A Guide to Medical Specialties

Medical students are often confident in stating their desire to ‘become a doctor’. But what about the specific types of medical practice that are open to you? By no means do you need to have your whole medical career path mapped out at the beginning of medical school. But at the end of the path, you will have to make the decision to specialise. It’s therefore pretty important to know what options there are once you’ve graduated. So here’s an introduction to your post-grad options. 

Generally, healthcare professionals are divided into primary care practitioners and specialists. Primary care practitioners are more generalised; they see a wide range of patients and refer difficult or specific cases to more specialised doctors. Examples of primary care practitioners include General Practitioners (GPs) and Paediatricians. A specialist could be a cardiologist or a neurosurgeon. In most countries (including the UK and US), specialists earn more money on average. 

If you want to read more about the experience of different specialities from the eyes of the doctor, check out these books every medical student should read. Otherwise, read on to delve further into all of the medical career options you might like to consider.

Surgery

Surgery naturally comes with the most physical interaction and hands-on approach of all medical specialities. It requires you not only to have good control over your hands but more importantly to be able to think and act quickly and decisively. There’s no time to check the textbooks when something unexpected happens in the operating theatre!

This is one discipline where doctors can instantly see the results yielded by their work, and therefore comes with huge satisfaction. When things go wrong, however, you need to be able to deal with the consequences on both a personal and professional level, arguably the most tricky aspect of being a surgeon.

Keep in mind that surgeons have to work extremely long shifts, and even on their days off can be on-call (which means that if you’re needed for an urgent operation, the hospital will call you in to do it – making the case your responsibility). 

What Are The Surgical Specialties?

Here are the surgical specialities available in the NHS (National Health Service):

• Cardiothoracic surgery – operates on the heart, lungs and everything else in the chest.
• General surgery – has the advantage of doing several different operations, which many people enjoy. However, not specialising further into one area of the body means that it’s more difficult to “master” a certain procedure or group of procedures.
• Neurosurgery – operates on the brain. This can be one of the toughest specialities for the surgeon’s own mental wellbeing, as described by a neurosurgeon Henry Marsh in ‘Do No Harm‘. 
• Oral and maxillofacial surgery – operates on the mouth and face.
• Trauma and orthopaedic surgery – concentrate on bones, joints and muscles.
• Otolaryngology – operates on ENT (ear, nose and throat) and the canals connecting the three.
• Paediatric surgery – performs surgery on infants and children. There are also subspecialties, e.g. a paediatric urologic surgeon operates on urologic problems in children.
• Plastic surgery – For a reconstructive plastic surgeon, this involves repair, reconstruction and replacement of parts of the body that are either disfigured (don’t look right) or dysfunctional (don’t work properly). A cosmetic plastic surgeon, on the other hand, improves the appearance (e.g. facelifts) even when it’s not medically needed.
• Urologic surgery – operates on the male and female genitals, as well as the urinary tracts (this includes the kidneys and bladder).
• Vascular surgery – manages diseases involving the blood vessels and lymph vessels. Most of a vascular surgeon’s work tends to be done with catheters (a small tube inserted into a blood vessel in the body) instead of open surgery.

Anaesthesia

Anaesthesia goes hand-in-hand with surgery. An anaesthesiologist cares for the patient before, during, and immediately after a medical procedure – their job is to give the correct amount of anaesthetic (usually a gas or intravenous fluid (or both) that makes the patient unconscious/insensitive to pain), and monitor the patient’s reactions since anaesthesia can go wrong very quickly. 

Academic Medicine

Clinical academics are doctors who combine their work with research and teaching. This is possible across all specialities, from anaesthesiology to public health. Clinical academics are employed by a hospital (where they have clinical duties) and at a university (where they teach students and conduct research). The research is usually patient-based, and data is collected from their hospital. 

Emergency Medicine

An emergency room doctor treats all patients that are admitted to the emergency room (or Accident and Emergency room, A&E), whatever their medical conditions. If they require surgery, the on-call trauma surgeon operates. The working conditions for an emergency doctor are often hectic and unpredictable, and the decisions they make play a huge role in the outcome for the patient.

General Internal Medicine

Doctors specialising in general medicine are called physicians, or internists.  The ‘Internal’ label comes from the fact that internists do not operate, but rather use other means to try to diagnose and treat diseases. This covers most hospital-based specialities (as opposed to a speciality in a primary setting, e.g. a General Practitioner). An internist’s job consists of preventing, diagnosing and managing a variety of diseases, which get narrowed down based on the speciality.

Subspecialties of Internal Medicine

General medicine is an umbrella term consisting of many specialities (around 30), some of which are:

• Cardiology – deals with diseases of the heart and blood vessels.

• Dermatology – deals with diseases of the skin.
• Neurology – deals with diseases of the brain, spinal cord and nerves. For more on neuroscience, check out our Psychology and Neuroscience Summer School. 

General Practice

The General Practitioner (GP) is someone that most people have had contact with in their life. The first point of contact for non-emergency medical problems, a GP can be seen as a filter in the medical world. Cases requiring specialised care are referred to the correct specialist (e.g. Dermatologist), and the rest are managed by the GP themselves. This requires a very broad knowledge of different diseases in different body systems to allow the GP to quickly diagnose and refer patients. This does, as is the case with general surgery, make it difficult to have in-depth knowledge in one specific area.

Obstetrics and Gynaecology

This is a combination of two disciplines required in women’s health: obstetrics is concerned with pregnancy and childbirth, while gynaecology deals with the diseases or problems specific to women and girls, especially to do with the reproductive tract. This includes a substantial amount of surgical work (e.g. performing Caesarean-sections).

Occupational Medicine

A practitioner in occupational medicine is responsible for maintaining the health and wellbeing of a specific workforce. The duties, therefore, differ greatly depending on the company, organisation and sector of work. It’s noteworthy that part-time work is very common and accessible in occupational medicine, depending on the size of the workforce.

Ophthalmology

This is a speciality concerned with eyes and maintaining eyesight. In ophthalmology there is less need for interaction with other healthcare providers. An ophthalmologist is responsible for the prevention, diagnosis, treatment and even surgery.

Paediatrics

A paediatrician acts as a GP for children, from birth to adulthood. A lot of time is spent on prevention of problems, as well as assessment of growth and development. A paediatrician has to be able to communicate well with children, young adults and parents. They must also relay information to and from GPs, schools, social workers and other parties.

Pathology

Patient contact is limited in pathology; the main role of a pathologist lies in the lab. Examining human tissue under the microscope, running and interpreting tests on blood or urine samples, and collecting patient information to come to a diagnosis are the main duties of a pathologist. However, they do work in close communication with other specialists.

Pathology subspecialties

There are three main subspecialties of pathology:

• Chemical Pathology – think test tubes.
• Histopathology – think microscopes.
• Medical Microbiology and Virology – deals with bacteria and viruses; think Petri dishes and tissue culture.

Psychiatry

Psychiatry is concerned with the assessment, diagnosis and treatment of mental illness, as well as behavioural and emotional disorders. Psychiatrists work in a variety of settings: hospitals, clinics, schools and more. As trained doctors, they can prescribe and manage medication of their patients. Psychology, on the other hand, is not a medical speciality and psychologists focus primarily on psychotherapy as a means to help their patients. 

Public Health Medicine

Public health doctors head a multidisciplinary team (i.e. with team members from a variety of backgrounds) to promote health in the population, working on the prevention of disease and improving quality of life. In public health there are also possibilities to work internationally, e.g. with the World Health Organisation (WHO).

Radiology – Oncology

Radiology is traditionally diagnostic: the study of images of the body to confirm or make a diagnosis. A radiologist, therefore, looks at X-rays, CT scans and more. With the introduction of interventional radiology, this role has now expanded to include more patient contact. This means that radiologists are now also involved in treatment as well as diagnosis. Oncology is concerned with cancer (malignancy). It is the non-surgical management of cancer, using both radiotherapy and chemotherapy. Clinical oncology is very patient-centred, and the oncologist (who also heads the multidisciplinary team in most cases) is responsible for following up with the patient after treatment. 

Sport and Exercise Medicine

Sport and exercise physicians treat athletes (and generally sports-related injuries), and they head the multidisciplinary team responsible for an athlete or group of athletes. Government positions (e.g. hospital or university) are limited, so many sports physicians work in the private sector.

The Future of Medical Specialities

This list details all of the existing medical specialities, but it’s important to note the rise of Systems Medicine as a way of looking at patients and diseases. 

Currently, medical specialities are defined based on which organ is affected. For example, a cardiologist specialises in diseases of the heart. Research is increasingly showing that this is an outdated way of dividing medicine up, since a lot of diseases have the same mechanism but affect different organs. 

Systems medicine is a new way of looking at things which groups diseases (and therefore specialities) based on which mechanisms they have in common. Why does this make sense? Let’s say if mechanism A goes wrong, it can either cause disease X or disease Y, but these diseases happen in completely different parts of the body with different symptoms. If we know that the same mechanism A is involved in both of these, and we already have a drug that works on disease X, then it might also work in disease Y – and voila!

That was just one simple example, but the actual real-world applications are countless.

Of course, the field of Medicine in general is changing in lots of other ways too. 

Next Steps for Aspiring Doctors

• Research the details of specialisations in the country you want to study and practice medicine in. For the UK, this means the NHS.
• Check out our Medicine Summer School for Teens to experience what it’s really like to be a medical student, and to find out whether this subject is right for you. Learn more about all of our prestigious Oxford Summer School programmes.