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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Nine thirty on a typical Wednesday morning&#46; Three dermatologists from different generations are chatting over coffee after the clinical session and exchanging their thoughts about residency training over the years&#46; Are there really that many differences&#63;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Dermatology Residents and their Relations to Others in the Hospital</span><p id="par0010" class="elsevierStylePara elsevierViewall">Dr Sergio Va&#241;&#243;-Galv&#225;n &#40;junior dermatologist&#41;&#58; Nowadays dermatology residents are highly esteemed by their peers at the hospital&#46; The ratio of women to men is 4&#58;1&#44; according to the latest figures from the Spanish medical residency system&#44; and most of these doctors come well prepared&#44; having earned admission to one of the most sought-after specialties&#46; Given such good grounding&#44; it is unsurprising that dermatology residents are often approached by others for advice as they begin to make medical decisions at work&#44; particularly in the emergency department&#46; Moreover&#44; in most cases&#44; they&#8217;re outgoing and popular with their peers&#44; as practically everybody at one stage or another turns to a friend in dermatology to check out a skin lesion &#40;perhaps this specialty is the most prone to &#8220;corridor consultations&#8221; from friend-patients&#46; This means the dermatology resident is well loved and respected by colleagues&#44; something we can be grateful for&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">As for relationships within the department&#44; cordiality reigns and there is excellent rapport between residents and the other staff physicians and the head of department&#46; It was different in the past&#44; when the authoritarian style of some heads and staff physicians seemed to interfere with that&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Dr Pedro Ja&#233;n &#40;senior dermatologist&#41;&#58; In our day&#44; dermatology wasn&#8217;t among the top-ranked specialties&#44; but the rest of the staff knew us and respected us&#8212;as our handling of &#8220;corridor consultations&#8221; was highly valued&#46; The publication of T&#46; B&#46; Fitzpatrick&#39;s <span class="elsevierStyleItalic">Dermatology in General Medicine</span> had a major impact on our training&#46; Among other things it did for us&#44; it underlined our conviction that&#44; though we specialized in a single organ&#44; the skin&#44; we should keep sight of the whole patient&#46; We residents were on call in the internal medicine and plastic surgery departments&#44; acquiring surgical skills that gained us more kudos within the hospital&#46; In fact&#44; when dermatologists went to a new hospital&#44; one of the best ways of winning respect from colleagues and hospital management alike&#44; and acquiring prestige&#44; was through dermatologic surgery&#44; particularly for skin cancer&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Dr Antonio Ledo &#40;venerable master&#41;&#58; My answer to the first question about whether times have changed in residency training is that learning was and will always be essentially based on clinical experience&#8212;the more patients the better and in our case the caseload was incredible&#46; Nowadays the techniques that complement physical examination of the patient have changed radically&#46; Once&#44; a resident gained access to training only when an instructor or department head&#8212;who would be familiar with the candidate&#39;s background&#8212;decided to provide it&#46; Later would come natural selection&#8212;let&#39;s call it an assimilation process&#8212;whereby anyone who was consistently conscientious would become respected and would be taken into account&#46; What has changed radically is how the dermatologist is perceived within the context of the hospital&#46; Colleagues used to say&#44; &#8220;Could you take a quick look at this patient and tell me what cream you think would work best&#63;&#8221; and show surprise at being asked for the patient&#39;s medical history&#46; I found this very hard to deal with&#46; We were seen to be in a second-tier specialty&#46; When I graduated&#44; I spent a year in internal medicine to gain experience before specializing&#46; This preparation as an internist led me to consider the possibility that skin lesions could be related to general processes&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">One of the happiest days of my life came at a large medical center when I was introduced to a professor from abroad as a dermatologist who knew a lot about internal medicine&#46; Our generation witnessed and actively participated in this change&#46; Today the high scientific level of dermatologists is beyond question&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Concerns</span><p id="par0035" class="elsevierStylePara elsevierViewall">Dr Va&#241;&#243;-Galv&#225;n&#58; Probably the most worrying aspect for residents these days is the uncertainty of finding a job at the end of their residency&#46; The economic downturn has reduced the number of new public-sector contracts&#46; Therefore&#44; residents&#8217; beliefs about finding work at a public hospital&#44; particularly at a center they consider acceptable&#44; are that it will depend rather more on what turns up on the job market &#40;to cover a leave of absence or replace a retiree&#41; than on the candidates&#8217; merits as dermatologists or their work history and accomplishments&#46; In other words&#44; you need to be in the right place at the right time&#8212;fortunately there are exceptions&#46; As a result&#44; final-year residents suffer a kind of syndrome whereby they become anxious and concerned about job opportunities&#44; increasingly so in the last 3 to 4 months of their residency&#46; That said&#44; dermatology residents &#40;and specialists&#41; are&#44; on the whole&#44; cheerful people who enjoy their work and the camaraderie of companions&#46; The proof of this is the congenial atmosphere at dermatology congresses and day or evening conferences that are organized these days&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Dr Ja&#233;n&#58; Concern for the future was also the norm for residents as they neared the end of their training period in the past&#46; The dermatologist was a consultant within the internal medicine department in other times&#44; and in fact most hospitals in Spain had no dermatology departments or units unless they were university or referral hospitals&#46; These residents found many employment opportunities in the public sector soon after completing their residencies&#46; As a result&#44; so-called &#8220;functional dermatology units&#8221; opened in many hospitals&#46; These initially employed a single dermatologist but they provided the foundation for the dermatology departments and units that are currently considered vital to all hospitals in Spain&#46; At the same time&#44; the surgical aspect of the specialty was developing and becoming widely applied&#46; Particular areas of development were skin cancer surgery and diagnostic and therapeutic techniques&#44; and as a result rising numbers of dermatologists joined public hospitals&#46; Monumental changes soon followed in our specialty&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Dermatology in the private sector was&#44; however&#44; reserved for the bosses&#46; The idea of a young staff physician setting up a private practice was frowned upon&#46; It was difficult to be accepted by insurance companies&#44; cosmetic dermatology did not exist&#44; and skin cancer treatment was left to surgeons&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Dr Ledo&#58; In my day&#44; we didn&#8217;t just live in a time of economic crisis&#46; Spain was in a real mess&#8212;ours was crisis with a capital <span class="elsevierStyleItalic">C</span>&#46; We didn&#8217;t have final-year resident syndrome&#46; We didn&#8217;t just feel worried about not having salaries&#8212;there were no salaries&#46; The number of hospital places weren&#8217;t reduced because there were no places to start with&#46; Poorly equipped hospitals weren&#8217;t the problem because there were no hospitals&#46; The few salaried positions that did exist were for the professor and the orderly&#46; Perhaps that doesn&#8217;t sound credible today but I speak without a shred of exaggeration or word of lie&#46; Our present was so bleak that it could only improve&#46; We started at absolute zero but tremendous tenacity and our foolish self-confidence carried us to a much better future&#46; That&#39;s how it was for us&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Aims During Residency</span><p id="par0055" class="elsevierStylePara elsevierViewall">Dr Va&#241;&#243;-Galv&#225;n&#58; The main aim of a resident now is to acquire knowledge and skills in the different fields of dermatology to ensure he or she will be able to continue to develop professionally later on&#46; This necessarily requires mastering clinical and surgical dermatology&#44; dermatopathology&#44; and research&#46; In recent years&#44; residents have gradually attributed more importance to gaining experience for career planning&#46; Nowadays&#44; all doctors acknowledge the vital role their work record and accomplishments will play in their future careers&#44; so they begin working on it at the start of their residency&#46; In fact&#44; most dermatology residents end their training with several publications and numerous conference presentations under their belts&#46; This is less common in other specialties&#46; On that point&#44; one of the greatest advantages of our time is doubtless the ease of accessing information and dermatology literature on the Internet&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Dr Ja&#233;n&#58; A resident&#39;s aim as I recall it was to acquire the knowledge needed to manage patients with skin disorders&#46; Particular emphasis was placed on clinical practice&#46; The most esteemed instructors had superior clinical know-how&#44; although an understanding of dermatopathology was also highly rated&#46; This was less true of surgery or the complementary techniques being developed at that time&#44; at least in most places&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Dr Ledo&#58; The medical residency system did not exist for us&#46; We were unpaid volunteer assistants and anyone wanting to specialize in dermatology &#40;not only from Madrid&#44; but from many parts of Spain&#41; would come to Hospital San Juan de Dios in Madrid&#44; the cradle of great Spanish dermatologists&#46; The clinical training we received was astonishing&#46; We had no Internet but we found the finest dermatological descriptions already impeccably written in the classic books&#46; They didn&#8217;t have to be invented&#46; As far as I&#8217;m concerned&#44; when you write a paper&#44; it&#39;s best to go back to the old descriptions&#44; compare them&#44; and then add any important advances in our understanding of the etiology or pathogenesis of the conditions&#46; In actual fact&#44; I don&#8217;t believe things were easier or more or less difficult than now&#59; they were&#44; are&#44; and always will be tough&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Training</span><p id="par0070" class="elsevierStylePara elsevierViewall">Dr Va&#241;&#243;-Galv&#225;n&#58; Today dermatology is perceived to have a very broad scope&#44; requiring residents to be trained in medical and surgical aspects and to master certain diagnostic techniques such as dermatoscopy as well as therapeutic procedures like cryotherapy&#44; laser&#44; and photodynamic therapy&#46; During residency we also acquire knowledge of dermatopathology and immunology&#44; as well as basic notions of research design&#46; Training in cosmetic dermatology is gradually becoming more important&#44; particularly at the end of the residency&#44; as this is an area of rising demand in the private sector&#46; Such diverse areas of knowledge are what probably make this specialty so attractive&#46; Today many more learning opportunities are available than in the past&#44; given the technological improvements for information gathering&#44; ease of travel&#44; and industry grants for attending courses and conferences&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Dr Ja&#233;n&#58; During our period of training&#44; clinical knowledge was the basis of the specialty and considerable importance was also given to dermatopathology&#46; However&#44; residents received very little instruction in dermatologic surgery and even less in cosmetic dermatology&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Dr Ledo&#58; Dermatologists are very well-prepared&#46; We don&#8217;t need to defend our degrees&#44; certifications&#44; or knowledge&#46; Those who infringe on our specialty from outside&#8212;because they see the possibility of profits and a prosperous business in this tempting field&#8212;are the ones who are required to demonstrate whether they are suitably qualified or not&#46; But we shouldn&#8217;t forget that our fundamental role is to diagnose and treat skin disease and keep up-to-date on the scientific grounding for practice&#46; It is not our remit to focus exclusively on economic prospects&#46; Dermatologic practice is what unquestionably gives us the advantage&#46; As a final message&#44; I believe that the roles of today&#39;s generation cannot differ from the ones we played&#46; We were called the &#8220;courageous generation&#8221; because we gave everything we had in exchange for very little&#44; according to a code of conduct that&#44; had we all kept it up&#44; we wouldn&#8217;t be saddled with today&#39;s fierce economic crisis and the despondency&#44; doubtless brought about by short-sighted politicians&#46; This code is based on the ethic of hard work&#44; passion for a job well done&#44; personal integrity&#44; and taking responsibility&#46; These are the 4 pillars of that courage we need to see it through&#46; I am hopeful and I genuinely believe that this generation will be able to use that same code of conduct to pull us out of the current situation&#46; I would like them to look to the future with the same foolish optimism that we did&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">We might say in summing this up that dermatology training has undergone significant changes&#8212;from the development of the medical residency system to the growing prestige that now surrounds our specialty&#46; Every dermatology resident should receive comprehensive training in all the wide range of areas that make up the specialty&#46; We also realize that even though time passes and there will always be difficulties&#44; they can and must be overcome by that job well done and the rash optimism Dr Ledo spoke of&#8212;and that we cannot help but feel&#46; Congratulations for having chosen to become a dermatologist&#46; Take heart&#46;</p></span></span>"
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Opinion article
Dermatology Residency Training: Past, Present, and Future
La formación de los dermatólogos: pasado, presente y futuro
S. Vañó-Galván
Autor para correspondencia
sergiovano@yahoo.es

Corresponding author.
, A. Ledo, P. Jaén
Servicio de Dermatología, Hospital Ramón y Cajal, Madrid, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Nine thirty on a typical Wednesday morning&#46; Three dermatologists from different generations are chatting over coffee after the clinical session and exchanging their thoughts about residency training over the years&#46; Are there really that many differences&#63;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Dermatology Residents and their Relations to Others in the Hospital</span><p id="par0010" class="elsevierStylePara elsevierViewall">Dr Sergio Va&#241;&#243;-Galv&#225;n &#40;junior dermatologist&#41;&#58; Nowadays dermatology residents are highly esteemed by their peers at the hospital&#46; The ratio of women to men is 4&#58;1&#44; according to the latest figures from the Spanish medical residency system&#44; and most of these doctors come well prepared&#44; having earned admission to one of the most sought-after specialties&#46; Given such good grounding&#44; it is unsurprising that dermatology residents are often approached by others for advice as they begin to make medical decisions at work&#44; particularly in the emergency department&#46; Moreover&#44; in most cases&#44; they&#8217;re outgoing and popular with their peers&#44; as practically everybody at one stage or another turns to a friend in dermatology to check out a skin lesion &#40;perhaps this specialty is the most prone to &#8220;corridor consultations&#8221; from friend-patients&#46; This means the dermatology resident is well loved and respected by colleagues&#44; something we can be grateful for&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">As for relationships within the department&#44; cordiality reigns and there is excellent rapport between residents and the other staff physicians and the head of department&#46; It was different in the past&#44; when the authoritarian style of some heads and staff physicians seemed to interfere with that&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Dr Pedro Ja&#233;n &#40;senior dermatologist&#41;&#58; In our day&#44; dermatology wasn&#8217;t among the top-ranked specialties&#44; but the rest of the staff knew us and respected us&#8212;as our handling of &#8220;corridor consultations&#8221; was highly valued&#46; The publication of T&#46; B&#46; Fitzpatrick&#39;s <span class="elsevierStyleItalic">Dermatology in General Medicine</span> had a major impact on our training&#46; Among other things it did for us&#44; it underlined our conviction that&#44; though we specialized in a single organ&#44; the skin&#44; we should keep sight of the whole patient&#46; We residents were on call in the internal medicine and plastic surgery departments&#44; acquiring surgical skills that gained us more kudos within the hospital&#46; In fact&#44; when dermatologists went to a new hospital&#44; one of the best ways of winning respect from colleagues and hospital management alike&#44; and acquiring prestige&#44; was through dermatologic surgery&#44; particularly for skin cancer&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Dr Antonio Ledo &#40;venerable master&#41;&#58; My answer to the first question about whether times have changed in residency training is that learning was and will always be essentially based on clinical experience&#8212;the more patients the better and in our case the caseload was incredible&#46; Nowadays the techniques that complement physical examination of the patient have changed radically&#46; Once&#44; a resident gained access to training only when an instructor or department head&#8212;who would be familiar with the candidate&#39;s background&#8212;decided to provide it&#46; Later would come natural selection&#8212;let&#39;s call it an assimilation process&#8212;whereby anyone who was consistently conscientious would become respected and would be taken into account&#46; What has changed radically is how the dermatologist is perceived within the context of the hospital&#46; Colleagues used to say&#44; &#8220;Could you take a quick look at this patient and tell me what cream you think would work best&#63;&#8221; and show surprise at being asked for the patient&#39;s medical history&#46; I found this very hard to deal with&#46; We were seen to be in a second-tier specialty&#46; When I graduated&#44; I spent a year in internal medicine to gain experience before specializing&#46; This preparation as an internist led me to consider the possibility that skin lesions could be related to general processes&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">One of the happiest days of my life came at a large medical center when I was introduced to a professor from abroad as a dermatologist who knew a lot about internal medicine&#46; Our generation witnessed and actively participated in this change&#46; Today the high scientific level of dermatologists is beyond question&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Concerns</span><p id="par0035" class="elsevierStylePara elsevierViewall">Dr Va&#241;&#243;-Galv&#225;n&#58; Probably the most worrying aspect for residents these days is the uncertainty of finding a job at the end of their residency&#46; The economic downturn has reduced the number of new public-sector contracts&#46; Therefore&#44; residents&#8217; beliefs about finding work at a public hospital&#44; particularly at a center they consider acceptable&#44; are that it will depend rather more on what turns up on the job market &#40;to cover a leave of absence or replace a retiree&#41; than on the candidates&#8217; merits as dermatologists or their work history and accomplishments&#46; In other words&#44; you need to be in the right place at the right time&#8212;fortunately there are exceptions&#46; As a result&#44; final-year residents suffer a kind of syndrome whereby they become anxious and concerned about job opportunities&#44; increasingly so in the last 3 to 4 months of their residency&#46; That said&#44; dermatology residents &#40;and specialists&#41; are&#44; on the whole&#44; cheerful people who enjoy their work and the camaraderie of companions&#46; The proof of this is the congenial atmosphere at dermatology congresses and day or evening conferences that are organized these days&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Dr Ja&#233;n&#58; Concern for the future was also the norm for residents as they neared the end of their training period in the past&#46; The dermatologist was a consultant within the internal medicine department in other times&#44; and in fact most hospitals in Spain had no dermatology departments or units unless they were university or referral hospitals&#46; These residents found many employment opportunities in the public sector soon after completing their residencies&#46; As a result&#44; so-called &#8220;functional dermatology units&#8221; opened in many hospitals&#46; These initially employed a single dermatologist but they provided the foundation for the dermatology departments and units that are currently considered vital to all hospitals in Spain&#46; At the same time&#44; the surgical aspect of the specialty was developing and becoming widely applied&#46; Particular areas of development were skin cancer surgery and diagnostic and therapeutic techniques&#44; and as a result rising numbers of dermatologists joined public hospitals&#46; Monumental changes soon followed in our specialty&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Dermatology in the private sector was&#44; however&#44; reserved for the bosses&#46; The idea of a young staff physician setting up a private practice was frowned upon&#46; It was difficult to be accepted by insurance companies&#44; cosmetic dermatology did not exist&#44; and skin cancer treatment was left to surgeons&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Dr Ledo&#58; In my day&#44; we didn&#8217;t just live in a time of economic crisis&#46; Spain was in a real mess&#8212;ours was crisis with a capital <span class="elsevierStyleItalic">C</span>&#46; We didn&#8217;t have final-year resident syndrome&#46; We didn&#8217;t just feel worried about not having salaries&#8212;there were no salaries&#46; The number of hospital places weren&#8217;t reduced because there were no places to start with&#46; Poorly equipped hospitals weren&#8217;t the problem because there were no hospitals&#46; The few salaried positions that did exist were for the professor and the orderly&#46; Perhaps that doesn&#8217;t sound credible today but I speak without a shred of exaggeration or word of lie&#46; Our present was so bleak that it could only improve&#46; We started at absolute zero but tremendous tenacity and our foolish self-confidence carried us to a much better future&#46; That&#39;s how it was for us&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Aims During Residency</span><p id="par0055" class="elsevierStylePara elsevierViewall">Dr Va&#241;&#243;-Galv&#225;n&#58; The main aim of a resident now is to acquire knowledge and skills in the different fields of dermatology to ensure he or she will be able to continue to develop professionally later on&#46; This necessarily requires mastering clinical and surgical dermatology&#44; dermatopathology&#44; and research&#46; In recent years&#44; residents have gradually attributed more importance to gaining experience for career planning&#46; Nowadays&#44; all doctors acknowledge the vital role their work record and accomplishments will play in their future careers&#44; so they begin working on it at the start of their residency&#46; In fact&#44; most dermatology residents end their training with several publications and numerous conference presentations under their belts&#46; This is less common in other specialties&#46; On that point&#44; one of the greatest advantages of our time is doubtless the ease of accessing information and dermatology literature on the Internet&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Dr Ja&#233;n&#58; A resident&#39;s aim as I recall it was to acquire the knowledge needed to manage patients with skin disorders&#46; Particular emphasis was placed on clinical practice&#46; The most esteemed instructors had superior clinical know-how&#44; although an understanding of dermatopathology was also highly rated&#46; This was less true of surgery or the complementary techniques being developed at that time&#44; at least in most places&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Dr Ledo&#58; The medical residency system did not exist for us&#46; We were unpaid volunteer assistants and anyone wanting to specialize in dermatology &#40;not only from Madrid&#44; but from many parts of Spain&#41; would come to Hospital San Juan de Dios in Madrid&#44; the cradle of great Spanish dermatologists&#46; The clinical training we received was astonishing&#46; We had no Internet but we found the finest dermatological descriptions already impeccably written in the classic books&#46; They didn&#8217;t have to be invented&#46; As far as I&#8217;m concerned&#44; when you write a paper&#44; it&#39;s best to go back to the old descriptions&#44; compare them&#44; and then add any important advances in our understanding of the etiology or pathogenesis of the conditions&#46; In actual fact&#44; I don&#8217;t believe things were easier or more or less difficult than now&#59; they were&#44; are&#44; and always will be tough&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Training</span><p id="par0070" class="elsevierStylePara elsevierViewall">Dr Va&#241;&#243;-Galv&#225;n&#58; Today dermatology is perceived to have a very broad scope&#44; requiring residents to be trained in medical and surgical aspects and to master certain diagnostic techniques such as dermatoscopy as well as therapeutic procedures like cryotherapy&#44; laser&#44; and photodynamic therapy&#46; During residency we also acquire knowledge of dermatopathology and immunology&#44; as well as basic notions of research design&#46; Training in cosmetic dermatology is gradually becoming more important&#44; particularly at the end of the residency&#44; as this is an area of rising demand in the private sector&#46; Such diverse areas of knowledge are what probably make this specialty so attractive&#46; Today many more learning opportunities are available than in the past&#44; given the technological improvements for information gathering&#44; ease of travel&#44; and industry grants for attending courses and conferences&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Dr Ja&#233;n&#58; During our period of training&#44; clinical knowledge was the basis of the specialty and considerable importance was also given to dermatopathology&#46; However&#44; residents received very little instruction in dermatologic surgery and even less in cosmetic dermatology&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Dr Ledo&#58; Dermatologists are very well-prepared&#46; We don&#8217;t need to defend our degrees&#44; certifications&#44; or knowledge&#46; Those who infringe on our specialty from outside&#8212;because they see the possibility of profits and a prosperous business in this tempting field&#8212;are the ones who are required to demonstrate whether they are suitably qualified or not&#46; But we shouldn&#8217;t forget that our fundamental role is to diagnose and treat skin disease and keep up-to-date on the scientific grounding for practice&#46; It is not our remit to focus exclusively on economic prospects&#46; Dermatologic practice is what unquestionably gives us the advantage&#46; As a final message&#44; I believe that the roles of today&#39;s generation cannot differ from the ones we played&#46; We were called the &#8220;courageous generation&#8221; because we gave everything we had in exchange for very little&#44; according to a code of conduct that&#44; had we all kept it up&#44; we wouldn&#8217;t be saddled with today&#39;s fierce economic crisis and the despondency&#44; doubtless brought about by short-sighted politicians&#46; This code is based on the ethic of hard work&#44; passion for a job well done&#44; personal integrity&#44; and taking responsibility&#46; These are the 4 pillars of that courage we need to see it through&#46; I am hopeful and I genuinely believe that this generation will be able to use that same code of conduct to pull us out of the current situation&#46; I would like them to look to the future with the same foolish optimism that we did&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">We might say in summing this up that dermatology training has undergone significant changes&#8212;from the development of the medical residency system to the growing prestige that now surrounds our specialty&#46; Every dermatology resident should receive comprehensive training in all the wide range of areas that make up the specialty&#46; We also realize that even though time passes and there will always be difficulties&#44; they can and must be overcome by that job well done and the rash optimism Dr Ledo spoke of&#8212;and that we cannot help but feel&#46; Congratulations for having chosen to become a dermatologist&#46; Take heart&#46;</p></span></span>"
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Información del artículo
ISSN: 15782190
Idioma original: Inglés
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