Journal Information
Vol. 111. Issue 6.
Pages 453-459 (July - August 2020)
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Vol. 111. Issue 6.
Pages 453-459 (July - August 2020)
Opinion Article
DOI: 10.1016/j.adengl.2019.12.012
Open Access
Emerging Formats for Dermatology Conferences and Meetings
Formatos emergentes de congresos y reuniones dermatológicas
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A. Martin-Gorgojoa,
Corresponding author
alejandromartingorgojo@aedv.es

Corresponding author.
, E. del Río de la Torreb
a Servicio de ITS/Dermatología, Centro de Diagnóstico Médico, Madrid, Spain
b Clínica Dermalar, Santiago de Compostela, Spain
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Table 1. Description of Alternative Conferences and Congresses.
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Since 1889, when José Eugenio de Olavide, the father of Spanish dermatology, and a small group of colleagues attended the First International Congress of Dermatology and Syphilology in Paris, France, scientific meetings and congresses have become extraordinary positive points of meeting, friendship, scientific debate and consensus in our professional setting.1 Their principal values lies in the personal, face-to-face exchanges between professional colleagues who share doubts and concerns, and who have complementary ways of resolving them, which gives rise to the synergetic aggregation of knowledge in a short period of time.2

While traditional meetings are theoretically aimed at disseminating and advancing research, training professionals, and helping to establish evidence-based policy, the truth is that qualitative and quantitative studies that allow us to state that these (a priori, logical and self-evident) noble objectives are being achieved and are having a practical impact when conference-goers return to work are lacking.3

Moreover, dermatology conferences and meetings held in Spain (since the first meeting of the Spanish Society of Dermatology and Syphilography, now the Spanish Academy of Dermatology and Venereology [AEDV], at the headquarters of the Madrid College of Physicians) have a long track record of successes and many high points, although it is also necessary to bear in mind its low points and areas where improvement and updating is required, which, until several decades ago, were not even considered. Because only by diagnosing the area for improvement can we establish the appropriate strategy for advancing.

Is There a Conference Bubble?

The diversification and gradual subspecialization of dermatologic activity have led to the proliferation of conferences dealing with increasingly specific fields of knowledge. This has taken place in parallel with the increase in professionals in each autonomous region of Spain, with increased exchange in more proximate settings. Indeed, there may be a genuine bubble of conferences and congresses, fed by a feeling (real or imagined) of the need for ongoing training or improvement. As well as the classic periodic institutional meetings promoted by the different national and international dermato-venereological associations, recent decades have seen a proliferation of a large number of meetings of different types, which are also fed by the resources supplied by the pharmaceutical and cosmetic industry (such as exclusive sponsorship or temporary exhibition stands of outreach and commercial interest). At certain times of year, the concentration (even overlapping) of conferences is such that, if you attend a decent number of them, the personal and family cost, the fatigue and the financial loss (if attending means missing out on private work) can far exceed the benefits of attending these meetings.

Who Pays?

This is, undoubtedly, the first question asked by any conference organizer or potential attendee. Probably, the most sensible and reasonable solution would be for each attendee to pay the proportional part of the expense generated: every congress and conference has transport costs, fees, infrastructure and rental, technical support, personnel expenses, hotel and catering expenses, etc., which have a positive effect on the local economy, gross domestic product, and economic growth. But this common sense and apparent benefit has gradually become distorted to the point where, in many meetings, most of the economic weight falls on the pharmaceutical or cosmetic industry, which somehow expects to recover and compensate for this cost by increasing its income. Furthermore, the high prices of some of these meetings may be partly justified by the gradual complication in terms of technical means and partly because they are a major source of income for the groups or people who promote them. And because “he (or she) who calls the piper pays the tune”, we see greater decision-making power on the part of the industry in our meetings, in which they often end up influencing the schedules, speakers, and topics for debate.

Scientific Meetings or Trade Fairs?

When Juan de Azúa inaugurated the initial sessions of AEDV, the content was strictly scientific and formal. Today, however, most dermatology conferences throughout the world have a trade-fair aspect, with presentation of new equipment and products. The pharmaceutical and cosmetic industry is a group of private corporations with a legitimate profit motive. This trade-fair aspect may be of interest and even justify the travel and time dedicated, but is may come to be a clear distraction from the educational role of these meetings. We should therefore think about the proportionality of these exhibitions and, while not prohibiting this informative and outreach work regarding the products, prevent it from eclipsing the true mission of the meeting, which is to provide independent scientific information. It is not a matter of blaming the industry but of assertively demanding responsibility from the organizers of scientific and professional events (and leaders of scientific societies) so that they do not distort the principles that justify this type of meeting.

Is the Content of our Congresses Representative of and Proportionate to Everyday Dermatology?

The aforementioned weight of the industry and our natural desire for novelty (hence the success of this format in a large part of our meetings) may notably distort or tilt the balance and proportionality of the content of our meetings. Thus, it is common for diseases or techniques that account for a small proportion of consultations or time dedicated in routine practice to be overrepresented in meetings. Following the Pareto rule (and without intending to make a precise, systematic, or sweeping statement), it may be the case that 20% of dermatology in routine clinical practice occupies up to 80% of the time of some conferences, which leads to significant areas of our speciality without economic champions and fallow in educational terms.

Is There a Concentration of Presentations by a Small Number of Speakers?

Another recurring phenomenon of the traditional system of conferences and congresses (linked to subspecialization) is that it is common to find the same speakers in the same settings talking about the same things. It is true, however, that, when an author works, dedicates time and effort to, and delves deeply into a specific topic, it is likely that few other (if any) will be able to approach and write about that topic as well. But we should not ignore the need to increase the diversity of speakers at conferences, with the goal of avoiding repetition and monotony in cases where this is not inevitable, by inviting new voices that are not imposed by outside agents.

The former distribution of power among the chairs of the speciality in Spain and the major dermatology departments in public tertiary hospitals has, until recent decades, constituted an enriching environment of knowledge and development yet, at the same time, a closed, deterministic system.4 This has been partially overcome in Spanish dermatology today, which is more dynamic, more diverse, and richer than ever.

Time Management in the 21st Century

Time is one of the most valuable resources and, unfortunately, very poorly managed, to the point were we sometimes try to fill up our lives and education with content that, in truth, we do not need. The big conferences that last between 3 and 5 days are seeing an increasing reduction in real attendance because it is increasingly difficult to avail of that much free, family, or professional time. We understand that some may prefer a single annual event over several days (instead of several short events) but reality tells us that a large proportion of dermatologists attend only 1 or 2 days of these congresses because it is simply not practicable or desirable to attend more.

Are the Number of Conference Attendees and Industry Presence Good Indicators of the Quality of a Conference?

We believe that the answer to this question is no. Although we intuitively tend to link success to attendance and to the intrinsic quality of a conference, it is common for excessively large and diverse meetings with a huge range of content to lead to a certain amount of saturation and dispersion. This option paralysis occurs due to the simple inability to decide between so many possibilities, with an excessive range of options that are often difficult to comprehend.

Are our Congresses Environmentally Friendly and Sustainable?

There is no doubt that any conference, on any topic, brings resources and wealth to the place where it is held, with a major economic impact. So much so that many cities develop specific conference or convention tourism plans as a programmed strategy with the support of local government and business, with greater or lesser success. But beyond this, how much redundant, superfluous, ephemeral material (papers, leaflets, etc.) and largely avoidable fuel and energy consumption, and plastic and other waste is generated by our meetings? Are we aware of this? Do we respect our environment? One of the first indicators is the ecological footprint caused by holding a traditional conference, with the release of greenhouse gases into the atmosphere, caused by transporting attendees and speakers, as well as the intensive use of resources to hold the conference. An editorial by the British Medical Journal in 2008 highlighted the fact that international congresses may contribute to global warming and should be considered a luxury that our planet cannot afford.5Fig. 1

Figure 1.

Image of the meeting on Critical Reading of Articles, held on the island of San Simón, on the Vigo Ria, on September 4, 2019.

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New Answers and New Congresses for New Times

After this analysis, we ask ourselves, what opportunities are provided by being aware of these weaknesses and dealing with them using old methods and new technologies? What trends are on the way? Where is the future of our conferences headed? Will we maintain the current formats of macro-conferences, meetings, and trade fairs? Will the current trend continue and even increase, even though we are beginning to be aware of its negative effects and weaknesses? We believe that the answer to this last question is affirmative for the present: the current model appears to be robust and few question it (reasons which, in dermatology and in medicine in general, will help it to remain vigorous for many years to come). But at the same time, initiatives are appearing that may begin to signal a change of trend or, at least, a readjustment of the system. We examine some of these initiatives in Table 1, with specific examples, together with a brief outline of what we think the alternatives should be to traditional congresses and conferences. Fig. 2

Table 1.

Description of Alternative Conferences and Congresses.

Type of Congress/Conference Proposed  Description and Thoughts  Proposed Solution and/or Example 
Short meetings  Very long meetings are unsustainable. In fact, a large part of the time is spent by some attendees on tourism. And why not? It may be a legitimate part of the trip. How often is the destination and conference site more attractive than the meeting itself? Nevertheless, increasing numbers of colleagues prefer to differentiate their time and dedicate a specific and intensive time to education and other moments to leisure tourism. Sacrificing personal or family time, from weekends or hobbies, is increasingly absent from the plans of professionals.  This is leading to increasing popularity of meetings held on Fridays and Saturdays, preferably up to midday, thus allowing attendees to return home in the afternoon and still enjoy some of their weekend. 
    Based on the above thoughts and objective market prices, in order to minimize hotel expenditure, taking into account the lower cost of establishments on Sunday nights and Mondays, it would be interesting to consider organizing meetings on days other than Fridays and Saturdays, which would, in principle, not have a greater impact on our weekly work but would reduce costs. 
Proximity Meetings  Exotic, far-away places may be an attraction in themselves. But if we add up the cost in terms of time, money, sacrifice and fatigue, they may not appear so reasonable and attractive. It is also not helpful to the content and making the best use of the conference for the setting to be so attractive that it overshadows the meeting itself, like form over content.  Thus, we believe that proximity to our usual setting may be more attractive due to ease of access and speedy return. Furthermore, from an environmental point of view, meetings that can be reached in 2-3 hours by train (clearly preferable to planes for medium distances) would be ideal, preferably in places no more than 400 km from the attendees’ places of work and residence. 
Informal meetings of dermatologists who are passionate about a specific topic  Although the working groups of the Spanish Academy of Dermatology cover almost all possible areas of interest in the speciality, there is a space for colleagues who are especially excited about a highly specific topic to meet to discuss it in depth.  This happens, for example, with the group “Nos Gusta el Láser” (we like lasers), which, as well as its own instant-messaging chat group, meets once a year in Madrid, on a Saturday morning, in facilities provided freely by our Spanish Academy of Dermatology, to share their opinions, concerns, difficulties, experiences, ideas, and solutions. 
Meetings of groups with a traditionally low profile  Some other groups, until recently, poorly organized and with little visibility, are also beginning to be seen and noticed in the context of dermatology. This is true, for example, of private-practice dermatologists, who often work as single professionals, in their own consulting rooms, with a strong requirement for resolution (on which their income depends), with little day-to-day interaction with other colleagues and at risk of burnout, yet highly exposed to public opinion (also on social media).  The consolidation of associations such as Dermus (Association of Private Dermatology Clinics), which is on its 13th annual meeting, is a clear example. 
  The justification is simple: if a hospital department organizes clinical and scientific exchange sessions, how much more necessary is this for those who work alone to get advice on decision-making or to exchange opinions?  More modest are the “Galicia Private Dermatology Sessions” (the 4th edition was held on 28 September 2019). In the Galician example above, usually 4 presentations on topics of common interest are given at a single annual conference; the presentations are open to any dermatologist, regardless of type of practice, and consist of 30-45 minutes of presentation and 15-20 minutes of discussion. They take place at the headquarters of the College of Physicians of Santiago de Compostela. 
    This type of local, small-scale approach makes it possible to organize and hold meetings at a minimum expense. 
Meetings paid for by the attendee  Who cannot afford a coffee and a working lunchtime fixed menu? Are our salaries, even those of residents, so miserable? The truth is that meetings with minimal expense and high learning value can be held.  An illustrative example is the “Meeting on Critical Reading of Articles”, held on the island of San Simón, on the Vigo ria, on September 4, 2019. The meeting was promoted, hosted and partially subsidized by the Galician section of AEDV. Travel and catering expenses amounted to 30 euros. The meeting was attended by some 30 dermatologists, from first-year residents to veteran dermatologists in public and private practice, all highly motivated and involved in the meeting (Fig. 1
Online and instant-messaging forums  We cannot ignore the enormous potential that has been provided for some years now by new information and communication technology. Videoconferences, webinars, social media, online repositories, virtual libraries of different associations and online video channels are an endless source of increasingly rich and better resources. Professional chats and forums, the successors of the “old” e-mail distribution lists, some of which still survive, are the most authentic and dynamic expression of these possibilities. So much so that they require some regulation due to their own agile dynamics, and regulatory and legal control.6  Of the many possible examples to illustrate this section, we would like to highlight Dermachat (Fig. 2), a forum of which both the authors of this article are members, and which includes some 500 dermatologists who regularly consult it, with a free and variable level of participation with which each member feels comfortable. The forum has been promoted and driven since 2014 on the Telegram instant-messaging platform by Mario Linares and Francisco Russo, with the minimum essential requirements of participation and respect for all opinions. It is a fertile and successful example of outreach and agile learning, of dialogue, of generous help in diagnosis, in sharing bibliographic resources or in the choice of treatment alternatives, sometimes immediate and with the patient in the consulting room. It should be given credit for having been able to rekindle excitement in a large group of dermatologists who are far removed from traditional meeting forums or who tend to work alone. 
Virtual conferences and congresses: 1st Virtual Dermachat Congress (September 14, 2019)  At Dermachat, between June and September 2019, an initiative arose to hold a virtual conference, which was finally held on September 14, 2019. The meeting began with a prior call and minimum coordination on a parallel virtual work forum, and got a good-sized group of participants (35 dermatologists and a dermatopathologist) to submit online presentations for this teaching, scientific and outreach initiative using only simple tools accessible by anyone: the channel of the Telegram instant-messaging application, on which Dermachat operates, and presentations recorded in MP4 video format (with 2 requirements: duration of less than 10 minutes and file size of less than 100 megabytes). This made it possible to hold a plural, diverse meeting with topics on methodology, management, clinical practice, surgery, and cosmetics, built in collaboration, thanks to the participants who decided step forward in this open, altruistic model by presenting a specific topic where they felt they could bring something more to the group or on which they had something (always something good) to say. The presentations were programmed beforehand, several days beforehand in some cases, to be broadcast according to the schedule. All the participants were able to follow this meeting live over the Internet, in a multiplatform format, from the comfort of their own homes, without having to travel or waste time and without having to spend a single cent, beyond the time, dedication and enthusiasm we put into it. Furthermore, the presentations are still on the channel of this semipublic group, which means that they can be viewed later whenever desired.   
Figure 2.

Logo of the Dermachat informal instant-messaging group, which includes almost 500 dermatologists, with the logo of the “1st Virtual Dermachat Congress”, which has held on Saturday, September 14, 2019.

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Final Thoughts

Despite these little giant steps and the proposed initiatives and alternatives, in-person conferences will continue to exist. And we are glad that this is the case because, alongside the dermatologic science and its contents, there is the other equally or more important part: the face-to-face interaction of dermatologists, the greetings, the hugs, the smiles and the real life. And in the end, direct interaction between people is and will continue to be the most professionally and emotionally enriching way for human beings.

Acknowledgments

The authors would like to thank Dr. Tomás Toledo Pastrana and Dr. Fernando Cabo Gómez for their review and critical reading of the manuscript.

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Are medical conferences useful? And for whom?.
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Are international medical conferences an outdated luxury the planet can’t afford? Yes.
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Please cite this article as: Martin-Gorgojo A, del Río de la Torre E. Formatos emergentes de congresos y reuniones dermatológicas. Actas Dermosifiliogr. 2020;111:453–459.

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