The Wales dermatology programme is split between north and south Wales, with candidates working either in north Wales or south Wales for four years. Candidates are not expected to rotate north to south or vice versa.
The south Wales programme rotates through sites including Bridgend, Swansea, Cardiff and Newport. The north Wales programme rotates through the three sites in Besti Cadwaladr UHB, Wrexham (two years), Glan Clwyd and Bangor (one year each).
Dermatology is one of the most varied of the physician specialities, allowing options for seeing all age groups of patients with inflammatory, inherited, environmental, occupational or malignant skin disorders.
At present, skin disease is one of commonest reasons for patients to consult a doctor, and given the current observed increases in skin cancer and inflammatory conditions like eczema, there is no doubt that dermatology will expand in the future. There is an ongoing need to have secondary care based dermatology clinics and services nationally, though in some parts of the UK a component of outpatient work may be carried out in other settings, for example community hospitals. Specialist dermatology involves predominantly outpatient work for diagnosis, investigation and treatment supported by appropriately staffed inpatient facilities for severe inflammatory disorders.
Within the hospital setting, dermatologists are often consulted about patients under the care of other specialists and not infrequently jointly manage patients e.g. those with connective tissue disorders. Skin cancer is dealt with via multidisciplinary teams which provides close liaisons with plastic, ENT and maxillo facial surgery colleagues and also with clinical and medical oncology.
Dermatology is one of the few remaining specialties with a wide variety of work. All age groups are covered and cases vary from cancer to inflammatory disorders. Clinical, surgical and ward work all play a part in a typical dermatologist's working week whereas some choose to sub-specialise in fields such as:
In addition, dermatopathology, lasers and phototherapy are areas you will come into contact with. Within Wales there is a regular weekly teaching session that includes an excellent dermatopathology session and opportunities to learn Mohs micrographic surgery as well as cutaneous allergy placements and photobiology/phototherapy. We have a dedicated lymphoma service which is the home of the internationally renowned Dermatology Life Quality Index.
There are also ample opportunities to become involved in research and to participate in national and local clinical and research meetings. Generic training in teaching, research, management and presentational skills are part of the training programme in Wales.
Trainees entering the four year dermatology programme will do so from core medical training. The rising use of systemic treatments for inflammatory conditions means that a sound knowledge of general medicine will remain a pre-requisite for future dermatologists.
For those in training, competency-based assessments exist in the form of mini CEX, DOPs and MSF. Dermatology was also one of the specialties involved in pilot knowledge-based assessment in 2006 and it is likely this will be fully developed for use in the near future.