. Watson
James D. Watson
James Dewey Watson is an American molecular biologist, geneticist, and zoologist, best known as one of the co-discoverers of the structure of DNA in 1953 with Francis Crick...

, Italy (Salvador Luria), Switzerland (Alexandre Yersin
Alexandre Yersin
Alexandre Emile Jean Yersin was a Swiss and French physician and bacteriologist. He is remembered as the co-discoverer of the bacillus responsible for the bubonic plague or pest, which was later re-named in his honour .Yersin was born in 1863 in Aubonne, Canton of Vaud, Switzerland, to a family...

), Japan (Kitasato Shibasaburō
Kitasato Shibasaburō
Baron was a Japanese physician and bacteriologist. He is remembered as the co-discoverer of the infectious agent of bubonic plague in Hong Kong in 1894, almost simultaneously with Alexandre Yersin.-Biography:...

), and France (Jean-Martin Charcot
Jean-Martin Charcot
Jean-Martin Charcot was a French neurologist and professor of anatomical pathology. He is known as "the founder of modern neurology" and is "associated with at least 15 medical eponyms", including Charcot-Marie-Tooth disease and amyotrophic lateral sclerosis...

, Claude Bernard
Claude Bernard
Claude Bernard was a French physiologist. He was the first to define the term milieu intérieur . Historian of science I. Bernard Cohen of Harvard University called Bernard "one of the greatest of all men of science"...

, Paul Broca
Paul Broca
Pierre Paul Broca was a French physician, surgeon, anatomist, and anthropologist. He was born in Sainte-Foy-la-Grande, Gironde. He is best known for his research on Broca's area, a region of the frontal lobe that has been named after him. Broca’s Area is responsible for articulated language...

 and others did significant work). Russian Nikolai Korotkov
Nikolai Korotkov
Nikolai Sergeyevich Korotkov was a Russian surgeon, a pioneer of 20th century vascular surgery, and the inventor of auscultatory technique for blood pressure measurement.-Associated eponyms:...

 also did significant work, as did Sir William Osler
William Osler
Sir William Osler, 1st Baronet was a physician. He was one of the "Big Four" founding professors at Johns Hopkins Hospital as the first Professor of Medicine and founder of the Medical Service there. Sir William Osler, 1st Baronet (July 12, 1849 – December 29, 1919) was a physician. He was...

 and Harvey Cushing
Harvey Cushing
Harvey Williams Cushing, M.D. , was an American neurosurgeon and a pioneer of brain surgery, and the first to describe Cushing's syndrome...

.

As science and technology developed, medicine became more reliant upon medication
Medication
A pharmaceutical drug, also referred to as medicine, medication or medicament, can be loosely defined as any chemical substance intended for use in the medical diagnosis, cure, treatment, or prevention of disease.- Classification :...

s. Throughout history and in Europe right until the late 18th century, not only animal and plant products were used as medicine, but also human body parts and fluids. Pharmacology
Pharmacology
Pharmacology is the branch of medicine and biology concerned with the study of drug action. More specifically, it is the study of the interactions that occur between a living organism and chemicals that affect normal or abnormal biochemical function...

 developed from herbalism
Herbalism
Herbalism is a traditional medicinal or folk medicine practice based on the use of plants and plant extracts. Herbalism is also known as botanical medicine, medical herbalism, herbal medicine, herbology, herblore, and phytotherapy...

 and many drugs are still derived from plants (atropine, ephedrine, warfarin, aspirin
Aspirin
Aspirin , also known as acetylsalicylic acid , is a salicylate drug, often used as an analgesic to relieve minor aches and pains, as an antipyretic to reduce fever, and as an anti-inflammatory medication. It was discovered by Arthur Eichengrun, a chemist with the German company Bayer...

, digoxin, vinca alkaloids, taxol, hyoscine, etc.). Vaccine
Vaccine
A vaccine is a biological preparation that improves immunity to a particular disease. A vaccine typically contains an agent that resembles a disease-causing microorganism, and is often made from weakened or killed forms of the microbe or its toxins...

s were discovered by Edward Jenner
Edward Jenner
Edward Anthony Jenner was an English scientist who studied his natural surroundings in Berkeley, Gloucestershire...

 and Louis Pasteur
Louis Pasteur
Louis Pasteur was a French chemist and microbiologist born in Dole. He is remembered for his remarkable breakthroughs in the causes and preventions of diseases. His discoveries reduced mortality from puerperal fever, and he created the first vaccine for rabies and anthrax. His experiments...

.

The first antibiotic was arsphenamine
Arsphenamine
Arsphenamine, also known as Salvarsan and 606, is a drug that was used beginning in the 1910s to treat syphilis and trypanosomiasis...

 / Salvarsan discovered by Paul Ehrlich
Paul Ehrlich
Paul Ehrlich was a German scientist in the fields of hematology, immunology, and chemotherapy, and Nobel laureate. He is noted for curing syphilis and for his research in autoimmunity, calling it "horror autotoxicus"...

 in 1908 after he observed that bacteria took up toxic dyes that human cells did not. The first major class of antibiotic
Antibiotic
An antibacterial is a compound or substance that kills or slows down the growth of bacteria.The term is often used synonymously with the term antibiotic; today, however, with increased knowledge of the causative agents of various infectious diseases, antibiotic has come to denote a broader range of...

s was the sulfa
Sulfonamide (medicine)
Sulfonamide or sulphonamide is the basis of several groups of drugs. The original antibacterial sulfonamides are synthetic antimicrobial agents that contain the sulfonamide group. Some sulfonamides are also devoid of antibacterial activity, e.g., the anticonvulsant sultiame...

 drugs, derived by French chemists originally from azo
Azo compound
Azo compounds are compounds bearing the functional group R-N=N-R', in which R and R' can be either aryl or alkyl. IUPAC defines azo compounds as: "Derivatives of diazene , HN=NH, wherein both hydrogens are substituted by hydrocarbyl groups, e.g. PhN=NPh azobenzene or diphenyldiazene." The more...

 dyes.

Pharmacology has become increasingly sophisticated; modern biotechnology
Biotechnology
Biotechnology is a field of applied biology that involves the use of living organisms and bioprocesses in engineering, technology, medicine and other fields requiring bioproducts. Biotechnology also utilizes these products for manufacturing purpose...

 allows drugs targeted towards specific physiological processes to be developed, sometimes designed for compatibility with the body to reduce side-effects
Side effect
In medicine, a side effect is an effect, whether therapeutic or adverse, that is secondary to the one intended; although the term is predominantly employed to describe adverse effects, it can also apply to beneficial, but unintended, consequences of the use of a drug.Occasionally, drugs are...

. Genomics
Genomics
Genomics is a discipline in genetics concerning the study of the genomes of organisms. The field includes intensive efforts to determine the entire DNA sequence of organisms and fine-scale genetic mapping efforts. The field also includes studies of intragenomic phenomena such as heterosis,...

 and knowledge of human genetics
Human genetics
Human genetics describes the study of inheritance as it occurs in human beings. Human genetics encompasses a variety of overlapping fields including: classical genetics, cytogenetics, molecular genetics, biochemical genetics, genomics, population genetics, developmental genetics, clinical genetics,...

 is having some influence on medicine, as the causative gene
Gene
A gene is a molecular unit of heredity of a living organism. It is a name given to some stretches of DNA and RNA that code for a type of protein or for an RNA chain that has a function in the organism. Living beings depend on genes, as they specify all proteins and functional RNA chains...

s of most monogenic genetic disorder
Genetic disorder
A genetic disorder is an illness caused by abnormalities in genes or chromosomes, especially a condition that is present from before birth. Most genetic disorders are quite rare and affect one person in every several thousands or millions....

s have now been identified, and the development of techniques in molecular biology
Molecular biology
Molecular biology is the branch of biology that deals with the molecular basis of biological activity. This field overlaps with other areas of biology and chemistry, particularly genetics and biochemistry...

 and genetics are influencing medical technology, practice and decision-making.

Evidence-based medicine
Evidence-based medicine
Evidence-based medicine or evidence-based practice aims to apply the best available evidence gained from the scientific method to clinical decision making. It seeks to assess the strength of evidence of the risks and benefits of treatments and diagnostic tests...

 is a contemporary movement to establish the most effective algorithms of practice (ways of doing things) through the use of systematic review
Systematic review
A systematic review is a literature review focused on a research question that tries to identify, appraise, select and synthesize all high quality research evidence relevant to that question. Systematic reviews of high-quality randomized controlled trials are crucial to evidence-based medicine...

s and meta-analysis
Meta-analysis
In statistics, a meta-analysis combines the results of several studies that address a set of related research hypotheses. In its simplest form, this is normally by identification of a common measure of effect size, for which a weighted average might be the output of a meta-analyses. Here the...

. The movement is facilitated by modern global information science
Information science
-Introduction:Information science is an interdisciplinary science primarily concerned with the analysis, collection, classification, manipulation, storage, retrieval and dissemination of information...

, which allows as much of the available evidence as possible to be collected and analyzed according to standard protocols that are then disseminated to healthcare providers. The Cochrane Collaboration
Cochrane Collaboration
The Cochrane Collaboration is a group of over 28,000 volunteers in more than 100 countries who review the effects of health care interventions tested in biomedical randomized controlled trials. A few more recent reviews have also studied the results of non-randomized, observational studies...

 leads this movement. A 2001 review of 160 Cochrane systematic reviews revealed that, according to two readers, 21.3% of the reviews concluded insufficient evidence, 20% concluded evidence of no effect, and 22.5% concluded positive effect.

Clinical practice


In clinical practice, doctors personally assess patients in order to diagnose
Medical diagnosis
Medical diagnosis refers both to the process of attempting to determine or identify a possible disease or disorder , and to the opinion reached by this process...

, treat, and prevent disease using clinical judgment. The doctor-patient relationship
Doctor-patient relationship
The doctor-patient relationship is central to the practice of healthcare and is essential for the delivery of high-quality health care in the diagnosis and treatment of disease. The doctor-patient relationship forms one of the foundations of contemporary medical ethics...

 typically begins an interaction with an examination of the patient's medical history
Medical history
The medical history or anamnesis of a patient is information gained by a physician by asking specific questions, either of the patient or of other people who know the person and can give suitable information , with the aim of obtaining information useful in formulating a diagnosis and providing...

 and medical record
Medical record
The terms medical record, health record, and medical chart are used somewhat interchangeably to describe the systematic documentation of a single patient's medical history and care across time within one particular health care provider's jurisdiction....

, followed a medical interview and a physical examination
Physical examination
Physical examination or clinical examination is the process by which a doctor investigates the body of a patient for signs of disease. It generally follows the taking of the medical history — an account of the symptoms as experienced by the patient...

. Basic diagnostic medical device
Medical device
A medical device is a product which is used for medical purposes in patients, in diagnosis, therapy or surgery . Whereas medicinal products achieve their principal action by pharmacological, metabolic or immunological means. Medical devices act by other means like physical, mechanical, thermal,...

s (e.g. stethoscope
Stethoscope
The stethoscope is an acoustic medical device for auscultation, or listening to the internal sounds of an animal body. It is often used to listen to lung and heart sounds. It is also used to listen to intestines and blood flow in arteries and veins...

, tongue depressor
Tongue depressor
A tongue depressor is a device used in medical practice to depress the tongue to allow for examination of the mouth and throat. The most common modern tongue depressors have thin wooden blade, smoothed and rounded at both ends, but historically tongue depressors have been made of a variety of...

) are typically used. After examination for signs and interviewing for symptoms, the doctor may order medical test
Medical test
A diagnostic test is any kind of medical test performed to aid in the diagnosis or detection of disease. For example:* to diagnose diseases, and preferably sub-classify it regarding, for example, severity and treatability...

s (e.g. blood test
Blood test
A blood test is a laboratory analysis performed on a blood sample that is usually extracted from a vein in the arm using a needle, or via fingerprick....

s), take a biopsy
Biopsy
A biopsy is a medical test involving sampling of cells or tissues for examination. It is the medical removal of tissue from a living subject to determine the presence or extent of a disease. The tissue is generally examined under a microscope by a pathologist, and can also be analyzed chemically...

, or prescribe pharmaceutical drugs or other therapies. Differential diagnosis
Differential diagnosis
A differential diagnosis is a systematic diagnostic method used to identify the presence of an entity where multiple alternatives are possible , and may also refer to any of the included candidate alternatives A differential diagnosis (sometimes abbreviated DDx, ddx, DD, D/Dx, or ΔΔ) is a...

 methods help to rule out conditions based on the information provided. During the encounter, properly informing the patient of all relevant facts is an important part of the relationship and the development of trust. The medical encounter is then documented in the medical record, which is a legal document in many jurisdictions. Followups may be shorter but follow the same general procedure.

The components of the medical interview and encounter are:
  • Chief complaint (cc): the reason for the current medical visit. These are the 'symptoms.' They are in the patient's own words and are recorded along with the duration of each one. Also called 'presenting complaint.'
  • History of present illness / complaint (HPI): the chronological order of events of symptoms and further clarification of each symptom.
  • Current activity: occupation, hobbies, what the patient actually does.
  • Medication
    Medication
    A pharmaceutical drug, also referred to as medicine, medication or medicament, can be loosely defined as any chemical substance intended for use in the medical diagnosis, cure, treatment, or prevention of disease.- Classification :...

    s (Rx): what drugs the patient takes including prescribed, over-the-counter
    Over-the-counter drug
    Over-the-counter drugs are medicines that may be sold directly to a consumer without a prescription from a healthcare professional, as compared to prescription drugs, which may be sold only to consumers possessing a valid prescription...

    , and home remedies
    Home remedy
    A home remedy is a treatment to cure a disease or ailment that employs certain spices, vegetables, or other common items. Home remedies may or may not have medicinal properties that treat or cure the disease or ailment in question, as they are typically passed along by laypersons...

    , as well as alternative and herbal medicines/herbal remedies
    Herbalism
    Herbalism is a traditional medicinal or folk medicine practice based on the use of plants and plant extracts. Herbalism is also known as botanical medicine, medical herbalism, herbal medicine, herbology, herblore, and phytotherapy...

    . Allergies
    Allergy
    An Allergy is a hypersensitivity disorder of the immune system. Allergic reactions occur when a person's immune system reacts to normally harmless substances in the environment. A substance that causes a reaction is called an allergen. These reactions are acquired, predictable, and rapid...

     are also recorded.
  • Past medical history (PMH/PMHx): concurrent medical problems, past hospitalizations and operations, injuries, past infectious disease
    Infectious disease
    Infectious diseases, also known as communicable diseases, contagious diseases or transmissible diseases comprise clinically evident illness resulting from the infection, presence and growth of pathogenic biological agents in an individual host organism...

    s and/or vaccination
    Vaccination
    Vaccination is the administration of antigenic material to stimulate the immune system of an individual to develop adaptive immunity to a disease. Vaccines can prevent or ameliorate the effects of infection by many pathogens...

    s, history of known allergies.
  • Social history (SH): birthplace, residences, marital history, social and economic status, habits (including diet
    Diet (nutrition)
    In nutrition, diet is the sum of food consumed by a person or other organism. Dietary habits are the habitual decisions an individual or culture makes when choosing what foods to eat. With the word diet, it is often implied the use of specific intake of nutrition for health or weight-management...

    , medications, tobacco
    Tobacco smoking
    Tobacco smoking is the practice where tobacco is burned and the resulting smoke is inhaled. The practice may have begun as early as 5000–3000 BCE. Tobacco was introduced to Eurasia in the late 16th century where it followed common trade routes...

    , alcohol).
  • Family history
    Family history (medicine)
    In medicine, a family history consists of information about disorders from which the direct blood relatives of the patient have suffered. Genealogy typically includes very little of the medical history of the family, but the medical history could be considered a specific subset of the total history...

     (FH): listing of diseases in the family that may impact the patient. A family tree
    Family tree
    A family tree, or pedigree chart, is a chart representing family relationships in a conventional tree structure. The more detailed family trees used in medicine, genealogy, and social work are known as genograms.-Family tree representations:...

     is sometimes used.

  • Review of systems (ROS) or systems inquiry: a set of additional questions to ask, which may be missed on HPI: a general enquiry (have you noticed any weight loss
    Weight loss
    Weight loss, in the context of medicine, health or physical fitness, is a reduction of the total body mass, due to a mean loss of fluid, body fat or adipose tissue and/or lean mass, namely bone mineral deposits, muscle, tendon and other connective tissue...

    , change in sleep quality, fevers, lumps and bumps? etc.), followed by questions on the body's main organ systems (heart
    Human heart
    The human heart is a muscular organ that provides a continuous blood circulation through the cardiac cycle and is one of the most vital organs in the human body...

    , lung
    Human lung
    The human lungs are the organs of respiration in humans. Humans have two lungs, with the left being divided into two lobes and the right into three lobes. Together, the lungs contain approximately of airways and 300 to 500 million alveoli, having a total surface area of about in...

    s, digestive tract
    Gastrointestinal tract
    The human gastrointestinal tract refers to the stomach and intestine, and sometimes to all the structures from the mouth to the anus. ....

    , urinary tract
    Urinary system
    The urinary system is the organ system that produces, stores, and eliminates urine. In humans it includes two kidneys, two ureters, the bladder and the urethra.-Kidney:...

    , etc.).


The physical examination
Physical examination
Physical examination or clinical examination is the process by which a doctor investigates the body of a patient for signs of disease. It generally follows the taking of the medical history — an account of the symptoms as experienced by the patient...

 is the examination of the patient looking for signs of disease ('Symptoms' are what the patient volunteers, 'Signs' are what the healthcare provider detects by examination). The healthcare provider uses the senses of sight, hearing, touch, and sometimes smell (e.g., in infection, uremia
Uremia
Uremia or uraemia is a term used to loosely describe the illness accompanying kidney failure , in particular the nitrogenous waste products associated with the failure of this organ....

, diabetic ketoacidosis
Diabetic ketoacidosis
Diabetic ketoacidosis is a potentially life-threatening complication in patients with diabetes mellitus. It happens predominantly in those with type 1 diabetes, but it can occur in those with type 2 diabetes under certain circumstances...

). Taste has been made redundant by the availability of modern lab tests. Four actions are taught as the basis of physical examination: inspection
Inspection (medicine)
In medicine, inspection is the thorough and unhurried visualization of the client. This requires the use of the naked eye.During inspection, the examiner observes:External signs:...

, palpation
Palpation
Palpation is used as part of a physical examination in which an object is felt to determine its size, shape, firmness, or location...

 (feel), percussion
Percussion (medicine)
Percussion is a method of tapping on a surface to determine the underlying structure, and is used in clinical examinations to assess the condition of the thorax or abdomen. It is one of the four methods of clinical examination, together with inspection, palpation and auscultation...

 (tap to determine resonance characteristics), and auscultation
Auscultation
Auscultation is the term for listening to the internal sounds of the body, usually using a stethoscope...

 (listen). This order may be modified depending on the main focus of the examination (e.g., a joint may be examined by simply "look, feel, move". Having this set order is an educational tool that encourages practitioners to be systematic in their approach and refrain from using tools such as the stethoscope
Stethoscope
The stethoscope is an acoustic medical device for auscultation, or listening to the internal sounds of an animal body. It is often used to listen to lung and heart sounds. It is also used to listen to intestines and blood flow in arteries and veins...

 before they have fully evaluated the other modalities.

The clinical examination involves study of:
  • Vital signs including height, weight, body temperature, blood pressure
    Blood pressure
    Blood pressure is the pressure exerted by circulating blood upon the walls of blood vessels, and is one of the principal vital signs. When used without further specification, "blood pressure" usually refers to the arterial pressure of the systemic circulation. During each heartbeat, BP varies...

    , pulse
    Pulse
    In medicine, one's pulse represents the tactile arterial palpation of the heartbeat by trained fingertips. The pulse may be palpated in any place that allows an artery to be compressed against a bone, such as at the neck , at the wrist , behind the knee , on the inside of the elbow , and near the...

    , respiration rate, hemoglobin oxygen saturation
    Oxygen saturation
    Oxygen saturation or dissolved oxygen is a relative measure of the amount of oxygen that is dissolved or carried in a given medium. It can be measured with a dissolved oxygen probe such as an oxygen sensor or an optode in liquid media, usually water.It has particular significance in medicine and...

  • General appearance of the patient and specific indicators of disease (nutritional status, presence of jaundice, pallor or clubbing)
  • Skin
    Human skin
    The human skin is the outer covering of the body. In humans, it is the largest organ of the integumentary system. The skin has multiple layers of ectodermal tissue and guards the underlying muscles, bones, ligaments and internal organs. Human skin is similar to that of most other mammals,...

  • Head, eye, ear
    Ear
    The ear is the organ that detects sound. It not only receives sound, but also aids in balance and body position. The ear is part of the auditory system....

    , nose, and throat (HEENT)
  • Cardiovascular (heart
    Heart
    The heart is a myogenic muscular organ found in all animals with a circulatory system , that is responsible for pumping blood throughout the blood vessels by repeated, rhythmic contractions...

     and blood vessel
    Blood vessel
    The blood vessels are the part of the circulatory system that transports blood throughout the body. There are three major types of blood vessels: the arteries, which carry the blood away from the heart; the capillaries, which enable the actual exchange of water and chemicals between the blood and...

    s)
  • Respiratory (large airways and lungs)
  • Abdomen
    Abdomen
    In vertebrates such as mammals the abdomen constitutes the part of the body between the thorax and pelvis. The region enclosed by the abdomen is termed the abdominal cavity...

     and rectum
    Rectum
    The rectum is the final straight portion of the large intestine in some mammals, and the gut in others, terminating in the anus. The human rectum is about 12 cm long...

  • Genitalia (and pregnancy if the patient is or could be pregnant)
  • Musculoskeletal (including spine and extremities)
  • Neurological (consciousness, awareness, brain, vision, cranial nerves
    Cranial nerves
    Cranial nerves are nerves that emerge directly from the brain, in contrast to spinal nerves, which emerge from segments of the spinal cord. In humans, there are traditionally twelve pairs of cranial nerves...

    , spinal cord and peripheral nerves
    Peripheral nervous system
    The peripheral nervous system consists of the nerves and ganglia outside of the brain and spinal cord. The main function of the PNS is to connect the central nervous system to the limbs and organs. Unlike the CNS, the PNS is not protected by the bone of spine and skull, or by the blood–brain...

    )
  • Psychiatric (orientation, mental state, evidence of abnormal perception or thought).


It is to likely focus on areas of interest highlighted in the medical history and may not include everything listed above.

Laboratory
Medical laboratory
A medical laboratory or clinical laboratory is a laboratory where tests are done on clinical specimens in order to get information about the health of a patient as pertaining to the diagnosis, treatment, and prevention of disease.-Departments:...

 and imaging studies
Medical imaging
Medical imaging is the technique and process used to create images of the human body for clinical purposes or medical science...

 results may be obtained, if necessary.

The medical decision-making (MDM) process involves analysis and synthesis of all the above data to come up with a list of possible diagnoses (the differential diagnoses
Differential diagnosis
A differential diagnosis is a systematic diagnostic method used to identify the presence of an entity where multiple alternatives are possible , and may also refer to any of the included candidate alternatives A differential diagnosis (sometimes abbreviated DDx, ddx, DD, D/Dx, or ΔΔ) is a...

), along with an idea of what needs to be done to obtain a definitive diagnosis that would explain the patient's problem.

The treatment plan may include ordering additional laboratory tests and studies, starting therapy, referral to a specialist, or watchful observation. Follow-up may be advised.

This process is used by primary care providers as well as specialists. It may take only a few minutes if the problem is simple and straightforward. On the other hand, it may take weeks in a patient who has been hospitalized with bizarre symptoms or multi-system problems, with involvement by several specialists.

On subsequent visits, the process may be repeated in an abbreviated manner to obtain any new history, symptoms, physical findings, and lab or imaging results or specialist consultations.

Institutions


Contemporary medicine is in general conducted within health care system
Health care system
A health care system is the organization of people, institutions, and resources to deliver health care services to meet the health needs of target populations....

s. Legal, credential
Credential
A credential is an attestation of qualification, competence, or authority issued to an individual by a third party with a relevant or de facto authority or assumed competence to do so....

ing and financing frameworks are established by individual governments, augmented on occasion by international organizations. The characteristics of any given health care system have significant impact on the way medical care is provided.

Advanced industrial countries (with the exception of the United States) and many developing countries
Developing country
A developing country, also known as a less-developed country, is a nation with a low level of material well-being. Since no single definition of the term developing country is recognized internationally, the levels of development may vary widely within so-called developing countries...

 provide medical services through a system of universal health care
Universal health care
Universal health care is a term referring to organized health care systems built around the principle of universal coverage for all members of society, combining mechanisms for health financing and service provision.-History:...

 that aims to guarantee care for all through a single-payer health care
Single-payer health care
Single-payer health care is medical care funded from a single insurance pool, run by the state. Under a single-payer system, universal health care for an entire population can be financed from a pool to which many parties employees, employers, and the state have contributed...

 system, or compulsory private or co-operative health insurance
Health insurance
Health insurance is insurance against the risk of incurring medical expenses among individuals. By estimating the overall risk of health care expenses among a targeted group, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to ensure that money is...

. This is intended to ensure that the entire population has access to medical care on the basis of need rather than ability to pay. Delivery may be via private medical practices or by state-owned hospitals and clinics, or by charities, most commonly by a combination of all three.

Most tribal
Tribe
A tribe, viewed historically or developmentally, consists of a social group existing before the development of, or outside of, states.Many anthropologists use the term tribal society to refer to societies organized largely on the basis of kinship, especially corporate descent groups .Some theorists...

 societies, but also some capitalist countries and the United States, provide no guarantee of healthcare for the population as a whole. In such societies, healthcare is available to those that can afford to pay for it or have self-insured it (either directly or as part of an employment contract) or who may be covered by care financed by the government or tribe directly.

Transparency of information is another factor defining a delivery system. Access to information on conditions, treatments, quality, and pricing greatly affects the choice by patients/consumers and, therefore, the incentives of medical professionals. While the US healthcare system has come under fire for lack of openness, new legislation may encourage greater openness. There is a perceived tension between the need for transparency on the one hand and such issues as patient confidentiality and the possible exploitation of information for commercial gain on the other.

Delivery


Provision of medical care is classified into primary, secondary, and tertiary care categories.

Primary care
Primary care
Primary care is the term for the health services by providers who act as the principal point of consultation for patients within a health care system...

 medical services are provided by physicians, physician assistants, nurse practitioners, or other health professionals who have first contact with a patient seeking medical treatment or care. These occur in physician offices, clinic
Clinic
A clinic is a health care facility that is primarily devoted to the care of outpatients...

s, nursing home
Nursing home
A nursing home, convalescent home, skilled nursing unit , care home, rest home, or old people's home provides a type of care of residents: it is a place of residence for people who require constant nursing care and have significant deficiencies with activities of daily living...

s, schools, home visits, and other places close to patients. About 90% of medical visits can be treated by the primary care provider. These include treatment of acute and chronic illnesses, preventive care and health education
Health education
Health education is the profession of educating people about health. Areas within this profession encompass environmental health, physical health, social health, emotional health, intellectual health, and spiritual health...

 for all ages and both sexes.

Secondary care medical services are provided by medical specialists in their offices or clinics or at local community hospitals for a patient referred by a primary care provider who first diagnosed or treated the patient. Referrals are made for those patients who required the expertise or procedures performed by specialists. These include both ambulatory care
Ambulatory care
Ambulatory care is a personal health care consultation, treatment or intervention using advanced medical technology or procedures delivered on an outpatient basis Ambulatory care is a personal health care consultation, treatment or intervention using advanced medical technology or procedures...

 and inpatient services, emergency room
Emergency department
An emergency department , also known as accident & emergency , emergency room , emergency ward , or casualty department is a medical treatment facility specialising in acute care of patients who present without prior appointment, either by their own means or by ambulance...

s, intensive care medicine
Intensive care medicine
Intensive-care medicine or critical-care medicine is a branch of medicine concerned with the diagnosis and management of life threatening conditions requiring sophisticated organ support and invasive monitoring.- Overview :...

, surgery services, physical therapy
Physical therapy
Physical therapy , often abbreviated PT, is a health care profession. Physical therapy is concerned with identifying and maximizing quality of life and movement potential within the spheres of promotion, prevention, diagnosis, treatment/intervention,and rehabilitation...

, labor and delivery
Childbirth
Childbirth is the culmination of a human pregnancy or gestation period with the birth of one or more newborn infants from a woman's uterus...

, endoscopy
Endoscopy
Endoscopy means looking inside and typically refers to looking inside the body for medical reasons using an endoscope , an instrument used to examine the interior of a hollow organ or cavity of the body. Unlike most other medical imaging devices, endoscopes are inserted directly into the organ...

 units, diagnostic laboratory
Medical laboratory
A medical laboratory or clinical laboratory is a laboratory where tests are done on clinical specimens in order to get information about the health of a patient as pertaining to the diagnosis, treatment, and prevention of disease.-Departments:...

 and medical imaging
Medical imaging
Medical imaging is the technique and process used to create images of the human body for clinical purposes or medical science...

 services, hospice centers, etc. Some primary care providers may also take care of hospitalized patients and deliver babies in a secondary care setting.

Tertiary care medical services are provided by specialist hospitals or regional centers equipped with diagnostic and treatment facilities not generally available at local hospitals. These include trauma center
Trauma center
A trauma center is a hospital equipped to provide comprehensive emergency medical services to patients suffering traumatic injuries. Trauma centers grew into existence out of the realization that traumatic injury is a disease process unto itself requiring specialized and experienced...

s, burn
Burn (injury)
A burn is a type of injury to flesh caused by heat, electricity, chemicals, light, radiation or friction. Most burns affect only the skin . Rarely, deeper tissues, such as muscle, bone, and blood vessels can also be injured...

 treatment centers, advanced neonatology
Neonatology
Neonatology is a subspecialty of pediatrics that consists of the medical care of newborn infants, especially the ill or premature newborn infant. It is a hospital-based specialty, and is usually practiced in neonatal intensive care units...

 unit services, organ transplant
Organ transplant
Organ transplantation is the moving of an organ from one body to another or from a donor site on the patient's own body, for the purpose of replacing the recipient's damaged or absent organ. The emerging field of regenerative medicine is allowing scientists and engineers to create organs to be...

s, high-risk pregnancy, radiation
Radiation therapy
Radiation therapy , radiation oncology, or radiotherapy , sometimes abbreviated to XRT or DXT, is the medical use of ionizing radiation, generally as part of cancer treatment to control malignant cells.Radiation therapy is commonly applied to the cancerous tumor because of its ability to control...

 oncology
Oncology
Oncology is a branch of medicine that deals with cancer...

, etc.

Modern medical care also depends on information – still delivered in many health care settings on paper records, but increasingly nowadays by electronic means.

Branches


Working together as an interdisciplinary team, many highly trained health profession
Health profession
The health care industry, or medical industry, is the sector of the economic system that provides goods and services to treat patients with curative, preventive, rehabilitative, palliative, or, at times, unnecessary care...

als besides medical practitioners are involved in the delivery of modern health care. Examples include: nurses, emergency medical technician
Emergency medical technician
Emergency Medical Technician or Ambulance Technician are terms used in some countries to denote a healthcare provider of emergency medical services...

s and paramedics, laboratory scientists, pharmacists, physiotherapists, respiratory therapists, speech therapists, occupational therapists
Occupational therapy
Occupational therapy is a discipline that aims to promote health by enabling people to perform meaningful and purposeful activities. Occupational therapists work with individuals who suffer from a mentally, physically, developmentally, and/or emotionally disabling condition by utilizing treatments...

, radiographers, dietitian
Dietitian
Dietitians supervise the preparation and service of food, develop modified diets, participate in research, and educate individuals and groups on good nutritional habits. The goals of dietitians are to provide medical nutritional intervention, and to obtain, safely prepare, serve and advise on...

s, and bioengineers.

The scope and sciences underpinning human medicine overlap many other fields. Dentistry
Dentistry
Dentistry is the branch of medicine that is involved in the study, diagnosis, prevention, and treatment of diseases, disorders and conditions of the oral cavity, maxillofacial area and the adjacent and associated structures and their impact on the human body. Dentistry is widely considered...

, while a separate discipline from medicine, is considered a medical field.

A patient admitted to hospital is usually under the care of a specific team based on their main presenting problem, e.g., the Cardiology team, who then may interact with other specialties, e.g., surgical, radiology, to help diagnose or treat the main problem or any subsequent complications/developments.

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.

The main branches of medicine are:
  • Basic sciences of medicine; this is what every physician is educated in, and some return to in biomedical research.
  • Medical specialties
  • Interdisciplinary fields, where different medical specialties are mixed to function in certain occasions.

Basic sciences

  • Anatomy
    Anatomy
    Anatomy is a branch of biology and medicine that is the consideration of the structure of living things. It is a general term that includes human anatomy, animal anatomy , and plant anatomy...

     is the study of the physical structure of organism
    Organism
    In biology, an organism is any contiguous living system . In at least some form, all organisms are capable of response to stimuli, reproduction, growth and development, and maintenance of homoeostasis as a stable whole.An organism may either be unicellular or, as in the case of humans, comprise...

    s. In contrast to macroscopic or gross anatomy, cytology and histology are concerned with microscopic structures.
  • Biochemistry
    Biochemistry
    Biochemistry, sometimes called biological chemistry, is the study of chemical processes in living organisms, including, but not limited to, living matter. Biochemistry governs all living organisms and living processes...

     is the study of the chemistry taking place in living organisms, especially the structure and function of their chemical components.
  • Biomechanics
    Biomechanics
    Biomechanics is the application of mechanical principles to biological systems, such as humans, animals, plants, organs, and cells. Perhaps one of the best definitions was provided by Herbert Hatze in 1974: "Biomechanics is the study of the structure and function of biological systems by means of...

     is the study of the structure and function of biological systems by means of the methods of Mechanics
    Mechanics
    Mechanics is the branch of physics concerned with the behavior of physical bodies when subjected to forces or displacements, and the subsequent effects of the bodies on their environment....

    .
  • Biostatistics
    Biostatistics
    Biostatistics is the application of statistics to a wide range of topics in biology...

     is the application of statistics to biological fields in the broadest sense. A knowledge of biostatistics is essential in the planning, evaluation, and interpretation of medical research. It is also fundamental to epidemiology
    Epidemiology
    Epidemiology is the study of health-event, health-characteristic, or health-determinant patterns in a population. It is the cornerstone method of public health research, and helps inform policy decisions and evidence-based medicine by identifying risk factors for disease and targets for preventive...

     and evidence-based medicine.
  • Biophysics
    Biophysics
    Biophysics is an interdisciplinary science that uses the methods of physical science to study biological systems. Studies included under the branches of biophysics span all levels of biological organization, from the molecular scale to whole organisms and ecosystems...

     is an interdisciplinary science that uses the methods of physics
    Physics
    Physics is a natural science that involves the study of matter and its motion through spacetime, along with related concepts such as energy and force. More broadly, it is the general analysis of nature, conducted in order to understand how the universe behaves.Physics is one of the oldest academic...

     and physical chemistry
    Physical chemistry
    Physical chemistry is the study of macroscopic, atomic, subatomic, and particulate phenomena in chemical systems in terms of physical laws and concepts...

     to study biological systems.
  • Cytology
    Cell biology
    Cell biology is a scientific discipline that studies cells – their physiological properties, their structure, the organelles they contain, interactions with their environment, their life cycle, division and death. This is done both on a microscopic and molecular level...

     is the microscopic study of individual cells
    Cell (biology)
    The cell is the basic structural and functional unit of all known living organisms. It is the smallest unit of life that is classified as a living thing, and is often called the building block of life. The Alberts text discusses how the "cellular building blocks" move to shape developing embryos....

    .
  • Embryology
    Embryology
    Embryology is a science which is about the development of an embryo from the fertilization of the ovum to the fetus stage...

     is the study of the early development of organisms.
  • Endocrinology
    Endocrinology
    Endocrinology is a branch of biology and medicine dealing with the endocrine system, its diseases, and its specific secretions called hormones, the integration of developmental events such as proliferation, growth, and differentiation and the coordination of...

     is the study of hormones and their effect throughout the body of animals.
  • Epidemiology
    Epidemiology
    Epidemiology is the study of health-event, health-characteristic, or health-determinant patterns in a population. It is the cornerstone method of public health research, and helps inform policy decisions and evidence-based medicine by identifying risk factors for disease and targets for preventive...

     is the study of the demographics of disease processes, and includes, but is not limited to, the study of epidemics.
  • Genetics
    Genetics
    Genetics , a discipline of biology, is the science of genes, heredity, and variation in living organisms....

     is the study of genes, and their role in biological inheritance.
  • Histology
    Histology
    Histology is the study of the microscopic anatomy of cells and tissues of plants and animals. It is performed by examining cells and tissues commonly by sectioning and staining; followed by examination under a light microscope or electron microscope...

     is the study of the structures of biological tissue
    Biological tissue
    Tissue is a cellular organizational level intermediate between cells and a complete organism. A tissue is an ensemble of cells, not necessarily identical, but from the same origin, that together carry out a specific function. These are called tissues because of their identical functioning...

    s by light microscopy
    Microscopy
    Microscopy is the technical field of using microscopes to view samples and objects that cannot be seen with the unaided eye...

    , electron microscopy
    Electron microscope
    An electron microscope is a type of microscope that uses a beam of electrons to illuminate the specimen and produce a magnified image. Electron microscopes have a greater resolving power than a light-powered optical microscope, because electrons have wavelengths about 100,000 times shorter than...

     and immunohistochemistry
    Immunohistochemistry
    Immunohistochemistry or IHC refers to the process of detecting antigens in cells of a tissue section by exploiting the principle of antibodies binding specifically to antigens in biological tissues. IHC takes its name from the roots "immuno," in reference to antibodies used in the procedure, and...

    .
  • Immunology
    Immunology
    Immunology is a broad branch of biomedical science that covers the study of all aspects of the immune system in all organisms. It deals with the physiological functioning of the immune system in states of both health and diseases; malfunctions of the immune system in immunological disorders ; the...

     is the study of the immune system
    Immune system
    An immune system is a system of biological structures and processes within an organism that protects against disease by identifying and killing pathogens and tumor cells. It detects a wide variety of agents, from viruses to parasitic worms, and needs to distinguish them from the organism's own...

    , which includes the innate and adaptive immune system in humans, for example.
  • Medical physics
    Medical physics
    Medical physics is the application of physics to medicine. It generally concerns physics as applied to medical imaging and radiotherapy, although a medical physicist may also work in many other areas of healthcare...

     is the study of the applications of physics principles in medicine.
  • Microbiology
    Microbiology
    Microbiology is the study of microorganisms, which are defined as any microscopic organism that comprises either a single cell , cell clusters or no cell at all . This includes eukaryotes, such as fungi and protists, and prokaryotes...

     is the study of microorganism
    Microorganism
    A microorganism or microbe is a microscopic organism that comprises either a single cell , cell clusters, or no cell at all...

    s, including protozoa
    Protozoa
    Protozoa are a diverse group of single-cells eukaryotic organisms, many of which are motile. Throughout history, protozoa have been defined as single-cell protists with animal-like behavior, e.g., movement...

    , bacteria, fungi
    Fungus
    A fungus is a member of a large group of eukaryotic organisms that includes microorganisms such as yeasts and molds , as well as the more familiar mushrooms. These organisms are classified as a kingdom, Fungi, which is separate from plants, animals, and bacteria...

    , and virus
    Virus
    A virus is a small infectious agent that can replicate only inside the living cells of organisms. Viruses infect all types of organisms, from animals and plants to bacteria and archaea...

    es.
  • Molecular biology
    Molecular biology
    Molecular biology is the branch of biology that deals with the molecular basis of biological activity. This field overlaps with other areas of biology and chemistry, particularly genetics and biochemistry...

     is the study of molecular underpinnings of the process of replication
    Replication
    Replication may refer to:Science* Replication is one of the main principles of the scientific method, a.k.a. reproducibility** Replication , the repetition of a test or complete experiment...

    , transcription
    Transcription (genetics)
    Transcription is the process of creating a complementary RNA copy of a sequence of DNA. Both RNA and DNA are nucleic acids, which use base pairs of nucleotides as a complementary language that can be converted back and forth from DNA to RNA by the action of the correct enzymes...

     and translation
    Translation
    Translation is the communication of the meaning of a source-language text by means of an equivalent target-language text. Whereas interpreting undoubtedly antedates writing, translation began only after the appearance of written literature; there exist partial translations of the Sumerian Epic of...

     of the genetic material.
  • Neuroscience
    Neuroscience
    Neuroscience is the scientific study of the nervous system. Traditionally, neuroscience has been seen as a branch of biology. However, it is currently an interdisciplinary science that collaborates with other fields such as chemistry, computer science, engineering, linguistics, mathematics,...

     includes those disciplines of science that are related to the study of the nervous system
    Nervous system
    The nervous system is an organ system containing a network of specialized cells called neurons that coordinate the actions of an animal and transmit signals between different parts of its body. In most animals the nervous system consists of two parts, central and peripheral. The central nervous...

    . A main focus of neuroscience is the biology
    Biology
    Biology is a natural science concerned with the study of life and living organisms, including their structure, function, growth, origin, evolution, distribution, and taxonomy. Biology is a vast subject containing many subdivisions, topics, and disciplines...

     and physiology of the human brain and spinal cord
    Spinal cord
    The spinal cord is a long, thin, tubular bundle of nervous tissue and support cells that extends from the brain . The brain and spinal cord together make up the central nervous system...

    . Some related clinical specialties include neurology
    Neurology
    Neurology is a medical specialty dealing with disorders of the nervous system. Specifically, it deals with the diagnosis and treatment of all categories of disease involving the central, peripheral, and autonomic nervous systems, including their coverings, blood vessels, and all effector tissue,...

    , neurosurgery
    Neurosurgery
    Neurosurgery is the medical specialty concerned with the prevention, diagnosis, treatment, and rehabilitation of disorders which affect any portion of the nervous system including the brain, spine, spinal cord, peripheral nerves, and extra-cranial cerebrovascular system.-In the United States:In...

     and psychiatry
    Psychiatry
    Psychiatry is the medical specialty devoted to the study and treatment of mental disorders. These mental disorders include various affective, behavioural, cognitive and perceptual abnormalities...

    .
  • Nutrition science (theoretical focus) and dietetics (practical focus) is the study of the relationship of food and drink to health and disease, especially in determining an optimal diet. Medical nutrition therapy is done by dietitians and is prescribed for diabetes, cardiovascular disease
    Cardiovascular disease
    Heart disease or cardiovascular disease are the class of diseases that involve the heart or blood vessels . While the term technically refers to any disease that affects the cardiovascular system , it is usually used to refer to those related to atherosclerosis...

    s, weight and eating disorder
    Mental illness
    A mental disorder or mental illness is a psychological or behavioral pattern generally associated with subjective distress or disability that occurs in an individual, and which is not a part of normal development or culture. Such a disorder may consist of a combination of affective, behavioural,...

    s, allergies, malnutrition
    Malnutrition
    Malnutrition is the condition that results from taking an unbalanced diet in which certain nutrients are lacking, in excess , or in the wrong proportions....

    , and neoplastic
    Neoplasia
    Neoplasm is an abnormal mass of tissue as a result of neoplasia. Neoplasia is the abnormal proliferation of cells. The growth of neoplastic cells exceeds and is not coordinated with that of the normal tissues around it. The growth persists in the same excessive manner even after cessation of the...

     diseases.
  • Pathology as a science is the study of disease—the causes, course, progression and resolution thereof.
  • Pharmacology
    Pharmacology
    Pharmacology is the branch of medicine and biology concerned with the study of drug action. More specifically, it is the study of the interactions that occur between a living organism and chemicals that affect normal or abnormal biochemical function...

     is the study of drugs and their actions.
  • Photobiology
    Photobiology
    Photobiology is the scientific study of the interactions of light and living organisms. The field includes the study of photosynthesis, photomorphogenesis, visual processing, circadian rhythms, bioluminescence, and ultraviolet radiation effects...

     is the study of the interactions between non-ionizing radiation
    Non-ionizing radiation
    Non-ionizing radiation refers to any type of electromagnetic radiation that does not carry enough energy per quantum to ionize atoms or molecules—that is, to completely remove an electron from an atom or molecule...

     and living organisms.
  • Physiology
    Physiology
    Physiology is the science of the function of living systems. This includes how organisms, organ systems, organs, cells, and bio-molecules carry out the chemical or physical functions that exist in a living system. The highest honor awarded in physiology is the Nobel Prize in Physiology or...

     is the study of the normal functioning of the body and the underlying regulatory mechanisms.
  • Radiobiology
    Radiobiology
    Radiobiology , as a field of clinical and basic medical sciences, originated from Leopold Freund's 1896 demonstration of the therapeutic treatment of a hairy mole using a new type of electromagnetic radiation called x-rays, which was discovered 1 year previously by the German physicist, Wilhelm...

     is the study of the interactions between ionizing radiation
    Ionizing radiation
    Ionizing radiation is radiation composed of particles that individually have sufficient energy to remove an electron from an atom or molecule. This ionization produces free radicals, which are atoms or molecules containing unpaired electrons...

     and living organisms.
  • Toxicology
    Toxicology
    Toxicology is a branch of biology, chemistry, and medicine concerned with the study of the adverse effects of chemicals on living organisms...

     is the study of hazardous effects of drugs and poison
    Poison
    In the context of biology, poisons are substances that can cause disturbances to organisms, usually by chemical reaction or other activity on the molecular scale, when a sufficient quantity is absorbed by an organism....

    s.

Specialties



In the broadest meaning of "medicine", there are many different specialties. In the UK, most specialities will have their own body or college (collectively known as the Royal Colleges, although currently not all use the term "Royal"), which have their own entrance exam. The development of a speciality is often driven by new technology (such as the development of effective anaesthetics) or ways of working (e.g., emergency departments), which leads to the desire to form a unifying body of doctors and thence the prestige of administering their own exam.

Within medical circles, specialities usually fit into one of 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". In the UK, this would traditionally have been evidenced by obtaining the MRCP (An exam allowing Membership of the Royal College of Physicians
Royal College of Physicians
The Royal College of Physicians of London was founded in 1518 as the College of Physicians by royal charter of King Henry VIII in 1518 - the first medical institution in England to receive a royal charter...

 or the equivalent college in Scotland or Ireland). "Surgery" refers to the practice of operative medicine, and most subspecialties in this area require preliminary training in "General Surgery." (In the UK: Membership of the Royal College of Surgeons of England
Royal College of Surgeons of England
The Royal College of Surgeons of England is an independent professional body and registered charity committed to promoting and advancing the highest standards of surgical care for patients, regulating surgery, including dentistry, in England and Wales...

 (MRCS).)There are some specialties of medicine that at the present time do not fit easily into either of these categories, such as radiology, pathology, or anesthesia. Most of these have branched from one or other of the two camps above – for example anaesthesia developed first as a faculty of the Royal College of Surgeons (for which MRCS/FRCS would have been required) before becoming the Royal College of Anaesthetists
Royal College of Anaesthetists
The Royal College of Anaesthetists is "the professional body responsible for the specialty of anaesthesia throughout the United Kingdom". It sets standards in anaesthesia, critical care, pain management, and for the training of anaesthetists, physician assistants - and practising critical care...

 and membership of the college is by sitting the FRCA (Fellowship of the Royal College of Anesthetists).

Surgery



Surgical specialties employ operative treatment. In addition, surgeons must decide when an operation is necessary, and also treat many non-surgical issues, particularly in the surgical intensive care unit (SICU), where a variety of critical issues arise. Surgeons must also manage pre-operative, post-operative, and potential surgical candidates on the hospital wards. Surgery has many sub-specialties, including general surgery
General surgery
General surgery, despite its name, is a surgical specialty that focuses on abdominal organs, e.g., intestines including esophagus, stomach, small bowel, colon, liver, pancreas, gallbladder and bile ducts, and often the thyroid gland . They also deal with diseases involving the skin, breast, soft...

, cardiovascular surgery, colorectal surgery, neurosurgery
Neurosurgery
Neurosurgery is the medical specialty concerned with the prevention, diagnosis, treatment, and rehabilitation of disorders which affect any portion of the nervous system including the brain, spine, spinal cord, peripheral nerves, and extra-cranial cerebrovascular system.-In the United States:In...

, maxillofacial surgery, orthopedic surgery
Orthopedic surgery
Orthopedic surgery or orthopedics is the branch of surgery concerned with conditions involving the musculoskeletal system...

, otolaryngology
Otolaryngology
Otolaryngology or ENT is the branch of medicine and surgery that specializes in the diagnosis and treatment of ear, nose, throat, and head and neck disorders....

, plastic surgery
Plastic surgery
Plastic surgery is a medical specialty concerned with the correction or restoration of form and function. Though cosmetic or aesthetic surgery is the best-known kind of plastic surgery, most plastic surgery is not cosmetic: plastic surgery includes many types of reconstructive surgery, hand...

, oncologic surgery, transplant surgery, trauma surgery
Trauma surgery
Trauma surgery is a surgical specialty involved in the invasive treatment of physical injuries, typically in an emergency setting. Trauma surgeons generally complete residency training in general surgery and often fellowship training in trauma or surgical critical care...

, urology
Urology
Urology is the medical and surgical specialty that focuses on the urinary tracts of males and females, and on the reproductive system of males. Medical professionals specializing in the field of urology are called urologists and are trained to diagnose, treat, and manage patients with urological...

, vascular surgery
Vascular surgery
Vascular surgery is a specialty of surgery in which diseases of the vascular system, or arteries and veins, are managed by medical therapy, minimally-invasive catheter procedures, and surgical reconstruction. The specialty evolved from general and cardiac surgery...

, and pediatric surgery
Pediatric surgery
Pediatric surgery or paediatric surgery is a subspecialty of surgery involving the surgery of fetuses, infants, children, adolescents, and young adults...

. 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
Ophthalmology
Ophthalmology is the branch of medicine that deals with the anatomy, physiology and diseases of the eye. An ophthalmologist is a specialist in medical and surgical eye problems...

 and dermatology
Dermatology
Dermatology is the branch of medicine dealing with the skin and its diseases, a unique specialty with both medical and surgical aspects. A dermatologist takes care of diseases, in the widest sense, and some cosmetic problems of the skin, scalp, hair, and nails....

, but are not considered surgical sub-specialties per se.

Surgical training in the U.S. 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.

'Medicine' as a specialty



Internal medicine is the medical specialty
Specialty (medicine)
A specialty in medicine is a branch of medical science. After completing medical school, physicians or surgeons usually further their medical education in a specific specialty of medicine by completing a multiple year residency to become a medical specialist.-History of medical specialization:To...

 concerned with the diagnosis, management and nonsurgical treatment of unusual or serious diseases, either of one particular organ system or of the body as a whole. According to some sources, an emphasis on internal structures is implied. In North America, specialists in internal medicine are commonly called "internists". Elsewhere, especially in Commonwealth
Commonwealth of Nations
The Commonwealth of Nations, normally referred to as the Commonwealth and formerly known as the British Commonwealth, is an intergovernmental organisation of fifty-four independent member states...

 nations, such specialists are often called physician
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...

s. These terms, internist or physician (in the narrow sense, common outside North America), generally exclude practitioners of gynecology and obstetrics, pathology, psychiatry, and especially surgery and its subspecialities.

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, gastroenterologist
Gastroenterology
Gastroenterology is the branch of medicine whereby the digestive system and its disorders are studied. The name is a combination of three Ancient Greek words gaster , enteron , and logos...

s and nephrologist
Nephrology
Nephrology is a branch of internal medicine and pediatrics dealing with the study of the function and diseases of the kidney.-Scope of the specialty:...

s specialize respectively in diseases of the gut and the kidneys.

In the Commonwealth of Nations
Commonwealth of Nations
The Commonwealth of Nations, normally referred to as the Commonwealth and formerly known as the British Commonwealth, is an intergovernmental organisation of fifty-four independent member states...

 and some other countries, specialist pediatricians
Pediatrics
Pediatrics or paediatrics is the branch of medicine that deals with the medical care of infants, children, and adolescents. A medical practitioner who specializes in this area is known as a pediatrician or paediatrician...

 and geriatricians
Geriatrics
Geriatrics is a sub-specialty of internal medicine and family medicine that focuses on health care of elderly people. It aims to promote health by preventing and treating diseases and disabilities in older adults. There is no set age at which patients may be under the care of a geriatrician, or...

 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
Primary care physician
A primary care physician, or PCP, is a physician/medical doctor who provides both the first contact for a person with an undiagnosed health concern as well as continuing care of varied medical conditions, not limited by cause, organ system, or diagnosis....

.

There are many subspecialities (or subdisciplines) of internal medicine
Internal medicine
Internal medicine is the medical specialty dealing with the prevention, diagnosis, and treatment of adult diseases. Physicians specializing in internal medicine are called internists. They are especially skilled in the management of patients who have undifferentiated or multi-system disease processes...

:
Training in internal medicine (as opposed to surgical training), varies considerably across the world: see the articles on Medical education
Medical education
Medical education is education related to the practice of being a medical practitioner, either the initial training to become a doctor or additional training thereafter ....

 and Physician
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...

 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 USA. 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.

Diagnostic specialties

  • Clinical laboratory sciences are the clinical diagnostic services that apply laboratory techniques to diagnosis and management of patients. In the United States, these services are supervised by a pathologist. The personnel that work in these medical laboratory
    Medical laboratory
    A medical laboratory or clinical laboratory is a laboratory where tests are done on clinical specimens in order to get information about the health of a patient as pertaining to the diagnosis, treatment, and prevention of disease.-Departments:...

     departments are technically trained staff who do not hold medical degrees, but who usually hold an undergraduate medical technology
    Medical technology
    Medical Technology encompasses a wide range of healthcare products and is used to diagnose, monitor or treat diseases or medical conditions affecting humans. Such technologies are intended to improve the quality of healthcare delivered through earlier diagnosis, less invasive treatment options and...

     degree, who actually perform the test
    Medical test
    A diagnostic test is any kind of medical test performed to aid in the diagnosis or detection of disease. For example:* to diagnose diseases, and preferably sub-classify it regarding, for example, severity and treatability...

    s, assay
    Assay
    An assay is a procedure in molecular biology for testing or measuring the activity of a drug or biochemical in an organism or organic sample. A quantitative assay may also measure the amount of a substance in a sample. Bioassays and immunoassays are among the many varieties of specialized...

    s, and procedures needed for providing the specific services. Subspecialties include Transfusion medicine
    Transfusion medicine
    Transfusion medicine is the branch of medicine that is concerned with the transfusion of blood and blood components. The blood bank is the section of the clinical laboratory where medical technologists process and distribute blood products under the supervision of a medical director, often...

    , Cellular pathology, Clinical chemistry, Hematology
    Hematology
    Hematology, also spelled haematology , is the branch of biology physiology, internal medicine, pathology, clinical laboratory work, and pediatrics that is concerned with the study of blood, the blood-forming organs, and blood diseases...

    , Clinical microbiology and Clinical immunology.
  • Pathology as a medical specialty
    Pathology as a medical specialty
    Pathologists are physicians who diagnose and characterize disease in living patients by examining biopsies or bodily fluid. Pathologists may also conduct autopsies to investigate causes of death. Pathology is a core discipline of medical school and many pathologists are also instructors...

     is the branch of medicine that deals with the study of diseases and the morphologic, physiologic changes produced by them. As a diagnostic specialty, pathology can be considered the basis of modern scientific medical knowledge and plays a large role in evidence-based medicine
    Evidence-based medicine
    Evidence-based medicine or evidence-based practice aims to apply the best available evidence gained from the scientific method to clinical decision making. It seeks to assess the strength of evidence of the risks and benefits of treatments and diagnostic tests...

    . Many modern molecular tests such as flow cytometry
    Flow cytometry
    Flow cytometry is a technique for counting and examining microscopic particles, such as cells and chromosomes, by suspending them in a stream of fluid and passing them by an electronic detection apparatus. It allows simultaneous multiparametric analysis of the physical and/or chemical...

    , polymerase chain reaction
    Polymerase chain reaction
    The polymerase chain reaction is a scientific technique in molecular biology to amplify a single or a few copies of a piece of DNA across several orders of magnitude, generating thousands to millions of copies of a particular DNA sequence....

     (PCR), immunohistochemistry
    Immunohistochemistry
    Immunohistochemistry or IHC refers to the process of detecting antigens in cells of a tissue section by exploiting the principle of antibodies binding specifically to antigens in biological tissues. IHC takes its name from the roots "immuno," in reference to antibodies used in the procedure, and...

    , cytogenetics
    Cytogenetics
    Cytogenetics is a branch of genetics that is concerned with the study of the structure and function of the cell, especially the chromosomes. It includes routine analysis of G-Banded chromosomes, other cytogenetic banding techniques, as well as molecular cytogenetics such as fluorescent in situ...

    , gene rearrangements studies and fluorescent in situ hybridization
    Fluorescent in situ hybridization
    FISH is a cytogenetic technique developed by biomedical researchers in the early 1980s that is used to detect and localize the presence or absence of specific DNA sequences on chromosomes. FISH uses fluorescent probes that bind to only those parts of the chromosome with which they show a high...

     (FISH) fall within the territory of pathology.
  • Radiology
    Radiology
    Radiology is a medical specialty that employs the use of imaging to both diagnose and treat disease visualized within the human body. Radiologists use an array of imaging technologies to diagnose or treat diseases...

     is concerned with imaging of the human body, e.g. by x-ray
    X-ray
    X-radiation is a form of electromagnetic radiation. X-rays have a wavelength in the range of 0.01 to 10 nanometers, corresponding to frequencies in the range 30 petahertz to 30 exahertz and energies in the range 120 eV to 120 keV. They are shorter in wavelength than UV rays and longer than gamma...

    s, x-ray computed tomography
    Computed tomography
    X-ray computed tomography or Computer tomography , is a medical imaging method employing tomography created by computer processing...

    , ultrasonography, and nuclear magnetic resonance
    Nuclear magnetic resonance
    Nuclear magnetic resonance is a physical phenomenon in which magnetic nuclei in a magnetic field absorb and re-emit electromagnetic radiation...

     tomography
    Tomography
    Tomography refers to imaging by sections or sectioning, through the use of any kind of penetrating wave. A device used in tomography is called a tomograph, while the image produced is a tomogram. The method is used in radiology, archaeology, biology, geophysics, oceanography, materials science,...

    .
  • Nuclear medicine
    Nuclear medicine
    In nuclear medicine procedures, elemental radionuclides are combined with other elements to form chemical compounds, or else combined with existing pharmaceutical compounds, to form radiopharmaceuticals. These radiopharmaceuticals, once administered to the patient, can localize to specific organs...

     is concerned with studying human organ systems by administering radiolabelled substances (radiopharmaceuticals) to the body, which can then be imaged outside the body by a gamma camera
    Gamma camera
    A gamma camera, also called a scintillation camera or Anger camera, is a device used to image gamma radiation emitting radioisotopes, a technique known as scintigraphy...

     or a PET scanner. Each radiopharmaceutical consists of two parts: a tracer that is specific for the function under study (e.g., neurotransmitter pathway, metabolic pathway, blood flow, or other), and a radionuclide (usually either a gamma-emitter or a positron emitter). There is a degree of overlap between nuclear medicine and radiology, as evidenced by the emergence of combined devices such as the PET/CT scanner.
  • Clinical neurophysiology
    Clinical neurophysiology
    Clinical neurophysiology is a medical specialty that studies the central and peripheral nervous systems through the recording of bioelectrical activity, whether spontaneous or stimulated....

     is concerned with testing the physiology or function of the central and peripheral aspects of the nervous system. These kinds of tests can be divided into recordings of: (1) spontaneous or continuously running electrical activity, or (2) stimulus evoked responses. Subspecialties include Electroencephalography
    Electroencephalography
    Electroencephalography is the recording of electrical activity along the scalp. EEG measures voltage fluctuations resulting from ionic current flows within the neurons of the brain...

    , Electromyography
    Electromyography
    Electromyography is a technique for evaluating and recording the electrical activity produced by skeletal muscles. EMG is performed using an instrument called an electromyograph, to produce a record called an electromyogram. An electromyograph detects the electrical potential generated by muscle...

    , Evoked potential
    Evoked potential
    An evoked potential is an electrical potential recorded from the nervous system of a human or other animal following presentation of a stimulus, as distinct from spontaneous potentials as detected by electroencephalography or electromyography .Evoked potential amplitudes tend to be low, ranging...

    , Nerve conduction study
    Nerve conduction study
    A nerve conduction study is a test commonly used to evaluate the function, especially the ability of electrical conduction, of the motor and sensory nerves of the human body.Nerve conduction velocity is a common measurement made during this test...

     and Polysomnography
    Polysomnography
    Polysomnography , also known as a sleep study, is a multi-parametric test used in the study of sleep and as a diagnostic tool in sleep medicine. The test result is called a polysomnogram, also abbreviated PSG...

    . Sometimes these tests are performed by techs without a medical degree, but the interpretation of these tests is done by a medical professional.

Other major specialties


The followings are some major medical specialties that do not directly fit into any of the above mentioned groups.
  • Anesthesiology (also known as anaesthetics): concerned with the perioperative management of the surgical patient. The anesthesiologist's role during surgery is to prevent derangement in the vital organs' (i.e. brain, heart, kidneys) functions and postoperative pain. Outside of the operating room, the anesthesiology physician also served the same function in the labor & delivery ward, and some are specialized in critical medicine.
  • Dermatology
    Dermatology
    Dermatology is the branch of medicine dealing with the skin and its diseases, a unique specialty with both medical and surgical aspects. A dermatologist takes care of diseases, in the widest sense, and some cosmetic problems of the skin, scalp, hair, and nails....

     is concerned with the skin and its diseases. In the UK, dermatology is a subspecialty of general medicine.
  • Emergency medicine
    Emergency medicine
    Emergency medicine is a medical specialty in which physicians care for patients with acute illnesses or injuries which require immediate medical attention. While not usually providing long-term or continuing care, emergency medicine physicians diagnose a variety of illnesses and undertake acute...

     is concerned with the diagnosis and treatment of acute or life-threatening conditions, including trauma
    Physical trauma
    Trauma refers to "a body wound or shock produced by sudden physical injury, as from violence or accident." It can also be described as "a physical wound or injury, such as a fracture or blow." Major trauma can result in secondary complications such as circulatory shock, respiratory failure and death...

    , surgical, medical, pediatric, and psychiatric emergencies.
  • Family medicine
    Family medicine
    Family medicine is a medical specialty devoted to comprehensive health care for people of all ages. It is a division of primary care that provides continuing and comprehensive health care for the individual and family across all ages, sexes, diseases, and parts of the body...

    , family practice, general practice or primary care is, in many countries, the first port-of-call for patients with non-emergency medical problems. Family physicians often provide services across a broad range of settings including office based practices, emergency room coverage, inpatient care, and nursing home care.
  • Obstetrics
    Obstetrics
    Obstetrics is the medical specialty dealing with the care of all women's reproductive tracts and their children during pregnancy , childbirth and the postnatal period...

     and gynecology (often abbreviated as OB/GYN (American English) or Obs & Gynae (British English)) are concerned respectively with childbirth and the female reproductive and associated organs. Reproductive medicine
    Reproductive medicine
    Reproductive medicine is a branch of medicine that deals with prevention, diagnosis and management of reproductive problems; goals include improving or maintaining reproductive health and allowing people to have children at a time of their choosing...

     and fertility medicine are generally practiced by gynecological specialists.
  • Medical Genetics
    Medical genetics
    Medical genetics is the specialty of medicine that involves the diagnosis and management of hereditary disorders. Medical genetics differs from Human genetics in that human genetics is a field of scientific research that may or may not apply to medicine, but medical genetics refers to the...

     is concerned with the diagnosis and management of hereditary disorders.
  • Neurology
    Neurology
    Neurology is a medical specialty dealing with disorders of the nervous system. Specifically, it deals with the diagnosis and treatment of all categories of disease involving the central, peripheral, and autonomic nervous systems, including their coverings, blood vessels, and all effector tissue,...

     is concerned with diseases of the nervous system. In the UK, neurology is a subspecialty of general medicine.
  • Ophthalmology
    Ophthalmology
    Ophthalmology is the branch of medicine that deals with the anatomy, physiology and diseases of the eye. An ophthalmologist is a specialist in medical and surgical eye problems...

     exclusively concerned with the eye and ocular adnexa, combining conservative and surgical therapy.
  • Pediatrics
    Pediatrics
    Pediatrics or paediatrics is the branch of medicine that deals with the medical care of infants, children, and adolescents. A medical practitioner who specializes in this area is known as a pediatrician or paediatrician...

     (AE) or paediatrics (BE) is devoted to the care of infants, children, and adolescents. Like internal medicine, there are many pediatric subspecialties for specific age ranges, organ systems, disease classes, and sites of care delivery.
  • Physical medicine and rehabilitation
    Physical medicine and rehabilitation
    Physical medicine and rehabilitation , physiatry or rehabilitation medicine, is a branch of medicine that aims to enhance and restore functional ability and quality of life to those with physical impairments or disabilities. A physician having completed training in this field is referred to as a...

     (or physiatry) is concerned with functional improvement after injury, illness, or congenital disorder
    Congenital disorder
    A congenital disorder, or congenital disease, is a condition existing at birth and often before birth, or that develops during the first month of life , regardless of causation...

    s.
  • Psychiatry
    Psychiatry
    Psychiatry is the medical specialty devoted to the study and treatment of mental disorders. These mental disorders include various affective, behavioural, cognitive and perceptual abnormalities...

     is the branch of medicine concerned with the bio-psycho-social study of the etiology
    Etiology
    Etiology is the study of causation, or origination. The word is derived from the Greek , aitiologia, "giving a reason for" ....

    , diagnosis, treatment and prevention of cognitive, perceptual, emotional and behavioral disorders. Related non-medical fields include psychotherapy
    Psychotherapy
    Psychotherapy is a general term referring to any form of therapeutic interaction or treatment contracted between a trained professional and a client or patient; family, couple or group...

     and clinical psychology
    Clinical psychology
    Clinical psychology is an integration of science, theory and clinical knowledge for the purpose of understanding, preventing, and relieving psychologically-based distress or dysfunction and to promote subjective well-being and personal development...

    .
  • Preventive medicine
    Preventive medicine
    Preventive medicine or preventive care refers to measures taken to prevent diseases, rather than curing them or treating their symptoms...

     is the branch of medicine concerned with preventing disease.
    • Community health
      Community health
      Community health, a field of public health, is a discipline that concerns itself with the study and betterment of the health characteristics of biological communities. While the term community can be broadly defined, community health tends to focus on geographic areas rather than people with shared...

       or public health
      Public health
      Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals" . It is concerned with threats to health based on population health...

       is an aspect of health services concerned with threats to the overall health of a community based on population health
      Population health
      Population health has been defined as “the health outcomes of a group of individuals, including the distribution of such outcomes within the group.” It is an approach to health that aims to improve the health of an entire population. One major step in achieving this aim is to reduce health...

       analysis.
    • Occupational medicines principal role is the provision of health advice to organizations and individuals to ensure that the highest standards of health and safety at work can be achieved and maintained.
    • Aerospace medicine deals with medical problems related to flying and space travel
      Human spaceflight
      Human spaceflight is spaceflight with humans on the spacecraft. When a spacecraft is manned, it can be piloted directly, as opposed to machine or robotic space probes and remotely-controlled satellites....

      .

Interdisciplinary fields


Some interdisciplinary sub-specialties of medicine include:
  • Addiction medicine
    Addiction Medicine
    Addiction medicine is a medical specialty that deals with the treatment of addiction. The specialty often crosses over into other areas, since various aspects of addiction fall within the fields of public health, psychology, social work, psychiatry, and internal medicine, among others...

     deals with the treatment of addiction.
  • Medical ethics
    Medical ethics
    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.-History:Historically,...

     deals with ethical and moral
    Moral
    A moral is a message conveyed or a lesson to be learned from a story or event. The moral may be left to the hearer, reader or viewer to determine for themselves, or may be explicitly encapsulated in a maxim...

     principles that apply values and judgments to the practice of medicine.
  • Biomedical Engineering
    Biomedical engineering
    Biomedical Engineering is the application of engineering principles and design concepts to medicine and biology. This field seeks to close the gap between engineering and medicine: It combines the design and problem solving skills of engineering with medical and biological sciences to improve...

     is a field dealing with the application of engineering
    Engineering
    Engineering is the discipline, art, skill and profession of acquiring and applying scientific, mathematical, economic, social, and practical knowledge, in order to design and build structures, machines, devices, systems, materials and processes that safely realize improvements to the lives of...

     principles to medical practice.
  • Clinical pharmacology
    Clinical pharmacology
    Clinical pharmacology is the science of drugs and their clinical use. It is underpinned by the basic science of pharmacology, with added focus on the application of pharmacological principles and methods in the real world...

     is concerned with how systems of therapeutics interact with patients.
  • Conservation medicine
    Conservation medicine
    Conservation medicine is an emerging, interdisciplinary field that studies the relationship between human and animal health, and environmental conditions. Also known as ecological medicine, environmental medicine, or medical geology....

     studies the relationship between human and animal health, and environmental conditions. Also known as ecological medicine, environmental medicine
    Environmental medicine
    Environmental medicine is a multidisciplinary field involving medicine, environmental science, chemistry and others. It may be viewed as the medical branch of the broader field of environmental health. The scope of this field involves studying the interactions between environment and human health,...

    , or medical geology
    Medical geology
    Medical geology is an emerging interdisciplinary scientific field consisting of those aspects of geology as they affect human, animal and plant health.Examples include:*Lead and other heavy metal exposure resulting from dust and other particulates...

    .
  • Disaster medicine
    Disaster medicine
    Disaster medicine is the area of physician medical specialization serving the dual areas of providing medical care to disaster survivors and providing medically related disaster preparation, disaster planning, disaster response and disaster recovery leadership throughout the disaster life cycle...

     deals with medical aspects of emergency preparedness, disaster mitigation and management.
  • Diving medicine
    Diving medicine
    Diving medicine, also called undersea and hyperbaric medicine , is the diagnosis, treatment and prevention of conditions caused by humans entering the undersea environment...

     (or hyperbaric medicine) is the prevention and treatment of diving-related problems.
  • Evolutionary medicine
    Evolutionary medicine
    Evolutionary medicine or Darwinian medicine is the application of modern evolutionary theory to understanding health and disease. It provides a complementary scientific approach to the present mechanistic explanations that dominate medical science, and particularly modern medical education...

     is a perspective on medicine derived through applying evolutionary theory
    Evolution
    Evolution is any change across successive generations in the heritable characteristics of biological populations. Evolutionary processes give rise to diversity at every level of biological organisation, including species, individual organisms and molecules such as DNA and proteins.Life on Earth...

    .
  • Forensic medicine deals with medical questions in legal context, such as determination of the time and cause of death.
  • Gender-based medicine
    Gender-based medicine
    Gender-based medicine or simply gender medicine is the field of medicine that studies the biological and physiological differences between the human sexes and how that affects differences in disease. Traditionally, medical research has mostly been conducted using the male body as the basis for...

     studies the biological and physiological differences between the human sexes and how that affects differences in disease.
  • Hospice and Palliative Medicine
    Hospice and Palliative Medicine
    Hospice and Palliative Medicine is a formal subspecialty of medicine in the United States that focuses on symptom management, relief of suffering and end-of-life care...

     is a relatively modern branch of clinical medicine that deals with pain and symptom relief and emotional support in patients with terminal illness
    Terminal illness
    Terminal illness is a medical term popularized in the 20th century to describe a disease that cannot be cured or adequately treated and that is reasonably expected to result in the death of the patient within a short period of time. This term is more commonly used for progressive diseases such as...

    es including cancer and heart failure.
  • Hospital medicine
    Hospital medicine
    Hospital medicine in the United States is the discipline concerned with the medical care of acutely ill hospitalized patients. Physicians whose primary professional focus is hospital medicine are called hospitalists; this type of medical practice has extended beyond the US into Canada...

     is the general medical care of hospitalized patients. Physicians whose primary professional focus is hospital medicine are called hospitalists in the USA and Canada. The term Most Responsible Physician (MRP) or attending physician is also used interchangeably to describe this role.
  • Laser medicine
    Laser medicine
    Laser medicine is the use of various types of lasers in medical diagnosis, treatment, or therapy. Types of lasers used in medicine include in principle any laser design, especially:* CO2 lasers* diode lasers* dye lasers* excimer lasers* fiber lasers...

     involves the use of lasers in the diagnostics and/or treatment of various conditions.
  • Medical humanities
    Medical humanities
    Medical humanities is an interdisciplinary field of medicine which includes the humanities , social science , and the arts and their application to medical education and practice...

     includes the humanities
    Humanities
    The humanities are academic disciplines that study the human condition, using methods that are primarily analytical, critical, or speculative, as distinguished from the mainly empirical approaches of the natural sciences....

     (literature
    Literature
    Literature is the art of written works, and is not bound to published sources...

    , philosophy
    Philosophy
    Philosophy is the study of general and fundamental problems, such as those connected with existence, knowledge, values, reason, mind, and language. Philosophy is distinguished from other ways of addressing such problems by its critical, generally systematic approach and its reliance on rational...

    , ethics
    Ethics
    Ethics, also known as moral philosophy, is a branch of philosophy that addresses questions about morality—that is, concepts such as good and evil, right and wrong, virtue and vice, justice and crime, etc.Major branches of ethics include:...

    , history and religion), social science (anthropology
    Anthropology
    Anthropology is the study of humanity. It has origins in the humanities, the natural sciences, and the social sciences. The term "anthropology" is from the Greek anthrōpos , "man", understood to mean mankind or humanity, and -logia , "discourse" or "study", and was first used in 1501 by German...

    , cultural studies
    Cultural studies
    Cultural studies is an academic field grounded in critical theory and literary criticism. It generally concerns the political nature of contemporary culture, as well as its historical foundations, conflicts, and defining traits. It is, to this extent, largely distinguished from cultural...

    , psychology
    Psychology
    Psychology is the study of the mind and behavior. Its immediate goal is to understand individuals and groups by both establishing general principles and researching specific cases. For many, the ultimate goal of psychology is to benefit society...

    , sociology
    Sociology
    Sociology is the study of society. It is a social science—a term with which it is sometimes synonymous—which uses various methods of empirical investigation and critical analysis to develop a body of knowledge about human social activity...

    ), and the arts (literature
    Literature
    Literature is the art of written works, and is not bound to published sources...

    , theater, film, and visual arts
    Visual arts
    The visual arts are art forms that create works which are primarily visual in nature, such as ceramics, drawing, painting, sculpture, printmaking, design, crafts, and often modern visual arts and architecture...

    ) and their application to medical education
    Medical education
    Medical education is education related to the practice of being a medical practitioner, either the initial training to become a doctor or additional training thereafter ....

     and practice.
  • Medical informatics, medical computer science, medical information and eHealth
    EHealth
    eHealth is a relatively recent term for healthcare practice supported by electronic processes and communication, dating back to at least 1999...

     are relatively recent fields that deal with the application of computers and information technology
    Information technology
    Information technology is the acquisition, processing, storage and dissemination of vocal, pictorial, textual and numerical information by a microelectronics-based combination of computing and telecommunications...

     to medicine.
  • Nosology is the classification of diseases for various purposes.
  • Nosokinetics
    Nosokinetics
    Nosokinetics is the science/subject of measuring and modelling the process of care in health and social care systems. Nosokinetics brings together the Greek words for noso: disease and kinetics: movement....

     is the science/subject of measuring and modelling the process of care in health and social care systems.
  • Pain management
    Pain management
    Pain management is a branch of medicine employing an interdisciplinary approach for easing the suffering and improving the quality of life of those living with pain. The typical pain management team includes medical practitioners, clinical psychologists, physiotherapists, occupational therapists,...

     (also called pain medicine, or algiatry) is the medical discipline concerned with the relief of pain.
  • Pharmacogenomics
    Pharmacogenomics
    Pharmacogenomics is the branch of pharmacology which deals with the influence of genetic variation on drug response in patients by correlating gene expression or single-nucleotide polymorphisms with a drug's efficacy or toxicity...

     is a form of individualized medicine.
  • Sexual medicine
    Sexual medicine
    Sexual medicine is a medical specialty that deals with sexual health. At times heavily influenced by current local views on morality, with heavy cultural overlay, in broad terms this specialty is concerned with diagnosing, assessing and treating all aspects which relate to sexuality.Issues can be...

     is concerned with diagnosing, assessing and treating all disorders related to sexuality.
  • Sports medicine
    Sports medicine
    Sports medicine is a branch of medicine that deals with physical fitness, treatment and prevention of injuries related to sports and exercise...

     deals with the treatment and preventive care of athletes, amateur
    Amateur
    An amateur is generally considered a person attached to a particular pursuit, study, or science, without pay and often without formal training....

     and professional
    Professional
    A professional is a person who is paid to undertake a specialised set of tasks and to complete them for a fee. The traditional professions were doctors, lawyers, clergymen, and commissioned military officers. Today, the term is applied to estate agents, surveyors , environmental scientists,...

    . The team includes specialty physicians and surgeons, athletic trainers, physical therapists, coach
    Coach (sport)
    In sports, a coach is an individual involved in the direction, instruction and training of the operations of a sports team or of individual sportspeople.-Staff:...

    es, other personnel, and, of course, the athlete.
  • Therapeutics is the field, more commonly referenced in earlier periods of history, of the various remedies that can be used to treat disease and promote health http://www.britannica.com/eb/article-9106176?query=Therapeutics&ct=.
  • Travel medicine
    Travel medicine
    Travel medicine or emporiatrics is the branch of medicine that deals with the prevention and management of health problems of international travelers.-Globalization and travel:...

     or emporiatrics deals with health problems of international travelers or travelers across highly different environments.
  • Urgent care
    Urgent care
    Urgent care is the delivery of ambulatory care in a facility dedicated to the delivery of medical care outside of a hospital emergency department, usually on an unscheduled, walk-in basis. Urgent care centers are primarily used to treat patients who have an injury or illness that requires immediate...

     focuses on delivery of unscheduled, walk-in care outside of the hospital emergency department for injuries and illnesses that are not severe enough to require care in an emergency department. In some jurisdictions this function is combined with the emergency room.
  • Veterinary medicine
    Veterinary medicine
    Veterinary Medicine is the branch of science that deals with the prevention, diagnosis and treatment of disease, disorder and injury in non-human animals...

    ; veterinarians apply similar techniques as physicians to the care of animals.
  • Wilderness medicine
    Wilderness medicine
    Wilderness medicine is defined by difficult patient access, limited equipment, and environmental extremes. Today, wilderness or expedition medicine is practiced by Wilderness First Responders, Wilderness EMTs, Remote/Offshore/Wilderness Paramedics and Physicians on expeditions, in outdoor...

     entails the practice of medicine in the wild, where conventional medical facilities may not be available.
  • Many other health science fields, e.g. dietetics

Education



Medical education and training varies around the world. It typically involves entry level education at a university medical school
Medical school
A medical school is a tertiary educational institution—or part of such an institution—that teaches medicine. Degree programs offered at medical schools often include Doctor of Osteopathic Medicine, Bachelor/Doctor of Medicine, Doctor of Philosophy, master's degree, or other post-secondary...

, followed by a period of supervised practice or internship
Medical intern
A medical intern is a term used in the United States for a physician in training who has completed medical school. An intern has a medical degree, but does not have a full license to practice medicine unsupervised...

, and/or residency
Residency (medicine)
Residency is a stage of graduate medical training. A resident physician or resident is a person who has received a medical degree , Podiatric degree , Dental Degree and who practices...

. 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.

Many regulatory authorities require continuing medical education
Continuing medical education
Continuing medical education refers to a specific form of continuing education that helps those in the medical field maintain competence and learn about new and developing areas of their field. These activities may take place as live events, written publications, online programs, audio, video, or...

, since knowledge, techniques and medical technology continue to evolve at a rapid rate.

Legal controls


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 charlatan
Charlatan
A charlatan is a person practicing quackery or some similar confidence trick in order to obtain money, fame or other advantages via some form of pretense or deception....

s 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.

Doctors who are negligent or intentionally harmful in their care of patients can face charges of medical malpractice
Medical malpractice
Medical malpractice is professional negligence by act or omission by a health care provider in which the treatment provided falls below the accepted standard of practice in the medical community and causes injury or death to the patient, with most cases involving medical error. Standards and...

 and be subject to civil, criminal, or professional sanctions.

Controversy


The Catholic social theorist Ivan Illich
Ivan Illich
Ivan Illich was an Austrian philosopher, Roman Catholic priest, and "maverick social critic" of the institutions of contemporary western culture and their effects on the provenance and practice of education, medicine, work, energy use, transportation, and economic development.- Personal life...

 subjected contemporary western medicine to detailed attack in his Medical Nemesis, first published in 1975. He argued that the medicalization
Medicalization
Medicalization is the process by which human conditions and problems come to be defined and treated as medical conditions and problems, and thus come under the authority of doctors and other health professionals to study, diagnose, prevent or treat...

 in recent decades of so many of life's vicissitudes — birth and death, for example — frequently caused more harm than good and rendered many people in effect lifelong patients. He marshalled a body of statistics to show what he considered the shocking extent of post-operative side-effects and drug-induced illness in advanced industrial society
Industrial society
In sociology, industrial society refers to a society driven by the use of technology to enable mass production, supporting a large population with a high capacity for division of labour. Such a structure developed in the west in the period of time following the Industrial Revolution, and replaced...

. He was the first to introduce to a wider public the notion of iatrogenesis
Iatrogenesis
Iatrogenesis, or an iatrogenic artifact is an inadvertent adverse effect or complication resulting from medical treatment or advice, including that of psychologists, therapists, pharmacists, nurses, physicians and dentists...

. Others have since voiced similar views, but none so trenchantly, perhaps, as Illich.

Through the course of the twentieth century, healthcare providers focused increasingly on the technology that was enabling them to make dramatic improvements in patients' health. The ensuing development of a more mechanistic, detached practice, with the perception of an attendant loss of patient-focused care, known as the medical model
Medical model
Medical model is the term cited by psychiatrist Ronald D. Laing in his The Politics of the Family and Other Essays , for the "set of procedures in which all doctors are trained." This set includes complaint, history, physical examination, ancillary tests if needed, diagnosis, treatment, and...

 of health, led to criticisms that medicine was neglecting a holistic model. The inability of modern medicine to properly address some common complaints continues to prompt many people to seek support from alternative medicine
Alternative medicine
Alternative medicine is any healing practice, "that does not fall within the realm of conventional medicine." It is based on historical or cultural traditions, rather than on scientific evidence....

. Although most alternative approaches lack scientific validation, some, notably acupuncture for some conditions and certain herbs, are backed by evidence.

Medical error
Medical error
A medical error may be defined as a preventable adverse effect of care, whether or not it is evident or harmful to the patient. This might include an inaccurate or incomplete diagnosis or treatment of a disease, injury, syndrome, behavior, infection, or other ailment.-Definitions:As a general...

s and overmedication
Overmedication
Overmedication is an inappropriate medical treatment that occurs when a patient takes unnecessary or excessive medications. This may happen because the prescriber is unaware of other medications the patient is already taking, because of drug interactions with another chemical or target population,...

 are also the focus of complaints and negative coverage. Practitioners of human factors
Human factors
Human factors science or human factors technologies is a multidisciplinary field incorporating contributions from psychology, engineering, industrial design, statistics, operations research and anthropometry...

 engineering
Engineering
Engineering is the discipline, art, skill and profession of acquiring and applying scientific, mathematical, economic, social, and practical knowledge, in order to design and build structures, machines, devices, systems, materials and processes that safely realize improvements to the lives of...

 believe that there is much that medicine may usefully gain by emulating concepts in aviation safety, where it is recognized that it is dangerous to place too much responsibility on one "superhuman" individual and expect him or her not to make error
Error
The word error entails different meanings and usages relative to how it is conceptually applied. The concrete meaning of the Latin word "error" is "wandering" or "straying". Unlike an illusion, an error or a mistake can sometimes be dispelled through knowledge...

s. Reporting systems and checking mechanisms are becoming more common in identifying sources of error and improving practice. Clinical versus statistical, algorithmic diagnostic methods were famously examined in psychiatric practice in a 1954 book by Paul E. Meehl
Paul E. Meehl
Paul Everett Meehl was an American psychology professor.Born in Minneapolis, Minnesota, Meehl attended University of Minnesota, earning his bachelor's degree in 1941 and his doctorate in 1945...

, which found statistical methods superior. A 2000 meta-analysis
Meta-analysis
In statistics, a meta-analysis combines the results of several studies that address a set of related research hypotheses. In its simplest form, this is normally by identification of a common measure of effect size, for which a weighted average might be the output of a meta-analyses. Here the...

 comparing these methods in both psychology and medicine found that statistical or "mechanical" diagnostic methods were, in general, although not always, superior.

Disparities in quality of care given are often an additional cause of controversy. For example, elderly mentally ill patients received poorer care during hospitalization in a 2008 study. Rural poor African-American men were used in a study of syphilis that denied them basic medical care.

Honors and awards


The highest honor awarded in medicine is the Nobel Prize in Medicine, awarded since 1901 by the Nobel Assembly at Karolinska Institutet
Nobel Assembly at Karolinska Institutet
The Nobel Assembly at Karolinska Institutet is a body at Karolinska Institutet which awards the Nobel Prize in Physiology or Medicine.The Nobel Assembly consists of fifty professors in medical subjects at Karolinska Institutet, appointed by the faculty of the Institute, and is a private...

.

Patronage


There are a number of patron saints
Patron saints of occupations and activities
-A:*Adrian of Nicomedia - arms dealers, butchers, guards, soldiers*Agatha - nurses, bellmaking*Albertus Magnus - natural scientists*Alexander of Comana - charcoal-burners*Alexius - nurses*Aloysius Gonzaga - children, Catholic students, Jesuit Scholastics...

 for physicians, the most important of whom are Saint Luke the Evangelist the physician and disciple of Christ
Christ
Christ is the English term for the Greek meaning "the anointed one". It is a translation of the Hebrew , usually transliterated into English as Messiah or Mashiach...

, Saints Cosmas and Damian
Saints Cosmas and Damian
Saints Cosmas and Damian were twin brothers, physicians, and early Christian martyrs born in Cilicia, part of today's Turkey. They practiced their profession in the seaport of Ayas, Adana, then in the Roman province of Syria...

 (3rd-century physicians from Syria
Syria
Syria , officially the Syrian Arab Republic , is a country in Western Asia, bordering Lebanon and the Mediterranean Sea to the West, Turkey to the north, Iraq to the east, Jordan to the south, and Israel to the southwest....

), and Saint Pantaleon
Saint Pantaleon
Saint Pantaleon , counted in the West among the late-medieval Fourteen Holy Helpers and in the East as one of the Holy Unmercenary Healers, was a martyr of Nicomedia in Bithynia during the Diocletian persecution of 303 AD...

 (4th-century physician from Nicomedia
Nicomedia
Nicomedia was an ancient city in what is now Turkey, founded in 712/11 BC as a Megarian colony and was originally known as Astacus . After being destroyed by Lysimachus, it was rebuilt by Nicomedes I of Bithynia in 264 BC under the name of Nicomedia, and has ever since been one of the most...

). Archangel Raphael is also considered a patron saint of physicians.

The patron saints
Patron saints of occupations and activities
-A:*Adrian of Nicomedia - arms dealers, butchers, guards, soldiers*Agatha - nurses, bellmaking*Albertus Magnus - natural scientists*Alexander of Comana - charcoal-burners*Alexius - nurses*Aloysius Gonzaga - children, Catholic students, Jesuit Scholastics...

 for surgeons are Saint Luke the Evangelist, the physician and disciple of Christ
Christ
Christ is the English term for the Greek meaning "the anointed one". It is a translation of the Hebrew , usually transliterated into English as Messiah or Mashiach...

, Saints Cosmas and Damian
Saints Cosmas and Damian
Saints Cosmas and Damian were twin brothers, physicians, and early Christian martyrs born in Cilicia, part of today's Turkey. They practiced their profession in the seaport of Ayas, Adana, then in the Roman province of Syria...

 (3rd-century physicians from Syria
Syria
Syria , officially the Syrian Arab Republic , is a country in Western Asia, bordering Lebanon and the Mediterranean Sea to the West, Turkey to the north, Iraq to the east, Jordan to the south, and Israel to the southwest....

), Saint Quentin
Saint Quentin
Saint Quentin , Quintinus in Latin, also known as Quentin of Amiens, is an early Christian saint. No real details are known of his life.-Martyrdom:...

 (3rd-century saint from France), Saint Foillan (7th-century saint from Ireland
Ireland
Ireland is an island to the northwest of continental Europe. It is the third-largest island in Europe and the twentieth-largest island on Earth...

), and Saint Roch (14th-century saint from France).

External links