Core Content for Undergraduate Medical Education in Spain: Recommendations of the Instructors' Group of the Spanish Academy of Dermatology and Venereology (AEDV).

BACKGROUND: Skin problems are among the most frequent reasons for seeking medical attention in primary care. In recent years, as a result of the process of adapting medical curricula to the requirements of the European Higher Education Area, the amount of time students spend learning the concepts of dermatology has been reduced in many universities. MATERIAL AND METHODS: In order to reach a consensus on core content for undergraduate education in dermatology, we sent a survey to the 57 members of the instructors' group of the Spanish Academy of Dermatology and Venereology (AEDV), asking their opinions on what objectives should be set for a dermatology course in Spain. A total of 131 previously selected objectives were listed. We then applied the Delphi method to achieve consensus on which ones the respondents considered important or very important (score≥4 on a Likert scale). RESULTS: Nineteen responses (33%) were received. On the second round of the Delphi process, 68 objectives achieved average scores of at least 4. The respondents emphasized that graduates should understand the structure and functions of the skin and know about bacterial, viral, and fungal skin infections, the most common sexually transmitted diseases (STDs), and the 4 main inflammatory dermatoses. Students should also learn about common complaints, such as itching and bald patches; the management of dermatologic emergencies; purpura and erythema nodosum as signs of internal disease; and the prevention of STDs and skin cancer. During clinical clerkships students should acquire the communication skills they will need to interview patients, write up a patient's medical history, and refer the patient to a specialist. CONCLUSIONS: The AEDV's group of instructors have defined their recommendations on the core content that medical faculties should adopt for the undergraduate subject of dermatology in Spain.

[Survey of post-graduate training for Dermatology and Venereology residents in France (2005-2010)]. / État des lieux de la formation des internes en DES de dermato-vénéréologie en France (2005-2010).

BACKGROUND: Training procedures for dermatology residents have never been evaluated in French university hospitals. The present study describes the methods used over the last 5 years. METHODS: This was a retrospective survey using a questionnaire sent to French dermatology-residents completing their residency between 2005 and 2010. The data collated included information on theoretical aspects (courses, local, regional or national seminars, meetings) and on practical training (consultations, surgery, laser and cosmetic dermatology), research, post-residency assistantship and additional university diplomas, as well as overall opinions on dermatology training. Statistical analysis was descriptive and comparative according to the number of dermatology teachers (professors, senior lecturers) in the region in which training was given. RESULTS: One hundred and twenty-two questionnaires were analyzed: 72 from regions with two or less than two university hospital dermatology teachers (group 1) and 50 with more than two such teachers (group 2). Fewer residents had completed a research year in group 1 (19% vs 40%; P=0.01), but the two groups were comparable concerning post-graduate training (DESC) (16%) or post-residency (87%) placement. There were no differences concerning local theoretical training or participation in seminars or meetings, apart from inter-regional seminars, which were more frequent in group 2 (24% vs 3%; P<0.001). There were no differences between the two groups in terms of personal consultations (91%), surgery (62%), laser treatment (13%) or cosmetic dermatology (3%). Satisfaction rates regarding theoretical and practical training were similar in both groups (69% vs 70% and 72% vs 78%, respectively). DISCUSSION: This is the first survey carried out with the aim of evaluating suitability of training for dermatology residents in France with regard to the "reference" dermatological practice recently submitted to the French health ministry. The present results, obtained from 47% of residents receiving training during this period, show only very few differences concerning dermatology residency training with respect to the number of university hospital dermatology teachers, apart from research training. CONCLUSION: Despite an overall good opinion on their residency, the dermatology residents involved underlined the need for greater focus on teaching of technical skills (surgery, laser, cosmetic dermatology).

Photograph as Skin, Skin as Wax: Indexicality and the Visualisation of Syphilis in Fin-de-Siècle France The William Bynum Prize Essay.

In early twentieth-century France, syphilis and its controversial status as a hereditary disease reigned as a chief concern for physicians and public health officials. As syphilis primarily presented visually on the surface of the skin, its study fell within the realms of both dermatologists and venereologists, who relied heavily on visual evidence in their detection, diagnosis, and treatment of the disease. Thus, in educational textbooks, atlases, and medical models, accurately reproducing the visible signposts of syphilis - the colour, texture, and patterns of primary chancres or secondary rashes - was of preeminent importance. Photography, with its potential claims to mechanical objectivity, would seem to provide the logical tool for such representations. Yet photography's relationship to syphilographie warrants further unpacking. Despite the rise of a desire for mechanical objectivity charted in the late nineteenth century, artist-produced, three-dimensional, wax-cast moulages coexisted with photographs as significant educational tools for dermatologists; at times, these models were further mediated through photographic reproduction in texts. Additionally, the rise of phototherapy complicated this relationship by fostering the clinical equation of the light-sensitive photographic plate with the patient's skin, which became the photographic record of disease and successful treatment. This paper explores these complexities to delineate a more nuanced understanding of objectivity vis-à-vis photography and syphilis. Rather than a desire to produce an unbiased image, fin-de-siècle dermatologists marshalled the photographic to exploit the verbal and visual rhetoric of objectivity, authority, and persuasion inextricably linked to culturally constructed understandings of the photograph. This rhetoric was often couched in the Peircean concept of indexicality, which physicians formulated through the language of witness, testimony, and direct connection.