Dermatology doctors pass a basic medical degree after 5 – 6 years at University (MBBS or MBChB). They then work for 2-5 years junior doctors in general medicine and study to pass the membership exams for the Royal College of Physicians (MRCP). They then work and train as a registrar in dermatology for at least four years. Getting a dermatology registrar job is highly competitive so only the best applicants are appointed.
During this time as a registrar they have to reach a high standard in many areas of dermatology including general clinics, surgery, allergy, paediatric dermatology, pathology and ultraviolet light therapy. Registrars are formally assessed up to 15 times per year for their communication and surgical skills and skills in audit, research presentations, analysis of complex cases and with patient feedback surveys. In 2009 a new exam was introduced for them to test knowledge. During this time they also produce research papers for scientific conferences and some study for a higher doctorate degree (MD or PhD). If they pass all these assessments, they are then registered on the General Medical Council specialist register and are allowed to apply for consultant posts. Usually they will be between 32 and 40 years old by this stage as training to become a consultant usually takes between 14 and 22 years from the beginning of medical school.
For various reasons, such as family commitments, some doctors decide a registrar job is not for them, and may decide to become specialty doctors in dermatology after other junior hospital jobs in general medicine. Some of these doctors can eventually apply to become consultants if they can demonstrate evidence of equivalent training and experience.
Other doctors who are keen to become registrars, but have not yet got the qualifications, experience or research expertise to be appointed, work in the department as clinical fellows.
During their training, most of the Norwich dermatology consultants did additional research work leading to a higher MD or PhD qualification. All consultants must undergo a minimum of ten days of continuing medical education every year monitored by the Royal College of Physicians and undergo annual appraisal to ensure their quality of care remains high and to be revalidated by the General Medical Council . Most consultants do much above this minimum. All participate in internal and national audit programmes.
The dermatology consultants continue to have active areas of medical research to develop and improve new treatments and they also teach medical students, junior doctors and GPs and are involved in medical examinations at all levels. Consultants are also expected to contribute to the running and improvement of the NHS both locally and nationally. In addition to doing their own clinics and operating lists, consultants also supervise the work and perform the assessments for the other doctors in the department, often dealing with over 40 patients per day.
The doctors all present Dermatology Research at national and international dermatology meetings giving a chance to share ideas with leading specialists from around the world. This enables Norwich to find out quickly about developments elsewhere in the world and to adopt these if they are safe and effective. This leads to advances in treatment.
Nurses pass their RGN qualification after three years of study. They then work in other areas of general nursing to gain experience before specialising in dermatology. All nurses undergo in-house training in all areas of dermatology rotating around the department. They attend training courses in specialised areas of dermatology and two nurses each year do a higher diploma course in dermatology. The dermatology department was the first in the hospital to have a nurse qualify as a nurse presciber. Six of the nurses have had surgical training so they can take skin biopsy samples for testing. Some nurses are involved in research and since 2009 the department has obtained funds for nurses who can focus entirely on clinical research.
The nurses are leading the development in the region of many services such as nurse led acne clinics and nurse led children's clinics.
In 2011 Dermatology became the first department in the NNUH to appoint a nurse consultant, Carrie Wingfield. There are only a handful of dermatology nurse consultants in the UK.
Clerical and Secretarial Staff
There is a team of ten secretaries and clerical staff backing up the thirty doctors and nurses. Many of these staff have worked in the department for over five years, and their experience is invaluable to organising over 20,000 patient appointments and producing well over 40,000 letters per year. There is mandatory annual training for all hospital staff in customer care, conflict resolution, manual handling, fire lectures and resuscitation.