In the article the typological classification of speech genres used in the sphere of institutional (medical) discourse is first presented. In the article the applicability of concept “paradigms” in the medical discourse is substantiated. It is marked that paradigmal units stipulating paradigmatics of medical discourse can be subdivided into two types: 1) basic paradigms functioning in the common model of anamnesis, and 2) highly specialized patterns related to certain aspects of common paradigms.