Studies comparing particular medical specialties in different national settings have not appeared in the sociology of the profession's literature. Consequently, little is known about how local contexts actually affect the professionalization process and medical specialization. Are certain determinants of specialization active in some countries and not in others? Can some determinants be said to be always active? Two recent independent studies of medical geneticists in the UK and Canada present a unique opportunity to reflect on earlier social-theoretical discussions concerning the determinants of medical specialization in the context of country-specific organizational frameworks. Placed side by side, the two studies lend support to earlier research that emphasizes, first, conceptual and technological innovations in medicine as driving specialty formation, and, second, the dominant position of physicians in the resulting division of medical labour. Beyond this, however, each study highlights local influenc...

/pdf/professionalization-theory-medical-specialists-and-the-35nmh5asw1.pdf

Professionalization theory, medical specialists and the concept of national patterns of specialization

There is a growing sense of concern among geneticists with regard to the place occupied by their discipline in the curriculum throughout the entire educational system. Surveys of genetics teaching in North American medical schools, especially over the last 30 years, have shown dramatically increasing interest in the subject (Table I). For example, the proportion of schools with formal courses in genetics rose from 8.6% in 1953 (Herndon, 1954) to 74.7% in 1978 (Childs et al., 1981). Similar studies have revealed the importance of genetics in the education of dentists (Sanger, 1980; Farrington et al., 1982), nurses (Brantl and Esslinger, 1962; Feetham, 1984; Mertens et al.,1984; Monsen, 1984), nurse practitioners (J.K. Williams, 1983), and social workers (Mealer et al., 1981; Bishop, 1984). The last decade has even seen the emergence of an entirely new type of genetic practitioner, the genetic counselor or genetic associate (Kenen, 1984; Marks, 1982, 1984; Marks and Richter, 1976).

Perspectives in the Teaching of Human Genetics

This article shows that the intellectual and specialist movements that supported the growth of medical genetics in Canada between 1947 and 1990 were emergent phenomena, created, split, and reattached to different groups of actors, and reconfigured numerous times over the course of four decades. In each instance, new kinds of working relationships appeared; sets of diverse actors in local university-hospital settings coalesced into a new collectivity; and, as a collectivity, actors defined and/or redefined occupational roles and work rules. In its beginnings, medical genetics appears to be the object of a serious institutional manoeuver: a movement in support of the creation of examining and teaching positions in human genetics in North American medical schools. With time, the institutionalization of ‘medical genetics’ took hold, spurred on by changes in the rate and direction of service delivery associated with genetic consultation and laboratory services in clinical settings. Medical genetics in Canada consequently gained a semblance of unanimity over its basic reference points and arrived at a meaning directly tributary to current acceptance of the term.

/pdf/the-early-history-of-medical-genetics-in-canada-3if13a0u60.pdf

The Early History of Medical Genetics in Canada

/pdf/tracing-the-shifting-sands-of-medical-genetics-what-s-in-a-2bm0hp0bpo.pdf

Tracing the shifting sands of 'medical genetics': what's in a name?

L'auteur s'appuie sur l'etude sur le developpement de la medecine genetique en tant que specialite medicale au Royaume-Uni et au Canada pour analyser la facon dont les contextes nationaux et locaux influe sur l'etablissement de la specialite. Il corrobore les resultats anterieurs qu'il a trouves dans la documentation qui mettent l'accent d'abord sur les innovations technologiques a mesure qu'elles ont entraine la constitution de la specialite et, ensuite, sur la domination des medecins dans la division du travail medical. De plus, l'auteur etudie les circonstances precises qui ont fait en sorte que les geneticiens ont commence a orienter leur travail vers une specialite medicale fondee sur une « approche genetique » de la maladie puis etudie comment la « medecine genetique » en tant que specialite a ete evaluee et faconnee pour satisfaire aux exigences des services de sante nationaux et regionaux.

/pdf/on-the-relevance-of-the-genetics-based-approach-to-medicine-2l5xdxvbx1.pdf

On the Relevance of the “Genetics‐Based” Approach to Medicine for Sociological Perspectives on Medical Specialization*

Comprehensive planning of human genetics education: a position statement.

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Comprehensive planning of human genetics education: a position statement.