Why are surgical subspecialties referred to as 'external medicine' (外科) in Chinese, as opposed to 'internal medicine' (内科)?

From the Research

The Chinese terminology for medical specialties, where surgical specialties are called '外科' (wài kē) or "external medicine," and non-surgical specialties are called '内科' (nèi kē) or "internal medicine," reflects a logical and intuitive categorization based on the approach to treatment. This distinction is rooted in the fundamental difference between surgical interventions, which involve physically manipulating tissues from the outside in, and internal medicine, which primarily uses medications and non-invasive treatments that work systemically from within the body. The terminology captures the essence of how surgical procedures access internal structures through external approaches, such as creating incisions through the skin and other tissues to reach and treat internal organs or structures. As noted in a study on the subspecialization of surgery 1, the evolution of surgical training and the factors contributing to subspecialization highlight the complexity and diversity within the field of surgery. However, the core principle behind the Chinese terminology remains relevant, providing a straightforward conceptual framework for understanding the basic division of medical practice. This framework is essential for medical students and professionals to grasp, as it influences decisions such as those made by female medical students when considering a career in surgical specialties, where factors like mentorship, intellectual challenge, and the rewarding nature of surgery play significant roles 2. Ultimately, the Chinese terminology offers a simple yet profound way to categorize medical specialties, emphasizing the unique approaches and principles that guide surgical and non-surgical interventions. Key points to consider include:

• The logical categorization of medical specialties based on treatment approach
• The fundamental difference between surgical and non-surgical interventions
• The relevance of the Chinese terminology in understanding the basic division of medical practice
• The influence of this framework on career decisions and perceptions within the medical field.