Dermatology Training

The Essentials

Mahbub M. U. Chowdhury, Tamara W. Griffiths, Andrew Y. Finlay, Mahbub M. U. Chowdhury, Tamara W. Griffiths, Andrew Y. Finlay

• Publisher: Wiley-Blackwell
• Year: 2021
• ISBN:
  9781119715733
• Edition: 1
• Topic: Medicine
• Subtopic: Dermatology

Dermatology Training: The Essentials helps readers understand what is required to work effectively in a demanding clinical dermatology training programme. Developed by the British Association of Dermatologists and British College of Dermatology, this accessible textbook covers all key themes outlined in the 2021 Joint Royal Colleges of Physicians Training Board (JRCPTB) curriculum.

The fundamentals of professional development, clinical practice, general dermatology, therapeutics and procedural dermatology, and specialist areas of dermatology relevant to all UK and international trainees and healthcare professionals are addressed in 29 reader-friendly chapters.

Throughout this highly practical textbook, the expert authors provide tips and advice for handling common clinical situations, developing leadership skills, getting into research and gaining surgical experience, as well as key pearls and pitfalls. The book contains over 70 Specialty Certificate Exam (SCE) questions to assist in exam preparation, and includes contributions from current trainees that offer real insights into day-to-day dermatology training. A must-have for all those involved in the dermatology training process, including educational supervisors, this textbook:

• Provides detailed descriptions of the key themes that trainees in dermatology need to understand
• Features over 500 clinical images, tables and figures including disease presentations in various skin types, and highlights relevant issues relating to skin diversity
• Aligns with the new Capabilities in Practice (CiPs) assessment tool, which evaluates the trainee's ability to deliver and perform in the workplace

Dermatology Training: The Essentials is highly recommended reading for all trainees in dermatology, doctors taking the Certificate for Eligibility for Specialist Registration (CESR) route to accreditation in dermatology, general practitioners training for an Extended Role (GPwER), and junior doctors and medical students considering a career in dermatology.

Section 1
Developing professionalism

1
Think critically, research and publish

Girish K. Patel , Andrew Y. Finlay and John R. Ingram

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• Introduction
• Why undertake research?
• When should I do research?
• What type of research should I conduct?
  • Clinical audit
  • Medical research
  • Evidence‐based dermatology
  • Critically appraised topic
  • Pyramid of evidence
• Where do I start and what are the hurdles?
  • Finding the hypothesis
  • Literature search and critical appraisal
  • Writing a protocol
• Seeking support and funding
• The path to successful research
  • Learn to say ‘no’
  • The mentor
  • Clear questions, ideal methods and data analysis
  • Publish or perish
  • How to write the first draft of your article
  • Full‐time research and higher degrees
  • Fellowships and research abroad
• But in the end…
• Pearls and pitfalls
• Further reading and key resources

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Introduction

This chapter describes how you can get involved in research, publishing and writing. Crucially, it describes the key concepts surrounding evidence‐based thinking and decision making in dermatology. These concepts are the essential foundations on which you can build your thinking and clinical approach during your career. This chapter is designed to help you to strengthen your academic expertise, and to gain satisfaction from investigating and contributing your ideas to the wider dermatology community.

Why undertake research?

Dermatology is a dynamic research‐led specialty. Skin‐related research leads the way in many spheres of scientific endeavour in relation to patient care. The dermatology training programme provides an ideal opportunity to appreciate and undertake research. So what is research?

Research is the creation of new knowledge that builds on the established foundation of our understanding. Medical research, ultimately seeking to improve individuals’ wellbeing, can take many forms, including laboratory experiments, clinical studies (observation or intervention), clinical trials, quality improvement projects and evidence‐based summation of findings.

Find something that genuinely interests you. The demands on your time are great, but they can be managed. Research projects do take time to complete. Moreover, if there’s a chance that things can go wrong, they invariably do and the only driving force to complete a project will be your desire to succeed. Supervisors look most of all for motivated individuals, as technical skills can be taught but motivation cannot. Research success comes from a motivated person working in a supportive environment.

When should I do research?

As a junior dermatology trainee, your immediate priority is to learn safe and efficient clinical competencies. But make use of the time allotted for research: as your interest in research grows you can try to expand your research sessions, for example by cross‐covering with colleagues. Start on a small project that you can complete within months. You will still be surprised at how long it takes to complete a project, and to present and publish the findings. Start the journey by writing a simple case report based on an interesting clinical observation, making sure that the patient concerned has given written consent for the clinical photographs to be used for medical publication. Then take care to write it up promptly and see it through to publication; a case report is often the first step on the publishing ladder.

What type of research should I conduct?

Evidence‐based medicine is the production of clinical protocols, guidelines and standards, which can inform the development of clinical care pathways. Clinical audit is used to evaluate and improve the implementation of such pathways. These approaches form the foundation for improving healthcare delivery.

Clinical audit

During your training you will be required to undertake clinical audit, preferably in cooperation with a colleague. Begin by identifying an area of clinical practice that could be improved (Table 1.1). Next identify all the key components of the process, from beginning to end (Figure 1.1).

Define standards that you can measure for each component and the acceptable benchmark for this standard that will demonstrate efficiency. The standard needs to be clearly defined so that data collection is free of ambiguity. Poorly defined standards are the main cause of failure to implement audit changes.

Next choose one simple intervention to the process pathway that will result in the greatest improvement. Discuss your proposed intervention with the staff and patients who follow the pathway. Decide on the standard for this step. Write a simp...