Dermatology the ‘invisible specialty’ when it comes to clinician research

By Michael Woodhead

2 Mar 2022

Despite moves to encourage dermatology trainees to take up research, Australia still lacks a nurturing environment for clinician‒scientists to flourish in the speciality, a group of academic dermatologists say.

With only two leading universities having chairs in dermatology and a lack of full-time hospital-based practitioners in dermatology departments, the speciality lacks capacity and career opportunities when it comes to dedicated research, according to a paper published in JID Innovations.

The authors, led by Dr Kiarash Khosrotehrani of the Diamantina Institute, University of Queensland, say Australia has very few dermatologists who spend significant amounts of time in research and only a handful lead or work full time in a research laboratory.

Most public hospitals place an emphasis on service provision over research, they note, while industry-sponsored research does not provide scope for dermatologists’ independent thinking and innovation, and often limits clinician input in study design and conduct.

“Overall, dermatology departments do not offer the mentors, role models, or supervisors who can help clinician‒scientists,” they write.

The authors, who include Professors Dedee Murrell and Peter Soyer, also argue that involvement in research is discouraged by the current four-year dermatology training program.

Although research is now part of the criteria for dermatology training selection, trainees are discouraged from continuing involvement in research by the study and financial pressures imposed by the need to pass rigorous examinations, they say.

They argue that this must change and dermatology needs to have more systemic commitment to research in order to drive improvements in clinical practice.

“Our discipline, more than ever, needs to be leading innovation in skin health and disease to remain a relevant and dominant specialty in medicine,” they write.

Building on existing programs set up by the Australasian College of Dermatology to foster research involvement, they call for newly accredited dermatologists to be offered research fellowships as a career option.

“This would be in the form of a secure three-five year clinician‒scientist early-career fellowship or junior-faculty position in research-intensive departments offering adequate mentoring, 70‒80% protected time for research while maintaining a reasonable income commensurate with their level of training,” they suggest.

“Such a period would offer these early-career researchers the time to start a scientific career, establish their footprint in an area of interest, and gain independence through funding.”

They acknowledge that academic dermatology departments in Australia currently do not have the staff or funding resources to support such positions, and say that new investment is needed to support this.

“Such commitment to academic dermatology would have long-lasting impacts on our discipline and trigger a virtuous circle over several generations for the benefit of our patients,” they conclude.

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