DERMATO-VENEREOLOGY, DERMATOLOGY AND VENEREOLOGY

Chapter 6, CHARTER on TRAINING of MEDICAL SPECIALISTS in the EU

REQUIREMENTS for the SPECIALTIES DERMATO-VENEREOLOGY (Continental Europe), DERMATOLOGY and VENEREOLOGY (UK and Ireland)

Approved by the UEMS Specialist Section and the European Board of Dermatology and Venereology in its meeting in Munich, 13 October 2001

DEFINITIONS

Dermatology is an organ specialty that involves the diagnosis, treatment (both medical and surgical) and prevention of diseases of the skin and subcutis, mucosae, cutaneous appendages as well as skin manifestations of systemic disease and systemic manifestations of skin diseases. It also encompasses the promotion of good skin health.

Venereology includes the diagnosis, treatment and prevention of sexually transmitted infections (STIs) and other medical conditions of the genito-anal tract. It also concerns promotion of good sexual health.

INSTITUTIONS

The institution or combination of institutions responsible for training should meet the following criteria:

• Adequate facilities for the diagnosis and management for a range of dermatology and/or venereology conditions, including a minimum requirement of dedicated in-patients beds, provision and support for research and postgraduate degrees.
• The trainee should be exposed to a full range of dermatology and/or venereology conditions.
• It is recommended that there should be at least the equivalent of 2 full time specialists in the department. Every institution should designate one person responsible for training.
• The European Board of Dermatology and Venereology (EBDV) recognizes the importance of 'Quality Assurance' in training. This should be the responsibility of the appropriate national body in association with the EBDV.
• 'Manpower' planning should exist in European countries. These should inform, consult and be subject to the EBDV.

QUALITY ASSURANCE

• For the quality assurance of training of dermato-venereologists all the topics listed in the Programme for Dermatology and the Programme for Venereology should be considered; whilst for the separate specialties of Dermatology and Venereology only those topics listed under each specialty need to be considered.

PROGRAMME OF DERMATOLOGY
According to the definition of the specialties Dermato-venereology and Dermatology the trainee should gain knowledge of and gain experience in the diagnosis and treatment of:

• General dermatology in 'out-patients clinics' and 'in-patients' clinics
• Dermatopathology, incl. biopsy and technical aspects
• Immunology, with particular reference to immune-mediated skin diseases
• Allergy
• Occupational and environmental dermatology
• Paediatric dermatology and genetics
• Geriatric dermatology
• Dermatologic oncology, diagnostic and treatment procedures
• Photodermatology and phototherapy
• Burns, reactions to physical agents and wound healing
• Bacterial, mycological, viral and parasitic infections and infestations affecting the skin
• Diagnosis and treatment of diseases of skin-adjacent mucous membranes, including proctology
• Vascular pathology of the skin, diagnostic and treatment procedures
• Non-invasive diagnostic procedures, dermoscopy, ultrasound and other measurements of skin function
• Molecular biology in diagnosis and treatment
• Topical and systemic treatments, dermatological formulations and prescribing
• Pharmacology and skin-related toxicology
• Dermatological surgery, electrosurgery, cryosurgery, lasers, radiotherapy and other physico-chemical treatments (including photodynamic therapy)
• Aesthetic and cosmetic dermatology, including correcting procedures
• Skin care, preventive dermatology and rehabilitation
• Psychodermatology and social aspects

PROGRAMME OF VENEREOLOGY
According to the definition of the specialties Dermato-venereology and Venereology the trainee should gain knowledge of and gain experience in the diagnosis and treatment of:

• Epidemiology of sexually transmitted infections (STIs) including HIV-infection
• Prevention and control of STIs, including partner notification
• Organization of STI services
• Sexual history-taking and genito-anal examination
• Clinical diagnosis and management of STIs, including systemic manifestations, genito-anal dermatoses and the local and systemic complications
• HIV infection and its complications, management and treatment
• HPV-related lower genital tract malignancies, including diagnosis and management of cellular abnormalities of the uterine cervix
• Common gynecological, proctal and andrological disorders
• STIs in pregnancy and neonates
• Multidisciplinary management of children with genital infections
• Laboratory diagnosis including serological tests for STIs
• Familiarity with at least one set of management guidelines for STIs (national, European, CDC)
• Methods of contraception
• Sexual health and education, and psychosexual problems

IN ADDITION TO THIS THE TRAINING PROGRAMME OF ALL THREE SPECIALTIES SHOULD CONTAIN:

• Epidemiology, data management and evidence based medicine
• Good clinical practice guidelines and medical ethics
• Basic principles of health economics
• Practice organisation and time management
• Research, clinical and laboratory
• Active participation in clinic sessions, dermatopathology sessions, journal sessions and telematics
• Teaching and communication skills

GENERAL ASPECTS of TRAINING in DERMATO-VENEREOLOGY, DERMATOLOGY and VENEREOLOGY

• Selection and access to the specialty is the responsibility of the appropriate national authority.
• A period in general common trunk training is recommended, before, during or after the minimum 4 years of specialty training.
• A training log-book in the specialty is necessary
• The national authorities can recognize for training purposes up to one year spent in a recognized centre abroad in an EU or non-EU country.
• The size of the training institution or group of institutions should be such that it has an adequate number and variety of disorders of out-patients and easy access to a sufficient number of beds.
• The institution should be such as to allow the trainee to carry out his/her training as outlined in the programme of dermatology and in the programme of venereology, as well as to allow appropriate access to other relevant specialties. Inspection of training institutions by the national authorities should be conducted at least once every 5 years. The national authority must report the results of their inspection to the EBDV (with due regards to privacy protection).
• Each institution should identify a chief of training who should have been practicing the specialty for at least 5 years after specialist certification. There must be additional training staff.
• The chief of training should be responsible for the training programme of the trainee in accordance with the experience of the trainee and the available facilities in the institution or group of institutions. When some facilities are not locally available it is the responsibility of the chief of training to make appropriate arrangements. There should be sufficient teaching staff to allow adequate monitoring of each trainee.
• To build up his/her experience the trainee should be involved in the treatment of a sufficient number of in-patients, day care patients and out-patients and should perform a sufficient number of practical procedures of sufficient diversity to fully cover dermatology and/or venereology.
• The trainee should have sufficient linguistic ability to communicate with patients.
• The trainee should have his/her personal logbook according to the recommendations of the EBDV.
• The trainees should be encouraged to involve themselves in original studies which may lead to a presentation or publication.