Embarking on a career in medicine after earning a Doctor of Medicine (MD) degree opens up a vast landscape of opportunities. The crucial next step for new MDs is deciding which path to specialize in, a decision that will shape their future and require significant postgraduate training. The American Association of Medical Colleges (AAMC), a trusted authority in medical education, catalogues over 135 medical specialties and subspecialties available for aspiring physicians. Each of these specialized fields demands a residency period ranging from three to eight years, emphasizing the depth and commitment required for specialization. Some fields further necessitate fellowship study, adding more years of focused learning.
To provide insights into this diverse medical landscape, American University of the Caribbean School of Medicine (AUC) has developed detailed resources outlining major doctor specialties and subspecialties. This guide aims to expand on that foundation, offering a comprehensive list of specialist doctor types to help aspiring medical professionals navigate their choices.
Allergy and Immunology
Allergy and immunology is a specialized field branching from internal medicine. Doctors in this specialty, known as allergist-immunologists, are experts in diagnosing, evaluating, and managing disorders related to the immune system. These conditions encompass a wide range, including common ailments like asthma, eczema, and rhinitis, as well as severe reactions such as anaphylaxis and allergies to drugs, foods, and insect stings.
Beyond common allergies, the field delves into the complexities of host defense mechanisms, immune deficiency diseases, and autoimmune disorders. Allergist-immunologists also play a critical role in managing complications arising from organ transplants and inherent faults within the immune system. Their primary task involves identifying the specific allergen or substance causing a reaction, devising strategies for its elimination, and implementing effective treatment plans.
The training pathway to become an allergist-immunologist includes a foundational three-year residency in either internal medicine or pediatrics. This is followed by a focused two-year residency in allergy and immunology. In some cases, allergy and immunology can be combined with rheumatology into a three-year residency program. The minimum postgraduate training duration for this specialty is five years.
Anesthesiology
Anesthesiology is a critical medical specialty focused on anesthesia, the administration of medication to induce a loss of sensation, particularly pain, within the body. Anesthesiologists are the linchpins of modern surgery; without their expertise, the vast majority of surgical operations would be impossible. These specialist doctors are rigorously trained in administering anesthetics across a spectrum of medical scenarios, including surgical procedures, childbirth, and various other medical interventions.
Their role extends beyond the operating room, encompassing comprehensive perioperative care. This includes pre-operative assessments and patient preparation, meticulous monitoring and care during procedures, and post-operative management to ensure patient comfort and recovery. Anesthesiology residency is a four-year commitment.
Subspecialties within anesthesiology include:
- Adult Cardiothoracic Anesthesiology
- Critical Care Medicine
- Pain Medicine
- Obstetric Anesthesiology
- Pediatric Anesthesiology
Cardiology
Cardiology, a subspecialty of internal medicine, focuses on the intricate workings of the heart and blood vessels – the cardiovascular system. Cardiologists are specialist doctors who diagnose, treat, and prevent diseases and conditions affecting this vital system. They are experts in understanding the mechanisms of heart disease, implementing preventative strategies, and improving survival rates and quality of life for individuals who have experienced cardiovascular events such as heart attacks or coronary artery disease.
The path to becoming a cardiologist involves a three-year residency in internal medicine, followed by an additional three-year residency in cardiology. This rigorous training ensures expertise in this critical area of medicine. The minimum postgraduate training for cardiology is six years.
Subspecialties in cardiology include:
- Advanced Heart Failure and Transplant Cardiology
- Clinical Cardiac Electrophysiology
- Interventional Cardiology
Colon and Rectal Surgery
Colon and rectal surgeons specialize in the diagnosis and treatment of diseases affecting the anal canal, colon, intestinal tract, perianal area, and rectum. Their expertise spans both medical (non-surgical) and surgical approaches. When dealing with intestinal diseases, these specialist doctors may also manage related conditions in the female reproductive system, liver, or urinary tract.
Their surgical skills are employed to treat intestinal and colon issues, including endoscopic procedures for cancer, inflammatory conditions, and polyps. They also manage common conditions like abscesses, constipation, incontinence, fissures, fistulae, and hemorrhoids through medical interventions. The minimum postgraduate training for colon and rectal surgery is six years.
Dermatology
Dermatology is the medical specialty dedicated to the health of the skin, hair, nails, and adjacent mucous membranes. Dermatologists are specialist doctors who diagnose, prevent, and treat over 3,000 different conditions, ranging from minor irritations to severe and life-threatening diseases. They play a crucial role in improving the quality of life for individuals suffering from a wide spectrum of dermatological issues.
The training to become a dermatologist involves a preliminary residency year in a broad clinical specialty, typically internal medicine, followed by a three-year residency in dermatology. The minimum postgraduate training is four years.
Subspecialties within dermatology include:
- Dermatopathology
- Micrographic Surgery
- Dermatologic Oncology
Emergency Medicine
Emergency medicine doctors, also known as emergency physicians, are specialists in the rapid diagnosis and treatment of unforeseen injuries and illnesses. In the fast-paced environment of an emergency department, these physicians function as triage experts, adept at making swift assessments and critical decisions under pressure. They are the front line of care in hospital emergency rooms and similar facilities.
An emergency medicine residency typically lasts three to four years and may be combined with internal medicine or other related disciplines to broaden their expertise.
Subspecialties in emergency medicine include:
- Medical Toxicology
- Pediatric Emergency Medicine
- Sports Medicine
Family Medicine
Family medicine physicians are the cornerstone of primary care, providing comprehensive medical services to individuals across all stages of life. These versatile doctors treat men and women, young and old, offering care from prenatal stages through childhood, adulthood, and into advanced age. Family medicine attracts doctors who appreciate a broad scope of primary care and value building long-term relationships with patients.
A family medicine residency is a three-year program. Many family physicians choose to further specialize by combining family medicine with another specialty or subspecialties like geriatrics or sports medicine, enhancing their range of services.
Forensic Pathology
Forensic pathology is a specialized branch of pathology focusing on cases of sudden, suspicious, or violent deaths. Forensic pathologists play a crucial role in legal and investigative contexts by determining critical factors surrounding a death. Their investigations aim to establish the time of death, the cause of death (specific injury or disease), the manner of death (categorized as natural, accidental, suicidal, homicidal, or undetermined), and, when relevant, the type of instrument that caused fatal injuries.
Their findings are often reported to insurance companies, families of the deceased, and courts of law. Forensic pathologists frequently serve as expert witnesses in court trials, providing crucial medical insights. A residency in forensic pathology typically extends from three to five years.
General Surgery
General surgeons are highly trained specialists proficient in performing a wide array of complex surgical procedures to treat diseases, deformities, and injuries. General surgery is a broad field encompassing surgical conditions affecting nearly every area of the body. A general surgeon’s responsibilities include making diagnoses, providing comprehensive perioperative care, and often managing trauma victims and critically ill patients.
Surgeons in this field must possess competence across various surgical techniques and be prepared to handle emergencies and unexpected situations that arise in the operating room. A general surgery residency is a demanding five-year program.
Subspecialties within general surgery include:
- Hand Surgery
- Pediatric Surgery
- Surgical Critical Care
- Vascular Surgery
Genetics and Genomics
Medical geneticists are specialist doctors who diagnose, evaluate, and manage genetic disorders and birth defects. They play a vital role in helping patients and their families understand and cope with the complexities of these conditions. Geneticists provide genetic counseling, utilizing biochemical, cytogenetic, and radiologic testing to aid in diagnosis and management. They also employ therapeutic interventions and contribute to disease prevention through prenatal diagnosis programs.
These specialists are instrumental in planning and coordinating screening programs for inborn errors related to blood, chromosomes, metabolism, and spinal cord abnormalities. A genetics and genomics residency is a three-year commitment.
Subspecialties include:
- Biochemical Genetics
- Molecular Genetic Pathology
Hospice and Palliative Medicine
Hospice and palliative medicine is a subspecialty that draws from various primary specialties. Hospice care focuses on providing comfort and support to patients with terminal conditions who have opted out of curative treatments. Palliative medicine, more broadly, is concerned with managing symptoms and pain caused by serious illnesses, regardless of prognosis. Physicians in this field aim to alleviate suffering and improve the quality of life for patients and their families facing serious illness or end-of-life stages.
A one-year hospice and palliative medicine fellowship is available after completing a residency in various specialties, including anesthesiology, emergency medicine, family medicine, internal medicine, obstetrics and gynecology, pediatrics, physical medicine and rehabilitation, psychiatry, neurology, or radiology. The minimum postgraduate training is four years.
Hospital Medicine
Hospital medicine is a subspecialty, typically within internal medicine. Hospitalists, as they are known, are specialist doctors who work exclusively in hospitals, providing general medical care to hospitalized patients. Beyond direct patient care, hospitalists are also involved in teaching, conducting research, and working to enhance hospital and healthcare system performance.
Hospitalists usually complete a three-year residency in emergency medicine, family medicine, internal medicine, or pediatrics, followed by a one-year fellowship in hospital medicine. The minimum postgraduate training is four years.
Subspecialties within hospital medicine include:
- Emergency Medical Services
- Hospice and Palliative Medicine
- Neurocritical Care
- Pediatric Hospital Medicine
- Sports Medicine
- Toxicology
- Undersea and Hyperbaric Medicine
Internal Medicine
Internal medicine is a broad and versatile medical discipline that often serves as a foundational specialty for physicians before they pursue further specialization. Doctors of internal medicine, or internists, are adept at evaluating, diagnosing, and managing a wide spectrum of disorders and illnesses affecting adults. Internists may function as primary care physicians, managing chronic illnesses, focusing on disease prevention, and promoting overall health.
Internal medicine encompasses all medical problems and organ systems in adults, making it an ideal base for those seeking additional specialized training. An internal medicine residency is a three-year program.
Subspecialties within internal medicine are extensive and include:
- Cardiovascular Disease
- Infectious Disease
- Pulmonary Disease
- Critical Care Medicine
- Geriatric Medicine
- Sports Medicine
- Endocrinology, Diabetes, and Metabolism
- Gastroenterology
- Hematology
- Medical Oncology
- Nephrology
- Transplant Hepatology
Neurology
Neurologists specialize in diagnosing, treating, and managing conditions affecting the nervous system, which includes the brain, spinal cord, peripheral nerves, muscles, and related blood vessels. They utilize various diagnostic tools such as computer-assisted tomography (CAT) scans, electroencephalograms (EEG), and magnetic resonance imaging (MRI) to identify neurological issues.
Neurologists treat a wide range of conditions including Alzheimer’s disease, encephalitis, epilepsy, headaches, learning disabilities, meningitis, muscular dystrophy, multiple sclerosis, neurodevelopmental disorders, Parkinson’s disease, strokes, and tumors, among other chronic conditions. A neurology residency typically lasts between four and five years.
Subspecialties include:
- Child Neurology
- Clinical Neurophysiology
- Endovascular Surgical Neuroradiology
- Neuromuscular Medicine
- Pain Medicine
Neurological Surgery
Neurological surgery focuses on treating disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply. Neurosurgeons are skilled in both nonoperative management, such as critical care, diagnosis, evaluation, prevention, and rehabilitation, and surgical procedures, including endovascular surgery, functional and restorative surgery, spinal fusion, and stereotactic radiosurgery.
They treat disorders affecting the brain, extracranial carotid and vertebral arteries, meninges, skull, cranial and spinal nerves, pituitary gland, spinal cord, and vertebral column. A neurological surgery residency is one of the longest, requiring seven years of training.
Obstetrics and Gynecology
Obstetrics (care during pregnancy, childbirth, and postpartum) and gynecology (reproductive health and conditions specific to women) are distinct yet closely linked disciplines, often combined in residency and practice. Obstetrician-gynecologists (OB/GYNs) are specialist doctors who are experts in women’s health, handling both obstetrics and gynecology. They provide comprehensive women’s health services, particularly those related to the reproductive organs, and often serve as primary care doctors for women.
OB/GYNs perform diagnostic procedures, surgeries, and other treatments, addressing issues ranging from urinary tract infections and incontinence to delivering babies and managing abnormal bleeding, genital itching, and hormone disorders. They also provide preventive care services, including contraception and immunizations. An obstetrics and gynecology residency is typically a four-year program.
Subspecialties include:
- Female Pelvic Medicine and Reconstructive Surgery
- Gynecologic Oncology
- Maternal-Fetal Medicine
- Reproductive Endocrinology and Infertility
Ophthalmic Surgery
Ophthalmic surgery is the specialty focused on treating diseases and disorders of the eyes. Ophthalmologists are specialist doctors who provide vision correction services, such as prescribing eyeglasses and contact lenses, and perform vision correction surgeries like LASIK and PRK. They also perform surgery to treat conditions such as cataracts, diabetic retinopathy, glaucoma, macular degeneration, and strabismus (cross-eyes). An ophthalmology residency is a four-year program.
Subspecialties in ophthalmic surgery include:
- Cornea and External Disease
- Ocular Oncology
- Neuro-Ophthalmology
- Ophthalmic Plastic and Reconstructive Surgery
- Vitreoretinal Disease
Orthopaedic Surgery
Orthopaedic surgery, also spelled orthopedic surgery, is dedicated to the care of the musculoskeletal system—bones, joints, muscles, ligaments, tendons, associated nerves, arteries, and overlying skin. Orthopaedic surgeons treat a wide range of conditions, including bone fractures, tendon and ligament injuries, and limb and spine deformities. They utilize braces, casts, physical therapy, splints, and surgical interventions to treat congenital deformities, degenerative conditions, infections, metabolic disturbances, trauma, and tumors. Their expertise extends to the surgical treatment of conditions like cerebral palsy, paraplegia, and stroke-related musculoskeletal issues. An orthopaedic surgery residency is a five-year program. The broad scope of the musculoskeletal system leads to numerous subspecialties within orthopaedic surgery, each requiring additional training.
Subspecialties include:
- Adult Reconstructive Orthopaedics
- Hand Surgery
- Musculoskeletal Oncology
- Orthopaedic Sports Medicine
- Orthopaedic Surgery of the Spine
- Pediatric Orthopaedics
Otolaryngology
Otolaryngologists, often referred to as ENTs (Ear, Nose, and Throat physicians), are specialist doctors who diagnose, evaluate, and manage disorders of the ear, nose, throat, and related structures of the head and neck. They treat common conditions like allergies, ear infections, sinusitis, and speech or swallowing problems. However, their expertise also extends to severe conditions such as cancers, nerve pain, thyroid conditions, traumatic injuries, and tumors. Otolaryngologists may also perform plastic or reconstructive surgery within their area of specialization. An otolaryngology residency generally lasts five years.
Subspecialties within otolaryngology include:
- Neurotology
- Pediatric Otolaryngology
Pathology
Pathologists are specialist doctors who are experts in diagnosing, prognosing, and treating disorders of body tissues and fluids. Pathology, the study of disease, combines science and medicine, requiring detailed knowledge in both areas. Pathologists are involved in all aspects of patient care, from disease prevention and diagnostic testing to treatment strategies and the application of new technologies. They play a critical role in identifying and treating numerous conditions, improving the quality of life for individuals with chronic and life-threatening illnesses. A pathology residency typically lasts three to four years. Pathologists may specialize further in analytic, diagnostic, or forensic pathology residencies.
Subspecialties within pathology include:
- Blood Banking-Transfusion Medicine
- Chemical Pathology
- Cytopathology
- Hematology
- Medical Microbiology
- Neuropathology
- Pediatric Pathology
Pediatrics
Pediatricians are specialist doctors dedicated to the care of infants, children, adolescents, and young adults. They focus on the physical, emotional, and psychological health of their young patients. Pediatricians treat illnesses, injuries, and infections and also monitor and support children’s development, ensuring they achieve milestones in growth, behavior, and skills. They also provide crucial advice to parents on health, nutrition, safety, and fitness. A pediatric residency is a three-year program, and many pediatricians choose to combine pediatrics with another specialty to broaden their expertise.
Subspecialties within pediatrics are numerous, reflecting the comprehensive nature of child healthcare:
- Adolescent Medicine
- Child Abuse Pediatrics
- Developmental-Behavioral Pediatrics
- Neonatal-Perinatal Medicine
- Pediatric Cardiology
- Pediatric Critical Care Medicine
- Pediatric Endocrinology
- Pediatric Gastroenterology
- Pediatric Hematology-Oncology
- Pediatric Infectious Diseases
- Pediatric Nephrology
- Pediatric Pulmonology
- Pediatric Rheumatology
- Pediatric Sports Medicine
- Pediatric Transplant Hepatology
Physical Medicine and Rehabilitation
Doctors of physical medicine and rehabilitation (PM&R), also known as physiatrists, are specialist doctors who are experts in diagnosing, prognosing, and treating disorders of the musculoskeletal system and nervous system as they relate to physical function. This includes bones, muscles, joints, and the nerves that control movement and sensation. Physiatrists aim to enhance and restore functional ability and quality of life for people with physical impairments or disabilities. PM&R physicians complete a preliminary year of internal medicine followed by a three-year PM&R residency. The minimum postgraduate training is four years.
Subspecialties within physical medicine and rehabilitation include:
- Neuromuscular Medicine
- Pain Medicine
- Spinal Cord Injury Medicine
- Sports Medicine
Plastic Surgery
Plastic surgeons are specialist doctors in the repair, reconstruction, or replacement of physical defects involving various parts of the body, including the breast and trunk, craniomaxillofacial structures, external genitalia, extremities, hands, musculoskeletal system, and skin. They also focus on the cosmetic enhancement of these areas to improve appearance and optimize outcomes of reconstructive procedures. A plastic surgery residency lasts five to six years.
Subspecialties include:
- Craniofacial Surgery
- Hand Surgery
Preventive Medicine
Preventive medicine specialists are experts in disease prevention and health promotion. These specialist doctors work to maintain and improve the health of individuals, groups, communities, or entire populations. Preventive medicine physicians assess medical conditions, conduct physical examinations, make diagnoses, develop treatment plans, and evaluate health programs and policies. They also utilize diagnostic studies and tests and provide guidance on lifestyle modifications such as smoking cessation, weight management, healthy eating, and reducing alcohol or drug use. They are also involved in ensuring healthy pregnancies, safe work environments, treating depression, working in poison control centers, and administering vaccinations. Preventive medicine residency typically begins with a transitional year of internal medicine followed by two years of specialized preventive medicine training. Alternatively, doctors may complete a three-year internal or family medicine residency and then add a year of preventive medicine training. The minimum postgraduate training is three years.
Subspecialties within preventive medicine include:
- Addiction Medicine
- Aerospace Medicine
- Occupational Medicine
- Undersea and Hyperbaric Medicine
- Clinical Informatics
- Medical Toxicology
- Public Health
Psychiatry
Psychiatrists are medical doctors specializing in the diagnosis, prevention, and treatment of a wide range of mental health disorders, including addictive, adjustment, anxiety, behavioral, emotional, mood, psychotic, and sexual or gender identity disorders. As medical doctors, psychiatrists understand the biological, psychological, and social factors contributing to mental illness. They evaluate and treat patients through behavior modification, individual and group therapy, and psychoanalysis, often adopting a holistic treatment approach. Psychiatrists are also qualified to prescribe pharmacological treatments when necessary. A psychiatry residency is a four-year program.
Subspecialties within psychiatry include:
- Addiction Psychiatry
- Administrative Psychiatry
- Child and Adolescent Psychiatry
- Community Psychiatry
- Consultation/Liaison Psychiatry
- Emergency Psychiatry
- Forensic Psychiatry
- Geriatric Psychiatry
- Intellectual Disability Psychiatry
- Military Psychiatry
- Pain Medicine
- Psychiatric Research
- Psychosomatic Medicine
Radiology
Radiologists are specialist doctors who interpret medical images to diagnose and treat diseases and injuries. They utilize technologies such as computed tomography (CT) scanning, magnetic resonance imaging (MRI), nuclear imaging, positron emission tomography (PET), X-rays, and ultrasound to generate these images. Radiologists’ expertise in image interpretation is crucial for detecting and treating a wide range of medical conditions. A doctor of radiology may specialize in diagnostic radiology, interventional radiology, or radiation oncology. Radiology residencies require a preliminary year in a broad-based clinical specialty like internal medicine, followed by a four to six-year residency, depending on the chosen radiology specialization. The minimum postgraduate training is five years.
Subspecialties within radiology include:
- Abdominal Radiology
- Cardiothoracic Radiology
- Endovascular Surgical Neuroradiology
- Musculoskeletal Radiology
- Neuroradiology
- Nuclear Medicine
- Pediatric Radiology
- Vascular Radiology
Rheumatology
Rheumatology, a subspecialty of internal medicine, focuses on the evaluation, diagnosis, and management of disorders affecting joints, muscles, and connective tissues. Rheumatologists treat a broad spectrum of musculoskeletal disorders, including autoimmune and inflammatory diseases that can affect other organ systems. Conditions they commonly treat include arthritis, crystalline diseases, fibromyalgia, gout, lupus, osteoporosis, osteoarthritis, polymyalgia rheumatica, spondyloarthropathies, vasculitis, and common musculoskeletal and sports injuries. Rheumatologists complete a three-year residency in internal medicine followed by a two-year residency in rheumatology. In some programs, rheumatology can be combined with allergy and immunology into a three-year residency. The minimum postgraduate training is five years.
Sleep Medicine
Sleep medicine, another subspecialty of internal medicine, is dedicated to the diagnosis and treatment of sleep disturbances and disorders. Physicians in sleep medicine, known as somnologists, address circadian sleep disorders and conditions such as insomnia, narcolepsy, sleep apnea, and somnambulism. Somnologists complete a three-year residency in internal medicine followed by a one-year residency in sleep medicine. The minimum postgraduate training is four years.
Thoracic Surgery
Thoracic surgeons specialize in surgeries of the chest, including cardiothoracic surgery, which is considered one of the most demanding medical specialties. This area of the body houses vital organs like the heart and lungs. Thoracic surgeons perform critical operations such as open-heart surgery, lung tissue removal for cancer, and tumor removal from the esophagus and chest wall. They also treat abnormalities of major blood vessels like the aorta and problems of the diaphragm, as well as airway issues and chest injuries. A thoracic surgery residency typically lasts seven years. Congenital cardiac surgery is a specialized subspecialty within thoracic surgery.
Urology
Urologists, also known as genitourinary surgeons, diagnose and treat disorders of the urinary tracts and the male reproductive system. They manage both nonsurgical conditions like urinary tract infections and prostatic hyperplasia, and surgical problems such as cancers, congenital abnormalities, and stress incontinence. A urology residency requires at least five years of training. Pediatric urology is a primary subspecialty within this field.
Vascular Surgery
Vascular surgeons specialize in diseases and disorders of the arteries, veins, and lymphatic systems, excluding those of the brain and heart. They are trained in both surgical and nonsurgical treatments for vascular disease. Vascular surgeons perform procedures to clear artery blockages, repair veins to improve circulation, and treat aneurysms in the aorta or vascular trauma. A vascular surgery residency lasts six to seven years.
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