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In most countries, it is a legal requirement for a medical doctor to be licensed or registered. Venezuela : Caracas, Isla Margarita, Maracaibo, Porlamar, etc. In low-income countries, modern healthcare is often too expensive for the average person. ANZ Journal of Surgery. Vanuatu : Port Vila, etc. The followings are some major medical specialties that do not directly fit into any of the above-mentioned groups: Medical education and training varies around the world. Sub-specialties of surgery often require seven or more years. McGill Journal of Medicine. Guatemala : Antigua Guatemala, etc. Conflicts can also arise between health care providers, or among family members. Surgery has many sub-specialties, including general surgeryophthalmic surgerycardiovascular surgerycolorectal surgeryneurosurgeryoral and maxillofacial surgeryoncologic surgeryorthopedic surgeryotolaryngologyplastic surgerypodiatric surgerytransplant surgerytrauma surgeryurologyvascular surgeryand pediatric surgery.