Dr Alastair Kerr, SpR in dermatology, just attained CCT
• What attracted you to dermatology? I was interested in the skin as a medical student but didn’t get as much teaching as I had hoped for. After obtaining my MRCP, I was lucky enough to get an SHO job in dermatol- ogy and found it was even more interesting than I had imagined. The low acute
workload out of hours is also appealing, and lends itself to flexible training for family and for research.
• What do you find most challenging about the job? There are a lot of diagnoses (about 3,000) so you’re always reading to try to keep up-to-date. There are also a lot of patients referred to out-patients, so you are very busy between 9-5 and have to be good at time management.
• Has anything surprised you about the role? When I first started, I didn’t know that dermatologists did any surgery. Even in the time I’ve been in training, the amount of surgery dermatologists do has increased a lot. There is always going to be a great demand for dermatological surgeons in any department, with the current epidemic of skin cancer. I was also surprised about the amount of blood tests and other investigations that dermatologists did, as I thought it was all just recognising patterns and prescribing creams. Dermatologists are physicians, and doing my MRCP stood me in good stead.
• What do you consider the most important personal characteristic in a good dermatologist? You have to be empathic towards those with skin disease, as there is a lot of morbidity and psychological upset that goes with having some skin conditions. Although rarely life-threat- ening, many are chronic in nature, which requires patience. Some of your patients will be with you for your whole career.
• What is your most memorable experience so far? Being given the opportunity to work in a friendly unit which is very research-active, and to publish several papers which have clinical relevance. I have also travelled to several interna- tional meetings to disseminate my work.
• Is there any advice you could give to a final year or FY trainee considering dermatology? I think there is a perception that it can be an easy option and the phrase “derma-holiday” is well known. However, the reality of it is like any other hospital specialty. It’s competitive at entry level and busy on a day-to-day basis. There are relatively few FY jobs which have dermatology placements, but you may be lucky to find one. If you really are interested, it can be a very rewarding specialty, with many subspecialties to choose from.
on-call commitment it is well suited to flexible training. In 2006, 13 per cent of specialty registrars were training flexibly.
Making the choice A recent article in BMJ Careers offered a list of the advantages and disadvantages of dermatology as a profession*.
Advantages • Variety of patients; all ages and genders
• Clinical variety • Reliance on clinical diagnostic skills
• Rewarding work – curable or controllable diseases
• Patients rarely life-threateningly unwell • Less demanding out-of-hours workload • Medical and surgical options
• Can link clinical findings to pathological findings
• Great opportunities for clinical or lab-based research – skin is visible and accessible
• Flexible specialist training
Disadvantages • Very large and increasing tumour workload
“ Some patients will be with you for your whole career”
• Busy working week, requiring good time management skills
• Competition for jobs is tough at specialty trainee year 3 level
• Less acute work than some other specialties
Further information Getting involved in societies is a good way of exploring an early interest in dermatology and this can also provide a network to meet clinicians and academics and to increase clinical knowledge, along with gaining an appreciation of the possibilities a career in dermatology can offer. Relevant societies include:
• British Association of Dermatologists – www.bad.org.uk
. The BAD website has a whole section devoted to medical students and how to attend dermatology meetings through their DermSchool initiative.
• British Society for Dermatological Surgery – www.bsds.org.uk
• British Society for Medical Dermatology – www.medderm.org.uk
• The British Skin Foundation – www.britishskinfoundation.org.uk
* Yusuf I, Turner R, Burge S. A career in dermatology. BMJ Careers 26 May 2010
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