Careers BMJ 2017; 359 doi: https://doi.org/10.1136/bmj.j5261 (Published 17 November 2017) Cite this as: BMJ 2017;359:j5261
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- Wedad Abdelrahman, specialty trainee year 5 specialist registrar in dermatology,
- Keith Armstrong, consultant dermatologist
- wedadabdelrahman{at}doctors.org.uk
Abstract
Wedad Abdelrahman and Keith Armstrong look at what you need to consider if you are thinking of pursuing a career in dermatology.
Dermatology is a highly competitive specialty. Most medical students, however, have limited exposure to it and so are given little insight into the variety that it can offer.
The skin is the body’s largest organ and more than 2000 diseases affect it. Dermatology is a specialty for those with keen visual skills.
With inflammatory dermatoses, the ability to recognise pattern distribution, colour variation, and textural change, and relate this to potential pathological processes is key. With skin lesions, the process is more localised but equally visually dominated. Dermoscopy adds another layer to that which is appreciated by the naked eye. With experience and variety of exposure, the dermatologist generally relies more on clinical diagnostic skills than extensive investigations.
In addition to diagnostic challenges, the management of patients with chronic inflammatory skin conditions gives the clinician the satisfaction of building a strong rapport with patients and an appreciation of the significant psychological impact that skin disease can have. With the relentless rise in the incidence of skin cancer throughout the UK, the surgical aspects of dermatology and its links with both plastic surgery and oncology are becoming more important.
Specialty training
After obtaining a formal medical qualification, a doctor interested in a career in dermatology must complete two years of foundation training, followed by a further two years of core medical training. Membership of the Royal College of Physicians (MRCP) must be obtained before applying for a four year training programme in dermatology. Paediatric trainees can access dermatology training, but must hold membership of the Royal College of Paediatrics and Child Health by the application deadline.
Over the past three years, entry into dermatology specialty training has been competitive with ratios of 4.1, 4.0, and 3.1 at round one interview in 2016, 2015, and 2014 respectively. An impressive CV is therefore paramount to increase the chances of success.
A national recruitment process is used to gain entry to specialty training in England, Scotland, and Wales. The Northern Ireland Deanery holds an independent recruitment process.
Important themes relevant to successful applicants are suitability and commitment to specialty, previous achievements, understanding of research and clinical governance, involvement in teaching, clinical knowledge, and understanding of ethical principles. Be prepared to critically appraise an abstract in less than 10 minutes and make a decision whether or not it will influence your practice.
Length of specialty training
The four years of dermatology specialty training are a short time in which to complete training in this field. There is, however, the opportunity to undertake out-of-programme degrees in research or medical education, which is strongly encouraged. The specialty certificate examination must be attempted by specialty trainee year 5 and passed by specialty trainee year 6.
Subspecialties within dermatology include paediatric dermatology, dermatological surgery and Mohs micrographic surgery (MMS), medical dermatology, contact dermatitis/patch testing, photodermatology, psychocutaneous medicine, genital dermatoses, cosmetic dermatology, disorders of hair and nails, and dermatopathology.
It is important to publish and present at national and international meetings as well as gain experience in teaching, leadership, and management. On completion of training, a certificate of completion of training (CCT) is awarded.
Following CCT, you may apply in a competitive manner for a limited number of national post-CCT subspecialty fellowships. At present, fellowship opportunities exist for medical dermatology, paediatric dermatology, and MMS. Such fellowships are particularly useful for those planning to deliver a subspecialty service within a tertiary centre.
Dermatology is an interesting and varied specialty. If you are a hands-on person with good diagnostic skills and enjoy managing patients with complex acute and chronic conditions, a career in dermatology may be just right for you.
Demonstrating an interest in the specialty
Arrange a taster week in dermatology
Attend Dermdoc and DermSchool, an annual educational conference for medical students and foundation doctors
Work in dermatology as part of core medical training. This will give you experience and allow you to decide whether it is suitable for you as a career
Apply for a British Association of Dermatologists junior membership which includes free subscription to the British Journal of Dermatology and Clinical and Experimental Dermatology
Find opportunities to get involved in research and audit projects related to dermatology during undergraduate and postgraduate training
Footnotes
Competing interests: We have read and understood BMJ’s policy on declaration of interests and declare that we have no competing interests.
