Dr. Vikas Sharma
A dermatologist is a physician trained to treat diseases and conditions of the skin, on any part of the body. Dermatologists can treat anything from a fungus or bacterial infection of the skin, to various types of cancer.
In addition to medical treatment of skin conditions, dermatologists also do aesthetic, elective procedures for patients who wish to improve skin tone and decrease signs of ageing. Some of these aesthetic treatments include laser treatment, botulinum toxin injections, or Dermal Fillers and collagen injections.
The new insights regarding convergence of the molecular basis of dermatological disorders has provided exciting new opportunities in form of newer therapeutic modalities to counter various dermatological diseases.
Lasers in dermatological science are currently the most precise and selective surgical tools having the qualities of “magic targeted bullet” — light traverses through the various epidermal and dermal layers of skin without affecting the normal cellular structure and behaviour only to reach and target the selective abnormal cells — the aim to achieve the desired action or role.
Skin is not only the largest and outermost organ system but even small changes on the skin can serve as markers or detect a lot of undiagnosed or hidden internal diseases (like Thyroid disorders, Diabetes Mellitus, Tuberculosis, Sarcoidosis, Liver disorders, Kidney Disorders, Haematological disorders, Polycystic ovarian disorders), AIDS and internal malignancies(cancers). The importance of skin examination by an expert and vigil dermatologist thus becomes much more.
Is skin interesting or important?
Skin is the largest organ in the human body, with an average surface area of 1.8 m2, and its three layers constitute 16% of a person’s total body weight far heavier than the healthy human brain or liver. It is, therefore, unsurprising that skin is the organ system that hosts the greatest number of diseases, with more than 3000 estimated primary or systemic cutaneous diseases.
Disorders of the skin, hair, and nails fall within the remit of a dermatologist. The specialty is divided broadly into medical and surgical fields, with clinicians in secondary care often practising both. It should be noted that in some countries like ours, training and practice in dermatology are combined with venereology, whereas in the United Kingdom, genitourinary medicine is a separate speciality.
Hence if you wish to specialise in Dermatology in India, you have a promising career ahead.
After due completion of the MBBS, you have to take PG entrance exams like All India Post Graduate medical test or other entrances of deemed universities.
Admissions depend on your rank in these tests.
One could opt for the three year MD in Dermatology, Venereology, and Leprology, or do the two year DDVL- Diploma in Dermatology, Venereology, and Leprology.
Some Dermatologists prefer doing fellowships in lasers, trichology, paediatric-dermatology, dermato-pathology, cosmetology, or different types of dermato surgeries, of three months, six months, or a year, from India or abroad.
Dermatology PG courses in Institutes like PGI, Chandigarh and AIIMS, Delhi are of the highest standards when equated worldwide. This specialisation is related to physiology and pathology of the skin, hair and nails. You will discover how a simple rash can be so complicated and troublesome. How a dermatologist can diagnose hidden internal disorders including malignancies by the clinical skills developed.
Diagnoses are clinical in the overwhelming majority of cases, and dermatology requires relatively few investigations. Clinically diagnosing skin disorders takes skill and experience, plus a good grounding in clinical medicine. Dermatologists use a comprehensive formulary with topical therapies, systemic drugs including novel immuno-modulatory drugs, photo-therapies, laser treatments, cryotherapy, and other treatment modalities alone or in combination — a huge variety of treatments to manage a tremendous number of diseases.
Positives of a career in dermatology
1. Dermatology is a skilled independent speciality. Dermatologist does not require a must support from other specialities like surgery, which is dependent upon anaesthesia, Medicine on Radio-diagnosis and Pathology, Obstetrics and Gynaecology on Anaesthesia and Paediatrics.
2. There are few emergencies. You can decide how much and when you want to work. In other words, "you are the king of your own OPD."
3. You need not be attached to an Intensive Care Unit as very critically ill patients are less.
4. If you perform well, and your skills prove beneficial to the patients, you start commanding brand loyalty at all socioeconomic levels.
· Variety of patients; all ages and genders. A dermatologist can interact and treat up to 300 patients in a day.
· Clinical variety
· Reliance on clinical diagnostic skills
· Rewarding work—curable or controllable diseases
· 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
· Very large and increasing OPD workload
· Busy working week, requiring good time management skills
For those of you keen to indulge your surgical passions, there is good news.
Aesthetic surgery & Surgical Hair Transplant has also made the speciality more popular.
Mohs micrographic surgery has added a further dimension to surgical dermatology by allowing microscopic confirmation of full excision of a primary tumour before surgical closure of a wound. Compared with many surgical disciplines, surgical dermatology boasts very favourable outcomes. Operative morbidity is low, mortality is essentially nonexistent, and most individuals are cured.
Get involved in research
Dermatology offers a wealth of research opportunities because skin is a visible and accessible organ. The speciality receives generous research funding, and dermatologists often have an academic background — an infrastructure that facilitates clinical research.
The surge in the demand for dermatologists is not temporary; In fact, it seems that it will not dip in the future as well, maybe because of the excessive demand or because of the limited seats. So, someone who aims at becoming a dermatologist needs to have a natural eye, a skilled hand and a strong base of general medicine. If you are a complete clinician and do not want to be in a non-clinical field, yet wish to have some semblance of control over your life, dermatology is the option for you.
The writer is Chief Consultant Dermatologist & Dermato-Laser Surgeon, National Skin Hospital, Panchkula
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