By the turn of the nineteenth century medicine had become so complicated that there started to emerge physicians who were medical doctors and those who were surgical doctors. Further divisions rapidly ensued. In the twentieth century, and particularly by the completion of the two great World Wars, medical physicians had expanded to include general practitioners, pediatricians, internists, psychiatrists, neurologists, cardiologists, respirologist, rheumatologists, endocrinologists, nephrologists, gerontologists, gastroenterologists, etc, etc. Similarly, the concept of a surgeon had expanded to include general surgeons, neurosurgeons, ophthalmologists, otolaryngologists, cardiovascular, thoracic, urologic, colorectal, obstetric and gynecologic, urogynecologic surgeons etc., etc
