Education and science of medicine

Examination in the faculty of medicine

Branches of medicine

Working together as an interdisciplinary team, many highly trained health professionals besides medical practitioners are involved in the delivery of modern health care. Some examples include: nurses, laboratory scientists, pharmacists, physiotherapists, respiratory therapists, speech therapists, occupational therapists, dietitians and bioengineers.

The scope and sciences underpinning human medicine overlap many other fields. Dentistry and psychology, while separate disciplines from medicine, are considered medical fields.

Midlevel Practitioner

Physician assistants, nurse practitioners and midwives treat patients and prescribe medication in many legal jurisdictions.

Veterinary Medicine

Veterinarians applies similar techniques as physicians to the care of animals.

Physicians have many specializations and subspecializations which are listed below. There are variations from country to country regarding which specialities certain subspecialities are in.

Diagnostic specialties

Clinical laboratory sciences are the clinical diagnostic services which 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 departments are technically trained staff, each of whom usually hold a medical technology degree, who actually perform the tests, assays, and procedures needed for providing the specific services.

Pathology 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 rôle in evidence-based medicine. Many modern molecular tests such as flow cytometry, polymerase chain reaction (PCR), immunohistochemistry, cytogenetics, gene rearragements studies and fluorescent in situ hybridization (FISH) fall within the territory of pathology.

Radiology is concerned with imaging of the human body, e.g. by x-rays, x-ray computed tomography, ultrasonography, and nuclear magnetic resonance tomography.

Clinical disciplines

Anesthesiology (AE) or anaesthesia (BE) is the clinical discipline concerned with providing anesthesia. Pain medicine is often practiced by specialised anesthesiologists.
Dermatology is concerned with the skin and its diseases. In the UK, dermatology is a subspeciality of general medicine.
Emergency medicine is concerned with the diagnosis and treatment of acute or life-threatening conditions, including trauma, surgical, medical, pediatric, and psychiatric emergencies.
General practice, family practice, family medicine or primary care is, in many countries, the first port-of-call for patients with non-emergency medical problems. Family practitioners are usually able to treat over 90% of all complaints without referring to specialists.
Hospital medicine is the general medical care of hospitalized patients. Physicians whose primary professional focus is hospital medicine are called hospitalists in the USA.
Internal medicine is concerned with systemic diseases of adults, i.e. those diseases that affect the body as a whole (restrictive, current meaning), or with all adult non-operative somatic medicine (traditional, inclusive meaning), thus excluding pediatrics, surgery, gynecology and obstetrics, and psychiatry. There are several subdisciplines of internal medicine:
- Cardiology
  Endocrinology
  Gastroenterology
  Hematology
  Infectious Diseases
  Intensive care medicine
  Nephrology
  Oncology
  Pulmonology
  Rheumatology
Neurology is concerned with the diagnosis and treatment of nervous system diseases. It is a subspeciality of general medicine in the UK.
Obstetrics and gynecology (often abbreviated as Ob/Gyn) are concerned respectively with childbirth and the female reproductive and associated organs. Reproductive medicine and fertility medicine are generally practiced by gynecological specialists.
Palliative care is a relatively modern branch of clinical medicine that deals with pain and symptom relief and emotional support in patients with terminal illnesses including cancer and heart failure.
Pediatrics (AE) or paediatrics (BE) is devoted to the care of infants, children, and adolescents. Like internal medicine, there are many pediatric subspecialities for specific age ranges, organ systems, disease classes, and sites of care delivery. Most subspecialities of adult medicine have a pediatric equivalent such as pediatric cardiology, pediatric endocrinology, pediatric gastroenterology, pediatric hematology, pediatric oncology, pediatric ophthalmology, and neonatology.
Physical medicine and rehabilitation (or physiatry) is concerned with functional improvement after injury, illness, or congenital disorders.
Preventive medicine is the branch of medicine concerned with preventing disease.
Psychiatry is the branch of medicine concerned with the bio-psycho-social study of the etiology, diagnosis, treatment and prevention of cognitive, perceptual, emotional and behavioral disorders. Related non-medical fields include psychotherapy and clinical psychology.
Radiation therapy is concerned with the therapeutic use of ionizing radiation and high energy elementary particle beams in patient treatment.
Radiology is concerned with the interpretation of imaging modalities including x-rays, ultrasound, radioisotopes, and MRI (Magnetic Resonance Imaging). A newer branch of radiology, interventional radiology, is concerned with using medical devices to access areas of the body with minimally invasive techniques.
Surgical specialties employ operative treatment. These include Orthopedics, Urology, Ophthalmology, Neurosurgery, Plastic Surgery, Otolaryngology and various subspecialties such as transplant and cardiothoracic. Some disciplines are highly specialized and are often not considered subdisciplines of surgery, although their naming might suggest so.
Urgent care 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.
Gender-based medicine studies the biological and physiological differences between the human sexes and how that affects differences in disease.

Interdisciplinary fields

Interdisciplinary sub-specialties of medicine are:

Aerospace medicine deals with medical problems related to flying and space travel.
Bioethics is a field of study which concerns the relationship between biology, science, medicine and ethics, philosophy and theology.
Biomedical Engineering is a field dealing with the application of engineering principles to medical practice.
Clinical pharmacology is concerned with how systems of therapeutics interact with patients.
Conservation medicine studies the relationship between human and animal health, and environmental conditions. Also known as ecological medicine, environmental medicine, or medical geology.
Diving medicine (or hyperbaric medicine) is the prevention and treatment of diving-related problems.
Evolutionary medicine is a perspective on medicine derived through applying evolutionary theory.
Forensic medicine deals with medical questions in legal context, such as determination of the time and cause of death.
Medical humanities includes the humanities (literature, philosophy, ethics, history and religion), social science (anthropology, cultural studies, psychology, sociology), and the arts (literature, theater, film, and visual arts) and their application to medical education and practice.
eHealth, Medical informatics, and medical computer science are relatively recent fields that deal with the application of computers and information technology to medicine.
Nosology is the classification of diseases for various purposes.
Pharmacogenomics is a form of individualized medicine.
PanVascular Medicine is an approach to deal with the problems of highly specialised but both, medical and economical inefficiently arranged human resources and medical equipment in today's vascular care facilities
Sports medicine deals with the treatment and preventive care of athletics, amateur and professional. The team includes specialty physicians and surgeons, athletic trainers, physical therapists, coaches, 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 [1] [2].
Travel medicine or emporiatrics deals with health problems of international travelers or travelers across highly different environments.

Medical education

Avicenna, considered the "Father of modern medicine", pioneered clinical pharmacology, and described inhalational anesthetics and various drugs and medications, in The Canon of Medicine (1025).

Medical education is education related to the practice of being a medical practitioner, either the initial training to become a physician or further training thereafter.

Medical education and training varies considerably across the world, however typically involves entry level education at a university medical school, followed by a period of supervised practice (Internship and/or Residency) and possibly postgraduate vocational training. Continuing medical education is a requirement of many regulatory authorities.

Various teaching methodologies have been utilised in medical education, which is an active area of educational research.

Legal restrictions

In most countries, it is a legal requirement for medical doctors to be licensed or registered. In general, this entails a medical degree from a university and accreditation by a medical board or an equivalent national organization, which may ask the applicant to pass exams. This restricts the considerable legal authority of the medical profession to physicians that are trained and qualified by national standards. It is also intended as an assurance to patients and as a safeguard against charlatans that practice inadequate medicine for personal gain. While the laws generally require medical doctors to be trained in "evidence based", Western, or Hippocratic Medicine, they are not intended to discourage different paradigms of health and healing, such as alternative medicine or faith healing.

Criticism

Criticism of medicine has a long history. In the Middle Ages, some people did not consider it a profession suitable for Christians, as disease was often considered God sent. God was considered to be the 'divine physician' who sent illness or healing depending on his will. However many monastic orders, particularly the Benedictines, considered the care of the sick as their chief work of mercy. Barber-surgeons (they had the sharpest knives) generally had a bad reputation that was not to improve until the development of academic surgery as a speciality of medicine, rather than an accessory field.

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 of health, led to further criticisms. This issue started to reach collective professional consciousness in the 1970s and the profession had begun to respond by the 1980s and 1990s.

Perhaps the most devastating criticism of modern medicine came from Ivan Illich. In his 1976 work Medical Nemesis, Illich stated that modern medicine only medicalises disease and causes loss of health and wellness, while generally failing to restore health by eliminating disease. This medicalisation of disease forces the human to become a lifelong patient.[3]Other less radical philosophers have voiced similar views, but none were as virulent as Illich. Another example can be found in Technopoly: The Surrender of Culture to Technology by Neil Postman, 1992, which criticises overreliance on technological means in medicine.

Criticism of modern medicine has led to some improvements in the curricula of medical schools, which now teach students systematically on medical ethics, holistic approaches to medicine, the biopsychosocial model and similar concepts.

The inability of modern medicine to properly address many common complaints continues to prompt many people to seek support from alternative medicine. Although most alternative approaches lack scientific validation, some may be effective in individual cases. The bioscience and alternative health care paradigms may differ to such an extent that what constitutes scientific evidence is contested. Many physicians practice alternative medicine alongside "orthodox" approaches but the general body of medical practitioners is often criticised for ignoring the purported value of alternative medicine.

Medical errors are also the focus of many complaints and negative coverage. Practitioners of human factors engineering believe that there is much that medicine may usefully gain by emulating concepts in aviation safety, where it was long ago realized that it is dangerous to place too much responsibility on one "superhuman" individual and expect him or her not to make errors. Reporting systems and checking mechanisms are becoming more common in identifying sources of error and improving practice.

Radical critics of certain medical traditions may hold that whole fields or traditions of medicine are intrinsically harmful or ineffective. They would reject any use or support of practices belonging to that tradition. However, generally, there is a spectrum of efficacy on which all traditions lie; some are more effective, some are less effective, but nearly all contain some harmful practices and some effective ones. Naturally, though, most individuals or groups seeking a health care practice to improve their own health would seek a tradition with the maximum degree of efficacy. There is no doubt whatsoever that Western Allopathic medicine, together with its cohorts of improved hygiene and nutrition, have been collectively responsible for most of the improvements in health worldwide over the last century or so, including: increasing longevity, decreased child mortality, increasing population numbers, better ability to monitor and halt disease spread and outbreaks, improved access to health care for all strata of society.

This guide is licensed under the GNU Free Documentation License. It uses material from the Wikipedia.

Nicolae Sfetcu