One-line ‘definition’ of specialty
The opportunity to ‘play detective’ with the body’s largest organ.
Brief run-down of training programme content and duration
This is a four-year programme which involves spending one year in a district general hospital and three years in hospitals in central Glasgow. You will gain experience in general dermatology and skin surgery but will also have specific attachments in paediatric dermatology at Yorkhill, at the Contact Dermatitis Unit in the Southern General and at the severe psoriasis clinic at the Western. There is also the opportunity to get involved in photobiology, lymphoma clinics and research. You will be expected to attend Mohs micrographic surgery, genetic, hair, connective tissue disease, plastic surgery lists, sexual health (GUM), vulval dermatoses and infectious disease clinics when you can. Every Friday afternoon involves attending a teaching session. Out-of-hours dermatology on-call is mandatory during training.
Exam requirements
The Dermatology Specialty Certificate Examination is a computer-based test of general and specialist dermatology knowledge that should ideally be sat at ST5 level and needs to be passed before completion of ST6.
Other requirements
Eportfolio: The current requirements are four mini-clinical evaluation exercises (CEX), ten case-based discussions (CBD), four surgical direct observations of procedural skills (DOPS), two non-surgical DOPS, a multi-source feedback (MSF) with a minimum of 12 respondees, a patient survey (minimum 20 questionnaires), a teaching observation, an audit assessment and a research assessment every year. More information on this is available on the Joint Royal Colleges of Physicians Training Board (JRCPTB) website.
Specialty skills: Dermatology involves a lot of skin surgery, dermatopathological analysis, photodermatology and topical treatments (most of which you learn on the job) but these are also assessed using DOPS.
Mandatory Courses: Four to six leadership and management programme (LaMP) courses (run by NHS Education for Scotland [NES]) must be completed. They cover topics such as teamwork, negotiation skills and leadership. There are no mandatory dermatology courses, however it is best practise to do the following courses – biology of skin, advanced paediatrics, photodermatology, dermatopathology, a basic surgical course and the thesis course (if you are interested in research).
Opportunities/expectations for out of programme/research
There are many opportunities in dermatology. Clinical fellowships in specialist fields (e.g. lymphoma, lymphovascular, skin surgery) can be applied to pre- and post- Certificate of Completion of Training (CCT).
A day in the life of a Registrar/Consultant
8:45 am – 9:15 am: Ward round.
9:15 am – 12:30 pm: Outpatient clinic (mixture of lesions and general dermatology).
12:30 pm – 1:30 pm: Lunch and arranging continuing medical education (CME) or pathology meetings.
1:30 pm – 4:30 pm: Outpatient clinic (returns) or biopsy list (usually six patients per list).
4:30 pm – 5:30 pm: Catch up with paperwork, start of on-call shift.
Pros and Cons of working in this specialty
Pros
- Wide variety of dermatological specialties.
- Good work/life balance.
- No general medicine.
Cons
- Outpatient-based specialty.
- Lots of phone calls for advice.
- Huge learning curve after Core Medical Training (CMT).
How this specialty differs to others and what made me choose it
The great thing about dermatology is that you see patients of all ages and all different health conditions, because diseases of almost every organ in the body show some signs on the skin. It also offers a great combination of surgery and medicine and a good work/life balance. For the curious mind and someone who loves challenges and is constantly seeking new knowledge, this field is perfect.
Tips for success in applying for this specialty
- Attend some of the above courses if possible (biology of the skin in particular)
- Get in touch with your local clinic lead in dermatology to set up opportunities to undertake audits/case reports/presentations
- Become a member of the Scottish Dermatology Association (SDS) and British Association of Dermatologists (BAD)
- Attend the ‘DermSchool’ for medical students and foundation year doctors at the BAD (usually annually in July)
- Spend time in local dermatology clinics/skin surgery clinics/dermatology wards
- Working in dermatology prior to specialty application e.g. a locum appointment for training/locum appointment for service (LAT/LAS) job or research is looked upon favourably
For more information
British Association of Dermatologists (BAD)
Scottish Dermatology Association (SDS)