title: Establishing specialty jurisdictions in medicine: the case of American obstetrics and gynaecology.
abstract: The profession of medicine has evolved into an extremely specialised occupation. Yet, recent research has neglected the intra-occupational processes influencing medical specialisation. This article aims to correct this oversight. It develops an historical account of intra-occupational factors influencing the decision to establish gynaecologic oncology as American ob/gyn's surgical subspecialty in 1972. Working within the framework initially developed by Everett C. Hughes and his students, the article examines this development as the outcome of a three-party relationship among gynaecologic oncologists, American ob/gyns, and gynaecologic pelvic surgeons. Aggressive movement by the gynaecologic pelvic surgeons challenging the established élite's identity definition for the ob/gyn specialty helped spur official recognition of gynaecologic oncology, a less threatening subspecialty. The article draws theoretical implications from the case regarding the role of a threatening other in influencing the specialisation process.
authors.affiliation: Department of Sociology, The University at Albany, State University of New York, NY 1222, USA. jzetka@albany.edu
authors.forename: James R
authors.initials: JR
authors.lastname: Zetka
mesh_terms: D002983:Clinical Competence; D005260:Female; D005833:Genital Neoplasms, Female / Q000266:history / Q000601:surgery; D013509:Gynecologic Surgical Procedures / Q000266:history* / Q000331:legislation & jurisprudence; D006176:Gynecology / Q000266:history* / Q000331:legislation & jurisprudence / Q000458:organization & administration; D049673:History, 20th Century; D006801:Humans; D008511:Medicine; D013513:Obstetric Surgical Procedures / Q000266:history* / Q000331:legislation & jurisprudence; D009774:Obstetrics / Q000266:history* / Q000331:legislation & jurisprudence / Q000458:organization & administration; D024382:Professional Role; D012933:Social Identification; D014481:United States; D016387:Women's Health / Q000266:history