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As the video suggests, the UK is a world leading centre for dermatological research. Treatment provided in the private sector is at a similar level and promptly available, yet this is not the case in the national health system.
Although we are a private clinic, our staff care about every dermatology patient and want to see their needs met. Half of us have a skin condition of some form each year, a quarter of us visit a GP, filling almost 14 million appointments.
An ageing population and an epidemic of skin cancer are factors. They add pressure to a state system which strives to provide the best treatment, although innate barriers are clear to those working in the field and to others.
The Oversight View
Dermatology being under-resourced at a national level is not a new revelation. A parliamentary health committee looked specifically at dermatology staff shortages, the NHS produced their own report.
They identified staff issues at different levels, more dermatology nurses would help but a core problem is the lack of specialists. Both reports highlighted a need to increase the number of people training in dermatology.
This is a clear UK problem but the same exists elsewhere to a degree. A US based study published in early 2023 looked at one perspective.
Why Dermatology Is Not A Prime Choice
Most doctors start in the same way, as medical students with their lives and careers ahead of them. Pursuing a specialty is not an unusual decision, yet the percentage choosing dermatology is quite low.
The study focused on medical students beliefs, with information drawn from related journals. The students, including non US students often viewed dermatology as monotonous, stigmatised, unfamiliar, or difficult to access.
These were misunderstandings to a significant degree. A field which treats over 2,000 types of skin conditions, in patients of all ages is not monotonous, dermatology is not stigmatised within the medical profession.
Comments read in the research papers suggested these views were extensions of the latter two feelings, a belief in barriers and a lack of familiarity.
Students who had been exposed to dermatology and held greater knowledge at an early stage were far more likely to adopt the specialty. Lack of exposure led to misconceptions and different choices being made.
An Outcome Of Culture
Decisions are related to perception and exposure. If people enter a field of work where certain aspects are seen as glamorous but others hardly mentioned, a negative view of the latter is no surprise.
A reflection to a degree of the public view, with cardiology, or primary care being seen as more critical than dermatology. The proportion of time dermatologists spend on cosmetic procedures is also overestimated.
Within the medical field, there can be misconceptions on the role of dermatologists. Not all medical staff recognise the range of care dermatologists provide, for mucosal, nail, or hair conditions, alongside our skin.
Equally, clinical staff who collaborated and interacted with dermatologists had a far more favourable perception. Being familiar with reality helps and for students, that needs to start at an early stage.
Instead, those who will become our GPs and devote a quarter of their time to skin conditions see little more than a week’s dermatology training as undergraduates. Others considering specialties will have limited exposure.
Amending An Incorrect View
In the study, those who were lucky enough to have early dermatology related activities had a greater understanding of the field. This led to confidence, finding mentors and a higher likelihood of choosing a dermatology career.
People making the choice appreciated that dermatology addresses community needs, by supporting patients across a wide area of health. They also welcomed a profession where diversity, equality, and inclusion matter.
Skilled dermatologists will only be recruited and retained if they are exposed to knowledge and can see the openings the profession offers. Dermatology is a natural path to working with patients in a beneficial way.
Skin Care Network are lucky to have experienced consultants, who did see the opportunity in medical dermatology. With a few changes in early knowledge provision, we could look forward to welcoming others in decades to come.
Our patients can also assist, by sharing their experiences. Those embarking on careers are influenced by family and friends, as well as teaching. Letting them know how valuable a choice for dermatology is will certainly help.