The growth of specialization in graduate medical education (GME) and
physician practice continues at a rapid rate, generating increasing national
attention. Although the major educational, accrediting, and certifying bodies
have mechanisms for approving new areas of study and practice, the results
of their efforts have not been consistently congruent. This article presents
information about GME since the beginnings of its standardization and accreditation
in the early 20th century, its growth during and following World War II, and
the variations among accredited specialties and subspecialties, certificates,
and self-designated practice areas that have resulted from this long period
of unstructured growth.
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