Performance of ChatGPT on dermatology Specialty Certificate Examination multiple choice questions.

ChatGPT is a large language model trained on increasingly large datasets by OpenAI to perform language-based tasks. It is capable of answering multiple-choice questions, such as those posed by the dermatology SCE examination. We asked two iterations of ChatGPT: ChatGPT-3.5 and ChatGPT-4 84 multiple-choice sample questions from the sample dermatology SCE question bank. ChatGPT-3.5 achieved an overall score of 63.1%, and ChatGPT-4 scored 90.5% (a significant improvement in performance (p<0.001)). The typical pass mark for the dermatology SCE is 70-72%. ChatGPT-4 is therefore capable of answering clinical questions and achieving a passing grade in these sample questions. There are many possible educational and clinical implications for increasingly advanced artificial intelligence (AI) and its use in medicine, including in the diagnosis of dermatological conditions. Such advances should be embraced provided that patient safety is a core tenet, and the limitations of AI in the nuances of complex clinical cases are recognised.

A UK-wide study to describe resource consumption and waste management practices in skin surgery including Mohs micrographic surgery.

BACKGROUND: There is a lack of national guidance specifying how skin surgery, including Mohs micrographic surgery (MMS), should be conducted, leading to a degree of heterogeneity in the set-up of skin surgery services and how skin surgeries are performed. OBJECTIVES: To provide the first UK-wide cross-sectional study reporting real-world data on the set-up and waste management practices of skin surgery, including MMS. METHODS: A UK-wide service evaluation study was conducted between 1 March 2022 and 30 June 2022 using a standardized data collection pro forma. Twelve participating sites from England, Northern Ireland, Scotland and Wales provided data from 115 skin surgery lists involving 495 patients and 547 skin surgery procedures between 1 March 2022 and 30 June 2022. RESULTS: Mean total weight of nonsharps skin surgery waste was 0.52 kg per procedure (0.39 kg clinical waste, 0.05 kg general waste and 0.08 kg recycling waste). Data from a single site using disposable surgical instruments reported a mean of only 0.25 kg of sharps waste per procedure. The recycling rate ranged between 0% and 44% across the cohort with a mean recycling rate of 16%. CONCLUSIONS: We advocate that staff transition to the British Society of Dermatological Surgery 2022 sustainability guidance, which made wide-ranging recommendations to facilitate staff to transition to sustainable practices in skin surgery.

Skin surgery training: a literature review of methods and their efficacy.

Skin surgery ranges from small biopsies to Mohs micrographic surgery and excisions necessitating complex skin flap design or grafting. For all dermatology doctors in training there is a need to acquire competence to perform skin surgery safely, in an appropriate timeframe and with minimal complication rates. There exist a range of different methods, with varying reliance upon advancing technology, to teach skin surgery and to refine surgical skills before procedures are performed on patients. We searched PubMed, MEDLINE and SCOPUS databases to identify all papers relevant to postgraduate dermatology skin surgery teaching and training published in the past 10 years in English (see Appendix S1 in the Supporting Information for our search strategy). This yielded 440 results, for which all abstracts were screened. Manuscripts related to aesthetic surgery training, such as robotic hair transplantation training are excluded.

Autoimmune pancreatitis with concomitant autoimmune haemolytic anaemia.

Autoimmune pancreatitis (AIP) is an infrequent cause of acute pancreatitis, being more commonly associated with chronic pancreatitis. AIP can be associated with other autoimmune manifestations, including Sjögren's, inflammatory bowel disease, primary biliary cirrhosis, rheumatoid arthritis, hypothyroidism and sarcoidosis. Rarely, concurrent autoimmune haemolytic anaemia (AIHA) is observed, as seen in our case report of a 33-year-old postpartum woman.