Subspecialties

Subspecialties are narrower fields within a broader discipline, focusing on specific diseases, organ systems, patient populations, or procedures. In medicine, subspecialization typically follows initial residency or general training and involves additional fellowship training and, in many systems, board certification. Subspecialists provide advanced expertise for complex conditions and may perform specialized procedures or manage unique patient groups.

Within internal medicine, subspecialties include cardiology, gastroenterology, endocrinology, infectious disease, nephrology, oncology, pulmonary medicine, rheumatology, and geriatrics. Within surgery, examples include vascular surgery, pediatric surgery, transplant surgery, and endocrine surgery. Radiology subspecialties include neuroradiology and interventional radiology; pathology includes neuropathology and forensic pathology; psychiatry includes child and adolescent psychiatry. Many fields have multiple layered subspecialties, with some pursuing further subspecialization within subspecialties.

Training typically consists of a residency in the base specialty followed by a fellowship in the subspecialty. Certification is often through a specialty board or a national college; requirements may include exams, case logs, and maintenance of certification.

Subspecialization can improve care for complex conditions and enable advanced procedures, but it may influence access, care coordination, and healthcare costs. The extent and organization of subspecialty training vary by country, healthcare system, and specialty, reflecting advances in knowledge and technology.