Why are some fields called a specialty vs. a sub-specialty?


5+ Year Member
Jun 4, 2012
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My understanding is that:
IM fellowship trained docs like cardiologists are "specialists" and those with additional training like interventional cardiology are "sub-specialists." However, neurology is a "specialty" from residency with "sub-specialty" fellowships. General surgeons aren't usually referred to as "specialists" but ENT or ortho are residencies of similar length and they are "surgical sub-specialties." Primary care docs are also not usually referred to as "specialists," but some will refer to IM as being their specialty.

Is there some sort of pattern to the nomenclature that I'm not understanding? It just doesn't feel consistent to me. Or is it just arbitrary and I should forget about it?


Infernal Internist / Enigmatic Endocrinologist
10+ Year Member
Apr 25, 2008
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A fair of it is historical happenstance, with a bit of arbitrariness thrown in on top. Don't worry too much about it.

Internal medicine is a specialty. Cardiology is a specialty and a subspecialty of internal medicine. Interventional cardiology is a specialty and a subspecialty of cardiology.

ENT is a specialty in its own right and has been since the 1910s, but some people say all the operative fields other than the specialty of general surgery are subspecialties. Larnygology (for example) is a subspecialty of ENT... or just a specialty.

The concept of a "generalist" doesn't even really exist any more. A general practitioner (in the US) refers to someone who just did one year of residency and hung up a shingle. These people more or less don't exist anymore. The few who practice either all trained 25+ years ago (and have been doing it since then) or washed out of residencies and were unable to complete their training.

Family Medicine is a specialty in its own right.
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