Dermatologists are doctors who diagnose, investigate, treat and manage the conditions of children and adults with skin disease, as well as hair and nail complaints.
This page provides useful information on the nature of the work, the common procedures/interventions, sub-specialties and other roles that may interest you.
Nature of the work
Skin disease is very common, with around 24% of those in England and Wales (12.9 million people) visiting their GP with a skin problem annually. The number of possible dermatological diagnoses has been estimated at over 2000, each of which can present in different ways, and many have a significant impact on patients’ quality of life.
There is not only extensive interface with primary care, but also in a tertiary care capacity, especially with the ageing population, increased patient complexity, co-morbidity (multiple diseases) and polypharmacy. In secondary care, dermatology offers a wide variety of case mix in all age groups from mild complaints to severe, life-limiting inflammatory disorders. Consultants lead multidisciplinary teams which may include SAS doctors, GPs with extended roles, specialist nurses, specialist trainees and medical students.
Dermatologists treat conditions such as:
- skin cancer
- severe drug rashes
Most dermatologists are skin surgeons as well as physicians. Skin surgery is an important part of practice, especially with the rapid rise in skin cancer - skin this being the most prevalent of all cancers.
Consultant dermatologists lead the skin cancer multidisciplinary teams which are an essential part of high quality care for patients, involving histopathologists, oncologists, plastic surgeons, cancer nurses and others.
Most dermatologists have at least one theatre list per week and may refer specific patients to dermatological surgeons or dermatologists who are laser specialists. Within the hospital setting, dermatologists are often consulted with regards to patients under the care of other physicians and patients may be managed jointly, for example in combined rheumatology and dermatology or gynaecology and dermatology clinics.
"The surgical aspect of the job is very enjoyable and there’s also lots of interaction with other specialties"
- excision of cutaneous cancers
- diagnostic biopsies of rashes
- UV light therapy for inflammatory dermatoses
- contact dermatitis investigation
- use of dermascope (a device used to examine the skin) for diagnostic purposes
- intralesional injections (eg steroid, botulinum toxin)
- cryosurgery for precancerous or benign skin lesions
There are accredited post-CCT sub-specialist fellowships in:
- advanced skin surgery and Mohs’ micrographic surgery
- paediatric dermatology
- cutaneous allergy and immunology
Other areas of sub-specialist interest include:
- advanced medical dermatology
- photodermatoses and photobiology
- oral and genital dermatoses
- hair and nails
- cosmetic/aesthetic dermatology
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Pay and conditions
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This section provides useful information about the pay for junior doctors (doctors in training), SAS doctors (specialty doctors and associate specialists) and consultants.
NHS Employers provides useful advice and guidance on all NHS pay, contracts terms and conditions.
Medical staff working in private sector hospitals, the armed services or abroad will be paid on different scales.
Where the role can lead
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Read about consultant and non-consultant roles in dermatology, flexible working and about wider opportunities.
You can apply for consultant roles six months prior to achieving your Certificate of Completion of Training (CCT). You will receive your CCT at the end of your dermatology training. The CESR qualification is an alternative process to gain entry onto the GMC Dermatology Specialist Register.
Managerial opportunities for consultants include:
- clinical lead - lead NHS consultant for the team
- clinical director - lead NHS consultant for the department
- medical director - lead NHS consultant for the Trust
Most NHS consultants will be involved with clinical and educational supervision of junior doctors.
Here are some examples of education and training opportunities:
- director of medical education - the NHS consultant appointed to the hospital board who is responsible for the postgraduate medical training in a hospital. They work with the postgraduate dean to make sure training meets GMC standards.
- training programme director - the NHS consultant overseeing the education of the local cohort of trainee doctors eg foundation training programme director. This role will be working within the HEE local offices/deanery/
- associate dean - the NHS consultant responsible for management of the entirety of a training programme. This role will be also be working within the HEE local offices/deanery
SAS doctor roles
There are also opportunities to work at non-consultant level, for example as a SAS (Specialist and Associate Specialist) doctor. SAS doctors are non-training roles where the doctor has at least four years of postgraduate training, two of those being in a relevant specialty. Find out more about SAS doctors roles.
Other non-training grade roles
These roles include:
- trust grade
- clinical fellows
As a well-structured outpatient based speciality with a relatively low on-call commitment, dermatology is well suited to flexible training.
If you have trained on an academic dermatology pathway or are interested in research there are opportunities in academic medicine. Dermatology is a research-orientated specialism with wide national and international academic networks.
For those with a particular interest in research, you may wish to consider an academic career in dermatology. Whilst not essential, some doctors start their career with an Academic Foundation post. This enables them to develop skills in research and teaching alongside the basic competences in the foundation curriculum. Others develop research interests during specialty training and may go out of programme to fulfil higher degrees.
Entry into an academic career would usually start with an Academic Clinical Fellowship (ACF) and may progress to a Clinical Lectureship (CL). Alternatively some trainees that begin with an ACF post then continue as an ST trainee on the clinical programme post-ST4.
Applications for entry into Academic Clinical Fellow posts are coordinated by the National Institute for Health Research Trainees Coordinating Centre (NIHRTCC).
There are also numerous opportunities for trainees to undertake research outside of the ACF/CL route, as part of planned time out of their training programme. Find out more about academic medicine.
The Clinical Research Network (CRN) actively encourages all doctors to take part in clinical research.
Job market and vacancies
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This page provides useful information about the availability of jobs, finding vacancies and where to find out more.
Job market information
Dermatology had 538 consultants and 259 medical registrars in England (NHS Digital, 2016). Women make up 55% of the consultant workforce, 75% of higher specialty trainees in the UK (2014/15 RCP census, 2016).
In 2016 the competition ratio for CT1/ST1 Core Medical Training was 1.53, and for ST3 Dermatology it was 4.56 (NHS specialty training 2016).
Given the increases in skin cancer and inflammatory conditions like eczema, it is expected that secondary-care-based dermatology clinics and services will expand in the future.
On this section we have information for England only. For information regarding Scotland, Wales and Northern Ireland please click on the links below.
Where to look for vacancies
All trainees apply through the online application system Oriel. You will be able to register for training, view all vacancies, apply, book interviews and assessment centres, and manage offers made to you.
All jobs will be advertised on the NHS Jobs website.
The BMJ Careers website also advertises vacancies.
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