Reflections on the Past Year

I n 2003, the attention of the American Academy of Dermatology (AAD) leadership to academic dermatology was a positive step forward. The efforts made by the leadership to keep dermatologists in academic settings or bring them back from private practice are really appreciated. The concern of the leadership of the AAD, and most of dermatologists with interest in teaching, is the quality of teaching provided to residents and medical students before they face the real professional world. The aim is to increase the strength of the training in all residency programs. Also, the recent approval of an ACGME-accredited PGY5 procedural dermatology fellowship represents a positive evolution in the field of dermatology. This fellowship will give dermatologists the chance to train in most of the surgical aspects of dermatology, as well as in cosmetic procedures, and will add to their credentials. When fellowship-trained dermatologists decide to stay in academic settings, this training will allow them to advertise that to their patients. Patients will get the good care, as well as the prestige and clinical reputation associated with a tertiary care medical center. Today, as was the case 10 years ago after my first dermatology residency training, more emphasis is put on inpatient dermatology. I want to encourage dermatologists to have a well-defined and essential role in the management of challenging cases of melanomas and other skin tumors among surgeons, dermatopathologists and oncologists. This is especially critical because skin cancer is one of the strongest arguments for supporting a valuable role for dermatology in academic medicine. The role of dermatologists should also be prominent in the management of internal and systemic diseases where much can be “seen through the skin.” In this environment, the academic dermatologist is looked at as being a sharp, knowledgeable and well-rounded physician. He or she not only knows the latest in new fillers and new lasers and devices used for cosmetic procedures, but also the latest information about biologic treatments for skin diseases that are FDA-approved and experimental. He or she also has a keen interest in the management of challenging, laboratory-intensive conditions. In short, he or she is the one to whom everybody should turn for sound advice. More encouragement should be made to encourage genuine people with sincere love for this type of practice to stay and enjoy their work in academic settings. Amor Khachemoune, M.D., C.W.S. Georgetown University Medical Center