I.M. Sechenov First Moscow State Medical University, The Ministry of Healfh of the Russion Federation
Three main systemic factors (we called them discipline-making factors) are crucial for the emergence of a clinical specialty (in our case this specialty is neurosurgery) − social-historical, scientific and institutional. This first factor includes level of society development (industrialization, urbanization and level of university education) and war. The WWI was characterized by large number of traumatic brain injuries and their consequences which played an important role in emergence of the new surgical specialty – neurosurgery – in Europe and North America. The second factor is special diagnostic methods, surgical instruments and new operative approaches. The third factor is setting up neurosurgery schools, postgraduate neurosurgical training, specialized departments, chairs and institutes, neurosurgical societies and journals. It is concluded that in the interwar period (1920s−1930s) neurosurgery became a separate medical specialty in USSR, Great Britain, France, Germany, USA and Canada. The theory of discipline-making factors might be used for study of emergence of other medical specialties and the phenomenon of specialization in medicine.
Keywords: specialization in medicine; discipline-making factors; history of neurosurgery; medicine, 20th century; WWI; craniotomy; scientific schools