One-line ‘definition’ of specialty
Dermatologists manage all 2,000+ of the acute and chronic disorders of the skin and its appendages.
Brief run-down of training programme content and duration
Dermatology training lasts a minimum of four years after Core Medical Training (CMT) and currently follows the specialty training (physician dermatology) 2021 curriculum. Most trainees undertake a year in a district general hospital (DGH) environment gaining substantial general clinic experience (ideally in year one). The remaining three years of training allow the trainee to gain exposure to a wide range of sub-specialty opportunities e.g. contact dermatitis, paediatric dermatology, cutaneous lymphoma, photodermatology and dermatopathogy, to name a few. Experience in managing dermatological emergencies and dermatology inpatients is picked up across all four years of training. Likewise, surgical skills are honed throughout.
Exam requirements
- MRCP (must have completed the full MRCP in order to take up an ST3 post in dermatology)
- Specialty Certificate Examination (SCE) in Dermatology (taken during training)
Other requirements
- Workplace-based assessments (Eportfolio)
- Surgical skills logbook
- Some mandatory training courses in cutaneous biology, dermatopathology, skin surgery and photobiology (funded by study leave budgets)
Opportunities/expectations for out of programme/research
Research is encouraged but is not mandatory. If interested, dermatology offers a wealth of both lab-based and clinical research opportunities. The specialty receives generous research funding and most departments have someone who is enthusiastic about research.
Out of programme (OOP) experiences can be arranged if deemed educationally worthwhile and there are many clinical fellowships on offer, for example in paediatrics or procedural dermatology (most are post-Certificate of Completion of Training [CCT] programmes).
A day in the life of a Registrar/Consultant
Every day is different. A standard day for me at present would be... a quick ward round with our general practitioner specialty training (GPST) team at 9:00 am, then off to clinic for 9.30 am. Clinic finishes around midday at which point I will go and see any ward referrals, check my letters and attend the skin cancer multi-disciplinary team (MDT) meeting (grabbing lunch in the middle of all that!). In the afternoon, from around 2:00 pm onwards I will have my surgical list until 5:00 pm, when I will go home, if I’m not on-call. On days when I don’t have a surgical list, I will have an afternoon clinic e.g. skin cancer assessment clinic or perhaps study/audit/research time.
Pros and Cons of working in this specialty
Pros
- Huge clinical variety
- Relies heavily on good clinical diagnostic skills
- Advice is always valued, as most non-dermatologists have limited training/knowledge in dermatology
- Acute and chronic disease management, including skin cancer management
- Patients are rarely life-threateningly unwell – but it still happens
- Rewarding work, with an opportunity to dramatically improve patients’ physical and psychological wellbeing
- Out-of-hours workload is not too onerous
- Medical and surgical elements
- Close links with other specialties e.g. medicine, infectious diseases (ID), rheumatology and plastics
- Opportunities for clinical or lab-based research
- Time for professional development and teaching
- Lots of regional, national and international meetings/conferences
- Flexible specialist training
Cons
- Common assumption that because the primary diseases have low mortality rates, the specialty isn’t important
- Increasing workload, with constant pressure on services (second only to orthopaedics as the busiest outpatient specialty)
- Less acute work than some other specialties
How this specialty differs to others and what made me choose it
Dermatology is a fascinating specialty which offers an interesting and varied clinical career in combination with a balanced and flexible working life, traits difficult to match in other medical specialties. One of the major plus points of the specialty for me is that I get to do some skin surgery which satisfies the practical and artistic sides of my personality.
Tips for success in applying for this specialty
- Dermatology is allocated a very modest amount of teaching time during undergraduate training and there are few dermatology posts in foundation training, therefore most junior doctors neglect it as a career possibility without genuinely considering the advantages
- Try to get some experience of the specialty. Arrange a ‘taster’ session with your local dermatology department and when you are there, see if you can get involved with an audit or research project. Try and get a poster or presentation at a local or national meeting
- Getting involved in societies (see below) is a great way to express an early interest in a specialty, to network and meet important clinicians and academics and to increase your clinical knowledge and appreciation of career possibilities
- It might be worth attending courses such as DERMDOC (see the British Society for Medical Dermatology [BSMD] website below) and ‘DermSchool’ (see the British Association of Dermatologists [BAD] website below)
For more information
British Association of Dermatologists (BAD)
British Society for Medical Dermatology (BSMD)
British Society for Dermatological Surgeons (BSDS)
Scottish Dermatological Society (SDS)
Joint Royal Colleges of Physicians Training Board (JRCPTB)