Clinical Biochemical/Molecular Geneticists (MG CBMG): Clinical biochemical/molecular geneticists have been issued a combined certificate certifying competence in both clinical biochemical genetics and clinical molecular genetics.

Clinical Cytogeneticists (MG CCytG): Clinical cytogeneticists demonstrate competence to provide cytogenetic laboratory diagnostic and clinical interpretive services. Competence in this area implies that the individual is trained in:

Clinical Geneticists (MG CGen): A clinical geneticist demonstrates competence to provide comprehensive diagnostic, management, and counseling services. Competence in this area implies that the individual is trained in:

Clinical Molecular Geneticists (MG CMGn): A clinical molecular geneticist demonstrates competence in performing and interpreting molecular analyses relevant to the diagnosis and management of human genetic diseases, and are consultants regarding laboratory diagnosis of a broad range of inherited disorders. Competence in this area implies that the individual is trained in:

Ph.D. Medical Geneticists (MG PhDMG): Medical geneticists work in association with a medical specialist, are affiliated with a clinical genetics program, and serve as a consultant to medical and dental specialists. Competence in this area implies that the individual is trained in:

Maternal & Fetal Medicine: (See OBSTETRICS & GYNECOLOGY)
Medical Oncology: (See INTERNAL MEDICINE; PEDIATRICS)
Medical Microbiology: (See PATHOLOGY)
Medical Toxicology: (See EMERGENCY MEDICINE; PEDIATRICS; PREVENTIVE MEDICINE)

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Nephrology: (See INTERNAL MEDICINE; PEDIATRICS)

NEUROLOGICAL SURGERY (NS)
GENERAL CERTIFICATE: NEUROLOGICAL SURGERY: Neurological surgery is the discipline of medicine and that specialty of surgery which provides the operative and nonoperative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system, including the hypophysis; and the operative and nonoperative management of pain. Neurological surgery encompasses treatment of patients with disorders of the nervous system: the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and spine, including treatment by fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution.

NEUROLOGY (N)
GENERAL CERTIFICATE ISSUED BY THE AMERICAN BOARD OF PSYCHIATRY AND NEUROLOGY
GENERAL CERTIFICATES FOR NEUROLOGY: Neurology; Neurology with Special Qualifications in Child Neurology
SUBSPECIALTY CERTIFICATES FOR NEUROLOGY: Clinical Neurophysiology
The specialty of neurology is concerned with the diagnosis and treatment of all categories of disease or impaired function of the brain, spinal cord, peripheral nerves, muscles, and autonomic nervous system, as well as the blood vessels that relate to these structures. The neurologist serves as a consultant to other physicians, but is often also the principal or primary physician and may render all levels of care commensurate with his or her training. This may include continuing care of outpatients and/or inpatients. The neurologist will often perform and interpret certain tests that relate to the central or peripheral nervous system or muscles.

The neurologist should have completed training in an accredited training program and may be certified through examination by the American Board of Psychiatry and Neurology, in neurology, and/or in neurology with special qualifications in child neurology.

Clinical Neurophysiology (C/NPh): The practice of clinical neurophysiology involves one additional year of training in the diagnosis and management of central and peripheral nervous system disorders using electrophysiological techniques.

Neuropathology: (See PATHOLOGY)
Neuroradiology: (See RADIOLOGY)
Neurotology: (See OTOLARYNGOLOGY)

NUCLEAR MEDICINE (NuM)
GENERAL CERTIFICATE: Nuclear Medicine
Nuclear medicine is the medical specialty that employs the nuclear properties of radioactive and stable nuclides in diagnosis, therapy, and research. These properties are used to evaluate metabolic, physiologic, and pathologic conditions in both the clinical and laboratory setting. A specialist in nuclear medicine is a physician who has been awarded a medical degree from an approved medical or osteopathic school, has satisfactorily completed two or more years of residency training in a general medical specialty, and two additional years of nuclear medicine residency in an accredited residency program. In addition, he or she has satisfactorily passed a rigorous written examination encompassing the diagnostic and therapeutic use of radioactive materials, and one in the related physical and biological sciences.

The professional competence of nuclear medicine physicians is in the diagnostic and therapeutic uses of radionuclides including: radioimmunoassay; therapy with radioisotopically labelled antibodies; positron emission tomography (PET); and single proton emission computerized tomography (SPECT). Additionally, the nuclear medicine physician has special knowledge in the biologic effects of radiation exposure; the principles of radiation safety and protection; the management of patients who have been exposed to ionizing radiation; and special knowledge in the physical sciences encompassing the fundamentals of nuclear physics and nuclear magnetic resonance; the principles and operation of radiation detection and nuclear imaging instrumentation systems; statistics and fundamentals of computer sciences.

The nuclear medicine specialist serves as a consultant to physicians, obtaining pertinent information from patients as necessary by means of history and physical examination and selecting and carrying out appropriate diagnostic or therapeutic uses of radionuclides.

The nuclear medicine physician has broad knowledge and experience in medicine and is capable of extending the scope of nuclear medicine as the specialty evolves and expands.

Nuclear Radiology: (See RADIOLOGY)
Neuroradiology: (See RADIOLOGY)

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OBSTETRICS AND GYNECOLOGY (ObG)
GENERAL CERTIFICATE: Obstetrics & Gynecology
SUBSPECIALTY CERTIFICATES: Critical Care Medicine; Gynecologic Oncology; Maternal & Fetal Medicine; Reproductive Endocrinology
Obstetrician-gynecologists are physicians who, by virtue of satisfactory completion of a defined course of graduate medical education and appropriate certification, possess special knowledge, skills, and professional capability in the medical and surgical care of the female reproductive system and associated disorders, such that it distinguishes them from other physicians and enables them to serve as consultants to other physicians, and primary physicians for women. Over the years of practice, each obstetrician-gynecologist builds on this broad base of knowledge and skills and may develop a unique type of practice and changing professional focus. Such diversity contributes to high quality health care for women.

Critical Care Medicine (CCM): The obstetrician-gynecologist who has received additional training in critical care medicine is a physician specialist whose knowledge is of necessity broad, involving all aspects of management of the critically ill patient, and whose base of operation is the intensive care unit (ICU). The critical care medicine physician has completed training in a primary specialty and is, in addition, trained in critical care medicine aspects of many disciplines. This enables the critical care medicine specialist to work in concert with the various specialties on the patient care team in the ICU; to utilize recognized techniques for vital life support; to teach other physicians, nurses, and health professionals the practice of intensive care; and to foster research. The discipline of critical care medicine is primarily concerned with the care of the patient with a critical illness.

Gynecologic Oncology (GO): A gynecologic oncologist is a specialist in obstetrics and gynecology who by virtue of education and training, is prepared to provide consultation and comprehensive management of patients with gynecologic cancer, and whose activity includes the practice of gynecologic oncology in an institutional setting wherein all the effective forms of cancer therapy are available. Comprehensive management should include those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and complications resulting therefrom.

Maternal and Fetal Medicine (MF): A maternal and fetal medicine specialist is a specialist in obstetrics and gynecology who by virtue of additional education is prepared to care for, or provide consultation on, patients with complications of pregnancy. This requires advanced knowledge of the obstetrical, medical, and surgical complications of pregnancy, and their effect on both the mother and the fetus. It also requires expertise in the most current diagnostic and treatment modalities used in the care of patients with complicated pregnancies. Advanced knowledge of newborn adaptation is also necessary to ensure a continuum of excellence in care from the fetal to newborn periods.

Reproductive Endocrinology (RE): A reproductive endocrinologist is a specialist in obstetrics and gynecology who is capable of managing complex problems relating to reproductive endocrinology and infertility, and whose current professional activity involves the practice of reproductive endocrinology in a setting wherein essential diagnostic and therapeutic resources are available and being used appropriately.

Occupational Medicine: (See PREVENTIVE MEDICINE)

OPHTHALMOLOGY (Oph)
GENERAL CERTIFICATE: Ophthalmology
An ophthalmologist is a physician who has been awarded a medical degree from an accredited medical or osteopathic school, who has had at least one year of general medical postgraduate (residency) training in an accredited program, and who has subsequently satisfactorily completed three or more additional years of postgraduate medical and surgical training in an accredited ophthalmology residency training program. Upon completion of training, board certified ophthalmologists will have passed the written and oral examinations of the American Board of Ophthalmology.

Ophthalmologists have the knowledge and professional skills needed to provide comprehensive eye and vision care. They are the only practitioners medically trained to diagnose, monitor, and medically or surgically treat all eyelid and orbital problems affecting the eye and visual pathways, and to diagnose, monitor, and treat all eye and visual disorders. In so doing, they often prescribe vision services (glasses and contact lenses). The ophthalmologist also serves as a consultant to physicians and other professionals.

ORTHOPAEDIC SURGERY (OrS)
GENERAL CERTIFICATE: Orthopaedic Surgery
SUBSPECIALTY CERTIFICATE: Hand Surgery
Orthopaedic surgery is the medical specialty that includes the preservation, investigation and restoration of the form and function of the extremities, spine, and associated structures by medical, surgical, and physical means.

Orthopaedic surgeons are involved with the care of patients whose musculoskeletal problems are present at birth or develop at any time during their lifetime. Congenital deformities, trauma, infections, tumors, and metabolic disturbances of the musculoskeletal system are problems cared for by the orthopaedic surgeon. These musculoskeletal problems include deformities, injuries, and degenerative diseases of the spine, hands, feet, knee, hip, shoulder, and elbow in children and adults. The orthopaedic surgeon is concerned with primary and secondary muscular problems. They are also involved in the care of patients who manifest the effects of central or peripheral nervous system lesions of the musculoskeletal system.

Hand Surgery (HS): Hand surgery is that special field of medicine that includes the investigation, preservation and restoration by medical, surgical, and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist.

The hand surgeon is trained to provide appropriate care for all structures in the upper extremity directly affecting the hand and wrist function and is taught both the cognitive and manual skills necessary to treat complex problems involving the hand and wrist.

OTOLARYNGOLOGY (Oto)
GENERAL CERTIFICATE: Otolaryngology
SUBSPECIALTY CERTIFICATES: Otology/Neurotology; Pediatric Otolaryngology
An otolaryngologist-head and neck surgeon is a physician who has been prepared by accredited residency programs to provide comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, the respiratory and upper alimentary systems and related structures, and the head and neck in general. The required five years of postgraduate specialty training must include one or more years of general surgery and three or more years of otolaryngology-head and neck surgery in approved residency programs. The otolaryngologist-head and neck surgeon has a command of the core of knowledge, and skills and understanding of the basic medical sciences relevant to the head and neck; the respiratory and upper alimentary systems; the communication sciences, including knowledge of audiology and speech-language pathology; the chemical senses and allergy, endocrinology, and neurology, as they relate to the head and neck.

The clinical aspects of diagnosis and the medical and/or surgical therapy or prevention of diseases, neoplasms, deformities, disorders and/or injuries of the ears, the respiratory and upper alimentary systems, the face, jaws, and the other head and neck systems. Head and neck oncology and facial plastic and reconstructive surgery are fundamental areas of expertise.

Otology/Neurotology: The otolaryngologist and head and neck surgeon who specializes in otology/neurotology is a physician who, after completion of training in otolaryngology and head and neck surgery, must receive additional training in the diagnosis, management, prevention, cure and care of patients with diseases of the ear and temporal bone, including disorders of hearing and balance. The additional training in otology and neurotology emphasizes the study of embryology, anatomy, physiology, epidemiology, pathophysiology, pathology, genetics, immunology, microbiology, and the etiology of diseases of the ear and temporal bone.

The operating microscope and the development of new technology and refined surgical techniques have enhanced the treatment opportunities for patients in need of cochlear implants, implantable hearing aids, and extensive reconstructive techniques on the tympanum and ossicular chains. The physician specializing in otology/neurotology is also knowledgeable about the newer developments in vestibular physiology and neurotologic surgery.

Pediatric Otolaryngology: The pediatric otolaryngologist is a subspecialist within the specialty of otolaryngology-head and neck surgery which is defined both by the age of the patient served and the training and education of the physician providing medical and surgical care. The pediatric otolaryngologist has special expertise in the management of infants and children with disorders that include congenital and acquired conditions involving the aerodigestive tract, nose and paranasal sinuses, the ear, and other areas of the head and neck. The pediatric otolaryngologist is competent to diagnose, treat, and manage (including the insertion of prosthetic devices) diseases and disorders of the laryngotracheal complex, the aerodigestive tract, the nose and paranasal sinuses, the head and neck, and the ear. The pediatric otolaryngologist has special skills in the diagnosis, treatment, and management of childhood disorders of voice, speech, language, and hearing.

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Pain Management: (See ANESTHESIOLOGY)

PATHOLOGY (Path)
GENERAL CERTIFICATE: Anatomic & Clinical Pathology; Anatomic Pathology; Clinical Pathology
SUBSPECIALTY CERTIFICATES: Blood Banking/Transfusion Medicine; Chemical Pathology, Cytopathology, Dermatopathology; Forensic Pathology; Hematology; Immunopathology; Medical Microbiology; Neuropathology; Pediatric Pathology
Pathology is that specialty of the practice of medicine dealing with the causes and nature of disease. It contributes to diagnosis, prognosis, and treatment through knowledge gained by the laboratory application of the biologic, chemical, and physical sciences to man, or materials obtained from man.

A certified specialist in pathology is a physician who voluntarily undertook and successfully completed an approved graduate medical education program in pathology and an evaluation process, including an examination administered by the American Board of Pathology. The purpose of the certification process is to assure the public and the medical profession that the pathologist has a level of knowledge, skill, and other abilities deemed necessary for the scientific practice of pathology.

Pathologists are prepared to use their skills and knowledge for the diagnosis, exclusion, and monitoring of disease by means of information gathered from the microscopic examination of tissue specimens, cells, and body fluids, and from clinical laboratory tests on body fluids and secretions. The application of the resulting information to patient care requires pathologists to be particularly knowledgeable in the management of laboratories and in data processing, and to be conversant with new developments in high technology. Pathologists have the clinical training as well as the laboratory expertise to function as consultants to physicians practicing clinical medicine and to patients.

Blood Banking/Transfusion Medicine (BBTM): A physician specializing in blood banking is responsible for the maintenance of an adequate blood supply, blood donor and patient-recipient safety, and appropriate blood utilization. Pretransfusion compatibility testing and highly specialized testing procedures for antibodies under his or her direction assure the clinician and the patient that blood transfusions, when indicated, are as safe as possible. The blood bank specialist directs the preparation and safe use of specially prepared blood components, including red blood cells, white blood cells, platelets, and plasma constituents.

Chemical Pathology (ChemP): A chemical pathologist is expert in the biochemistry of the human body as it applies to the understanding of the cause and progress of disease. Chemical pathology entails the application of biochemical data to the detection, confirmation, or monitoring of disease. The chemical pathologist functions as a clinical consultant in the diagnosis and treatment of human disease.

Cytopathology (CytoP): A cytopathologist is a fully trained and certified anatomic pathologist who, in addition, has special training and experience in the diagnosis of human disease by means of the study of cells. The cells are obtained from body secretions and fluids, by scraping, washing, or sponging the surface of a lesion, or by the aspiration of a tumor mass or body organ with a fine needle. The cells are studied using special stains and chemical analyses. A major aspect of a cytopatho-logist's practice is the interpretation of Papanicolaou-stained smears of cells from the female reproductive systems, the "Pap" test.

However, the cytopathologist's expertise is applied to the diagnosis of cells from all systems and areas of the body. The cytopathologist is a consultant to all medical specialists. Dermatopathology (DP): A dermatopathologist is expert in diagnosing and monitoring diseases of the skin including infectious, immunologic, degenerative, and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings, and smears of skin lesions by means of light microscopy, electron microscopy, and fluorescence microscopy. In order to fulfill his or her consulting role to the patient and to the patient's physician, the dermatopathologist is required to have a good general knowledge of medicine and in-depth knowledge of dermatology, microbiology, parasitology, new technology, and laboratory management.

Forensic Pathology (FP): A forensic pathologist is expert in investigating and evaluating cases of sudden, unexpected, suspicious and violent death as well as other specific classes of death defined by law. The forensic pathologist serves the public as coroner or medical examiner, or by performing medico-legal autopsies for such officials.

Hematology (Hem): A hematologist/pathologist is expert in diseases that affect blood cells, blood clotting mechanisms, bone marrow, and lymph nodes. This specialist has the knowledge and technical skills essential for the laboratory diagnosis of anemias, leukemias, lymphomas, bleeding disorders, and blood clotting disorders. The hematologist/pathologist functions as a consultant to all physicians and works closely with clinical hematologists and oncologists.

Immunopathology (IP): An immunopathologist is concerned with the scientific study of the causes, diagnosis, and prognosis of disease by the application of immunological principles to the analysis of tissues, cells, and body fluids. The immunopathologist is required to have a detailed understanding of the immunologic basis of disease from the perspective of anatomic and clinical pathology, and to have the knowledge and ability to interpret laboratory data in relation to patients with immunologic diseases and organ transplant recipients.

Medical Microbiology (MMB): A medical microbiologist devotes expertise to the isolation and identification of microbial agents that cause infectious disease. Viruses, bacteria and fungi, as well as single-cell and larger parasites are identified and, where possible, tested for susceptibility to appropriate antimicrobial agents. This pathologist frequently acts as consultant to primary care physicians in the diagnosis and selection of therapy for patients with infectious disease, to the hospital quality assurance program in the area of infection control, and to the hospital pharmacy in the area of antibiotic utilization.

Neuropathology (NP): A neuropathologist is expert in the diagnosis of disease of the nervous system and skeletal muscles and functions as a consultant primarily to neurologists and neurosurgeons. The neuropathologist is knowledgeable in the infirmities of man as they affect the nervous and neuromuscular systems, be they degenerative, infectious, metabolic, immunologic, neoplastic, vascular, or physical in nature. In the diagnosis of these diseases, the neuropathologist employs the special skills and techniques necessary for the scientific study of tissues, cells, and body fluids.

Pediatric Pathology (PdP): The specialist in pediatric pathology is expert in the laboratory diagnosis of diseases that occur during fetal growth and infant and childhood development. The practice of this specialty requires a strong foundation in general pathology and substantial understanding of normal growth and development, along with extensive knowledge of pediatric medicine. The pediatric pathologist is a consultant to pediatricians and all physicians involved in the care of infants and children.

PEDIATRICS (Ped) GENERAL CERTIFICATE: Pediatrics
SUBSPECIALTY CERTIFICATES: Adolescent Medicine; Clinical & Laboratory Immunology; Medical Toxicology; Neonatal-Perinatal Medicine; Pediatric Cardiology; Pediatric Critical Care Medicine; Pediatric Emergency Medicine; Pediatric Endocrinology; Pediatric Gastroenterology; Pediatric Hematology-Oncology; Pediatric Infectious Disease; Pediatric Nephrology; Pediatric Pulmonology; Pediatric Rheumatology; Sports Medicine
Pediatrics is the specialty of medical science concerned with the physical, emotional, and social health of children from birth to young adulthood. Pediatric care encompasses a broad spectrum of health services ranging from preventive health care to the diagnosis and treatment of acute and chronic diseases.

Pediatrics is a discipline that deals with biological, social, and environmental influences on the developing child, and with the impact of disease and dysfunction on development. Children differ from adults anatomically, physiologically, immunologically, psychologically, developmentally, and metabolically. The pediatrician understands this constantly changing functional status of his or her patients incident to growth and development, and the consequent changing standards of what is "normal" for a specific age.

A pediatrician is a medical specialist who is primarily concerned with the health, welfare, and development of children and is uniquely qualified for these endeavors by virtue of interest and initial training. Maintenance of these competencies is achieved by experience, training, and continuous education.

A pediatrician is able to accurately define a child's health status, as well as serve as a consultant and make use of other specialists as consultants. Because children's welfare is heavily dependent on the home and family, the pediatrician supports efforts to create a nurturing environment. Such support includes education about healthful living and anticipatory guidance for both patients and parents.

A pediatrician participates at the community level in preventing or solving problems in child health care and publicly advocates the causes of children.

Adolescent Medicine (AM): The pediatrician specializing in adolescent medicine is a multidisciplinary health care specialist trained in the unique physical, psychological, and social characteristics of adolescents, their health care problems and needs. The adolescent medicine specialist in pediatrics connects the treatment of adolescent patients with general adult medicine and the health sciences. The practice of adolescent medicine includes relevant areas of pediatrics, internal medicine, Family Medicine, psychiatry, and obstetrics and gynecology among the primary fields; orthopaedics/sports medicine, endocrinology, dermatology, infectious disease, and clinical pharmacology among the subspecialty areas of medicine, and such allied health fields as law, psychology, social work, nutrition, juvenile justice, and public health.

Clinical and Laboratory Immunology (CLI): This is a subspecialty field in which laboratory tests and complex procedures are used to diagnose and treat disorders characterized by defective responses of the body's immune system.

Medical Toxicology (MT): A pediatric medical toxicologist is a physician with specialized training focusing on the evaluation and management of patients with accidental or intentional poisoning through exposure to prescription and non-prescription medications, drugs of abuse, household or industrial toxins, and environmental toxins. These physicians provide specialty consultations through affiliations with regional poison control centers, or are recognized as specialists and provide toxicological consultations within their respective medical institutions. The more important areas of medical toxicology include, but are not limited to, the following list of subjects: acute pediatric and adult drug ingestion; drug abuse, addiction and withdrawal; chemical poisoning exposure and toxicity; hazardous materials exposure and toxicity; occupational toxicology; biological poisons; basic concepts of toxicology such as kinetics, dose-response relationships, indices of toxicity and safety standards; and basic principles of toxic exposure and preventive methodologies.

Neonatal-Perinatal Medicine (NP): A specialist in neonatal-perinatal medicine is the principal care provider for sick newborn infants. He or she brings extensive experience derived from an intensively focused clinical interest in the problems of newborns.

This clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. The extensive and focused clinical experience with sick newborns prepares the specialist as a consultant to general pediatricians as they routinely care for most newborns.

Pediatric Cardiology (Cd): A pediatric cardiologist is a medical specialist for children from fetal life to young adulthood who, by clinical and research training and experience, is competent to provide comprehensive care to patients with cardiovascular problems. The pediatric cardiologist is skilled in selecting, performing, and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease.

Pediatric Critical Care Medicine (CCM): The pediatric critical care medicine specialist is a pediatrician with special competence in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients, and to the support of vital physiological functions. As a pediatric generalist, the PCCM specialist coordinates the multitude of health care plans prescribed for the patient by other involved physicians. The PCCM specialist has the responsibility to coordinate and order the priority of health care services provided by the intensive care unit.

Pediatric Emergency Medicine (PEM): The pediatric emergency medicine physician is one who has special qualifications to manage emergencies in infants and children. Pediatric emergency medicine also requires the application of knowledge in the technological advances in diagnosis and treatment of pediatric emergencies, enhanced by the broad understanding of child health and development which evolves with additional training in pediatric emergencies and experience with children and their families.

Pediatric Endocrinology (En): A pediatric endocrinologist provides expert care to infants, children and adolescents who have diseases that result from an abnormality in the endocrine glands (glands which secrete hormones). These diseases include, but are not limited to, diabetes mellitus, growth failure, unusual size for age, early or late pubertal development, birth defects, the genital region, disorders of the thyroid, and the adrenal and pituitary glands.

Pediatric Gastroenterology (Ge): A pediatric gastroenterologist understands the pathophysiology of disorders of the digestive systems of infants, children, and adolescents, and has achieved competence in the clinical diagnosis and medical treatment of these disorders. He or she is able to select, perform, and evaluate procedures necessary for morphological, physiological, immunological, microbiological, and psychosocial assessment of gastrointestinal diseases.

Pediatric Hematology-Oncology (HO): A pediatric hematologist-oncologist is a specialized physician with three interrelated characteristics. First, this physician has been trained in the growth and development of normal children from birth to adulthood, as well as in the recognition and management of disease in these age groups. Second, this physician has been trained both in the basic science and clinical expression of hematologic (blood disorders) and oncologic (cancerous) diseases. Third, the work of this physician combines his or her knowledge of general pediatrics, hematology, and oncology in a continuous process of study and service.

Pediatric Infectious Diseases (Inf): The pediatric infectious diseases specialist is a physician who cares for children and spends more of his or her professional time and skills on treatment and prevention of infectious diseases than on any other single endeavor, except for routine health care. More than 20% of all pediatric health care visits and the majority of unscheduled visits are for diagnosis and treatment of infectious diseases. The pediatric infectious disease specialist also participates in the process and public decision regarding recommendations for inoculations to prevent infectious disease. The great majority of children with infectious diseases appropriately continue to be cared for by general pediatric practitioners.

The pediatric infectious disease specialist also acts as a consultant and can apply specific knowledge to improve the outcome for those with complicated courses, underlying diseases that predispose to unusual or severe infections, unclear diagnoses, uncommon diseases, and complex or investigational treatments. Although the pediatric infectious disease specialist's role will usually be a consultative one, when asked, or when circumstances warrant, he or she could take primary responsibility for an individual patient or for a group of patients with certain diseases, examples of which might be human immuno-deficiency virus (HIV) infection or tuberculosis.

The pediatric infectious disease specialist appropriately, on occasion, takes primary care of patients with certain diagnoses in conjunction with other specialists, such as orthopaedic surgeons for osteomyelitis, and neurosurgeons for shunt-related ventriculitis. Additionally, the pediatric infectious disease specialist provides guidelines and education for others who care for seriously ill children with infectious diseases such as neonatologists and oncologists.

Pediatric Nephrology (Ne): A pediatric nephrologist is a medical specialist for children from fetal life to young adulthood who deals with the normal and abnormal development and maturation of the kidney and urinary tract, the mechanisms by which the kidney can be damaged, the evaluation and treatment of renal diseases, fluid and electrolyte abnormalities, hypertension, and renal replacement therapy.

Pediatric Otolaryngology: (See OTOLARYNGOLOGY)

Pediatric Pathology: (See PATHOLOGY)

Pediatric Pulmonology (Pul): The pediatric pulmonologist is dedicated to the prevention and treatment of all respiratory diseases affecting infants, children, and young adults. This involves familiarity with organ and cellular pathophysiology, knowledge of growth and development of the lung, assessment of respiratory function in infants and children, experience with a variety of invasive and noninvasive diagnostic techniques, and design of clinical investigation.

Pediatric Radiology: (See RADIOLOGY)

Pediatric Rheumatology (Rhu): A pediatric rheumatology specialist is a pediatrician whose primary responsibilities are to treat and provide an excellent level of patient care for the infant, child, or adolescent with a rheumatic or related disease, and participates in the prevention, understanding of the cause, and treatment of the various rheumatic disorders. In addition, he or she promotes understanding of the basic mechanisms of the disease in the interrelated areas of immunology, genetics, inflammation, and infectious diseases.

Sports Medicine (SM): A pediatric sports medicine specialist is a pediatrician with special training and education in the body of knowledge and the broad area of health care involving exercise as an essential component of health throughout life, medical supervision of recreational and competitive athletes, those who exercise, and those who exercise for prevention and treatment of disease and injury. The pediatric sports medicine specialist has special knowledge and ability in the following practice areas:

PHYSICAL MEDICINE AND REHABILITATION (PMR)
GENERAL CERTIFICATE: Physical Medicine & Rehabilitation
SUBSPECIALTY CERTIFICATES: Spinal Cord Injury Medicine
Physical medicine and rehabilitation, also referred to as rehabilitation medicine, is the medical specialty concerned with diagnosing, evaluating, and treating patients with impairments and/or disabilities that involve musculoskeletal, neurologic, cardiovascular, or other body systems. The primary focus is on maximal restoration of physical, psychological, social, and vocational function and on alleviation of pain. For diagnosis and evaluation, a physiatrist may include the techniques of electromyography and electrodiagnosis as supplements to the standard history, physical, x-ray, and laboratory examinations. In addition to traditional treatment modes, the specialist in physical medicine and rehabilitation may use therapeutic exercise, prosthetics, orthotics, and mechanical and electrical devices.

PLASTIC SURGERY (PlS)
GENERAL CERTIFICATE: Plastic Surgery
SUBSPECIALTY CERTIFICATES: Hand Surgery
Plastic surgery deals with the repair, reconstruction, or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk, and external genitalia. It uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.

Special knowledge and skill in the design and surgery of grafts, flaps, free tissue transfer and replantation is necessary. Competence in the management of complex wounds, the use of implantable materials, and in tumor surgery is required. Plastic surgery has been prominent in the development of innovative techniques such as microvascular and craniomaxillofacial surgery, liposuction, and tissue transfer. A foundation in surgical anatomy, physiology, pathology, and other basic sciences is fundamental to this specialty.

Competency in plastic surgery implies a special combination of basic knowledge, surgical judgement, technical expertise, ethics, and interpersonal skills in order to achieve satisfactory patient relationships and problem resolution.

The minimum commitment in years of training is five with some individuals training for a total of seven years.

Surgery of the Hand (HS): Surgery of the hand is that special field of medicine that includes the investigation, preservation, and restoration by medical, surgical, and rehabilitative means, of all structures of the upper extremity directly affecting the form and function of the hand and wrist.

The hand surgeon is trained to provide appropriate care for all structures in the upper extremity directly affecting the hand and wrist function and is taught both the cognitive and the manual skills necessary to treat complex problems involving the hand and wrist.

PREVENTIVE MEDICINE (PrM)
GENERAL CERTIFICATES: Aerospace Medicine; Occupational Medicine; Public Health & General Preventive Medicine (Older Certificates may appear as Public Health Medicine, General Public Health, and General Preventive Medicine)
SUBSPECIALTY CERTIFICATES: Medical Toxicology; Undersea Medicine
Preventive medicine is a specialty that focuses on the health of individuals and defined populations in order to protect, promote and maintain health and well-being, and to prevent disease, disability and premature death. In addition to the knowledge of basic and clinical sciences and the skills common to all physicians, the distinctive components of preventive medicine include:

Preventive medicine physicians may be specialists in general preventive medicine, public health, occupational medicine, or aerospace medicine. They work with large population groups as well as with individual patients to promote health, and understand the risks of disease, injury, disability, and death, seeking to modify and eliminate these risks.

In addition to providing clinical care, physicians trained in preventive medicine work in various settings: public health agencies and managed care systems, often managing large health care systems; occupational health settings to treat patients at the work site and to assess and modify work site conditions to reduce work-related risks and improve employee health; and clinical settings to enhance the health and performance of aviators and astronauts. Most preventive medicine specialists engage in prevention research to improve the effectiveness of public health and clinical preventive services.

Medical Toxicology (MT): The specialty of preventive medicine also provides for the opportunity of subspecialty training in medical toxicology. The additional training requirements focus on the evaluation and management of patients with accidental or intentional poisoning through exposure to prescription and nonprescription medications, drugs of abuse, household or industrial toxins, and environmental toxins. These physicians provide specialty consultations through affiliations with regional poison control centers, or are recognized as specialists and provide toxicological consultations within their respective medical institutions.

The more important areas of medical toxicology include but are not limited to the following list of subjects: acute pediatric and adult drug ingestion; drug abuse, addiction and withdrawal; chemical poisoning exposure and toxicity; hazardous materials exposure and toxicity; occupational toxicology; biological poisons; basic concepts of toxicology such as kinetics, dose response relationships, indices of toxicity and safety standards; basic principles of toxic exposure, and preventive methodologies.

Undersea Medicine (UM): The undersea medicine specialist is required to pursue additional residency training of at least one year. Undersea medicine practice includes therapy for disease entities caused by barometric pressures that are lower or higher than normal atmospheric pressure for the treatment of specific disease entities. These specialists treat decompression illness and diving accident cases, serve as consultants to other physicians in all aspects of hyperbaric chamber operations, and assess risks and apply appropriate standards to prevent disease and disability in divers and other persons working in altered atmospheric conditions.

Psychiatry & Neurology: (American Board of Psychiatry and Neurology issues the certificates in Psychiatry and Neurology)

PSYCHIATRY (Psyc)
GENERAL CERTIFICATE ISSUED BY THE AMERICAN BOARD OF PSYCHIATRY AND NEUROLOGY
GENERAL CERTIFICATES FOR PSYCHIATRY: Psychiatry
SUBSPECIALTY CERTIFICATES FOR NEUROLOGY: Addiction Psychiatry; Child & Adolescent Psychiatry; Clinical Neurophysiology; Forensic Psychiatry; Geriatric Psychiatry
A psychiatrist specializes in the prevention, diagnosis, and treatment of mental, addictive, and emotional disorders, e.g., psychoses, depression, anxiety disorders, substance abuse disorders, developmental disabilities, sexual dysfunctions, and adjustment reactions. The psychiatrist has had four years of specialized training after obtaining a medical degree. He or she is thus able to understand the biological, psychological, and social components of illness, and is qualified to order diagnostic laboratory tests and to prescribe medications, as well as to evaluate and treat psychological and interpersonal problems. The psychiatrist is also prepared to intervene with individuals and families who are coping with stress, crises, and other problems in living.

Some psychiatrists have also had further training in specialized areas such as psychoanalysis, psychiatric aspects of general medicine, psychopharmacology, alcohol and substance abuse, geriatrics, neuropsychiatry, and forensic psychiatry.

With an understanding of the biological, psychological, and social aspects of health and illness, the psychiatrist is uniquely prepared to treat the whole person.

Addiction Psychiatry (AdP): With one additional year of training, a psychiatrist can subspecialize in the area of addiction psychiatry, which is a field of psychiatry dedicated to the understanding of addictive disorders and the special and emotional problems related to addiction and substance abuse. The psychiatrist trained and educated in addiction psychiatry is capable of providing psychiatric care for those individuals with alcohol, drug, or substance abuse disorders, along with the emotional and behavioral consequences of such diseases.

Child and Adolescent Psychiatry (ChAP): Formal subspecialization exists in child and adolescent psychiatry. A child and adolescent psychiatrist has devoted two additional years of training to the diagnosis and treatment of mental, addictive, and emotional disorders of childhood and adolescence.

Clinical Neurophysiology (C/NPh): Formal subspecialization is also available in clinical neurophysiology, and involves one additional year of training in the diagnosis and management of central and peripheral nervous system disorders using electrophysiological techniques.