Railway surgery was a branch of medical practice that flourished in the 19th and early 20th centuries. It concerned itself with the medical requirements of railway companies. Depending on country, it included some or all of: general practice for railway staff, trauma surgery as a result of accidents on the railways, occupational health and safety, medico-legal activities regarding compensation claims against the company, and occupational testing.
Railway surgery was especially well-developed in the US with formal professional organisations and scholarly journals. One of the reasons for this was that US railways were particularly dangerous with a high number of casualties from crashes and an even higher number of workers hurt in industrial accidents. Another reason was that many US routes passed through areas with little or no existing medical infrastructure. In Europe the railways were safer and infrastructure was generally already in place. The duties of railway surgeons in Europe mostly involved investigations into accidents and the resulting claims arising from passengers. In India the railways also faced a lack of existing medical infrastructure and, like the US, had to build it from scratch. Indian Railways still maintains a network of hospitals.
By the middle of the 20th century railway surgery had lost its separate identity. The growth of other industries and improving rail safety meant that the railways no longer stood out as a leading cause of injuries. Likewise, industrial medicine and health and safety became a concern for all industries. There was no longer a need for an industry-specific branch of medicine.