Trainee Awards reports

Dr Christina Wlodek, Bristol

The British Society for Medical Dermatology Fellowship has exceeded my expectations. I have come away feeling more confident in the management of some very challenging conditions. Furthermore team work with other medical specialties, through combined clinics, is highly rewarding and a fantastic way to continue one’s professional development.

I arranged to attend the following clinics:

  1. Hospital Henri Mondor, Paris, France
    French Reference Centre for Toxic & Autoimmune Blistering Diseases –
    Professor Olivier Chosidow & Dr. Saskia Oro & colleagues.
    This was an eye-opening experience both into the French healthcare
    system and the differing management strategies for these conditions used in Europe.
  2. King’s College Hospital, London.
    Sarcoidosis clinic with Dr. Sarah Walsh. This was a fantastic opportunity for observing numerous cases of cutaneous sarcoidosis. I saw more cases in this clinic than I had in my career to date.
  3. Royal Victoria Infirmary, Newcastle.
    Lupus, Dermatomyositis, Joint Dermatology/Rheumatology clinics – Dr. Simon Meggitt & colleagues. I spent a highly enjoyable four days with an associate fellowship winner Dr. Antonia Lloyd-Lavery. This was a great opportunity to see numerous patients with a variety of connective tissue conditions. We were very well looked after by Dr. Meggitt! (including fish and chips by the sea).
  4. St George’s Hospital, London.
    Lymphoedema clinic – Dr. Kristiana Gordon & Prof. Mortimer. This was a completely novel experience into a niche area of dermatology, where I saw several cases of primary lymphedema.
  5. St John’s Institute of Dermatology, London: Severe eczema and severe psoriasis clinic – Prof. Catherine Smith & Prof. Jonathan Barker; Immunobullous clinic – Dr. Richard Groves; Lupus – Dr. David McGibbon, Professor David de Cruz.
    These clinics involved some of the most challenging medical dermatology
    cases. Learning from these highly experienced clinicians was a
    huge privilege and pleasure. It also highlighted the satisfying role in
    clinical trial participation and research.
  6. The Royal London Hospital, London Behcet’s clinic – Professor Farida Fortune & colleagues.
    This was an extremely useful visit. I largely spent time with an excellent
    clinician and passionate teacher, Professor Fortune (a consultant in oral
    medicine & immunology). I also attended the team’s annual Behcet’s

A heartfelt thanks to the BSMD for this unique opportunity. The fellowship reaffirmed my interest in this subspecialty, which I intend to pursue as a Consultant. I also look forward to remaining in contact with those I met during the past year such that I can provide the best care to my most complex medical dermatology patients.

Dr Antonia Lloyd-Lavery ST5, Oxford

Attending the three day “Essential Medical Dermatology” course was an excellent starting point for my Fellowship which focused on complex inflammatory skin disorders and connective tissue disease.

My clinical experience at Guys and St Thomas’included attending four immunobullous clinics under the supervision of Dr Richard Groves. This experience was complimented by spending three mornings in the Immunodermatology laboratory. I also observed multidisciplinary assessment of patients with complex inflammatory skin disease in the complex eczema and psoriasis clinics, under the supervision of Prof Catherine Smith and Prof Jonathan Barker. Use of a range of pre-clinic questionnaire assessments and access to a psychologist facilitates holistic management of these patients and I am keen to develop a similar approach in my work as a consultant dermatologist.

I was also able to attend three oral dermatology clinics, under the supervision of Dr Jane Setterfield, and two additional oral medicine clinics at the Eastman Dental Hospital, under the supervision of Dr Tim Hodgson and Dr Martina Shephard. These have provided me with valuable insight into the assessment and management of a range of oral mucosal disorders particularly relevant to dermatology.

I was most fortunate to spend a week with Dr Simon Meggitt at the Royal Victoria Infirmary, Newcastle, where I attended a cutaneous lupus clinic, a joint skin and muscle disease clinic and a joint dermatology/rheumatology connective tissue disease clinic. This valuable experience has particularly developed my ability to manage cutaneous lupus and dermatomyositis. I gained further, experience in connective tissue disease by joining Dr Cate Orteu at the Royal Free Hospital, in the morphoea, lupus and dermatomyositis, and systemic sclerosis and overlap connective tissue disease clinics.

Before I complete my BSMD Fellowship, I am planning to attend the cutaneous sarcoid clinic at Kings College Hospital, the hidradenitis suppurativa clinic at Guys and St Thomas’ Hospitals, the complex psoriasis clinic at the Royal Free Hospital and the joint lupus dermatology clinic at Guys and St Thomas’ Hospitals.

This Fellowship has not only provided me with an excellent opportunity to see patients with a wide range of complex medical dermatological problems, but also to observe how sub-specialty services are organised in large, tertiary centres and to develop personal contacts within the field to facilitate the management of such patients in the future. I am most grateful to the BSMD for funding a wonderful, personalised training opportunity and would like to thank my supervisors for welcoming me to their clinics and providing me with such invaluable experience.

Dr Saman Fatah ST6 trainee, University Hospital of North Durham

I have found Medical Dermatology the most challenging and stimulating aspect of my training, requiring problem-solving skills to diagnose and optimise management in the face of multiple complaints and co-morbidities. This interest has been consolidated by clinical experience under the supervision of Drs Andrew Carmichael, Shyamal Wahie and Simon Meggitt and more recently in depth research experience in the DLE.

The BSMD fellowship was a magnificent experience and involved attending the following clinics/venues:

  1. Joint Lupus Dermatology clinic at Guy’s and St Thomas’ Hospitals; supervised by Professor David D’Cruz, Dr David McGibbon and Dr Emma Benton.
  2. Immunobullous Diseases clinic at Guy’s and St Thomas’ Hospitals; supervised by Dr Richard Groves and Dr Emma Benton, followed by further experience at immunodermatology laboratory under the supervision of Balbir Bhogal and Dr John Mee.
  3. Antiphospholipid Syndrome clinic at Guy’s and St Thomas’ Hospitals; supervised by Professor Beverley Hunt.
  4. Cutaneous Sarcoid clinic at King’s College Hospital; supervised by Dr Sarah Walsh.
  5. Cutaneous Lupus clinic at Chapel Allerton Hospital, Leeds; supervised by Professor Mark Goodfield.
  6. Through attendance at these specialised clinics I gained insight into the logistics of Medical Dermatology clinics and how experts approach and manage complex Medical Dermatological conditions. I now aim to incorporate the experience into the management of similar cases and be in a better position to offer a sub-specialty Medical Dermatology service. Additionally, the personal contacts made will allow me to network over challenging cases to improve the standard of Medical Dermatology care I provide at James Cook University Hospital, Middlesbrough, where I have recently been appointed a Consultant Dermatologist.

I am very grateful to all of the above clinicians for accommodating me in their highly sought after subspecialist clinics and to the generosity of BSMD Fellowship scheme, for providing such excellent opportunity.

Dr Arpita Debroy Kidambi ST5 trainee, Royal Hallamshire Hospital, Sheffield

I am very grateful to the British Society of Medical Dermatology for providing me with an excellent training opportunity to gain experience in two specialised areas of Medical Dermatology of my choice – lymphovascular disease and immunobullous/inherited blistering disorders.

I spent one week in lymphovascular medicine under the supervision of Dr Kristiana Gordon in St George’s Hospital, London. This involved attendance in specialist lymphoedema clinics, including the monthly paediatrics lymphoedema genetics clinic. I had the opportunity to observe how treatment is routinely carried out by lymphoedema specialist nurses on patients with varying degrees of lymphoedema and gained appreciation of current best practice, including potential investigations for lymphoedema management.

I am currently attending the Epidermolysis Bullosa (EB) Clinic at St John’s Institute, London under the supervision of Dr Emma Wedgeworth and Dr Jemima Mellerio. I have observed patients with varying severities of EB. It has allowed me to appreciate first-hand the multi-disciplinary approach taken towards these patients and increased my confidence in the assessment and general management of patients with EB and the potential complications arising. I look forward to on-going experience at these specialist EB clinics and am due to attend the Practical Paediatric EB for professionals course in the near future.

Once again, I would like to take this opportunity to thank the BSMD and the supervisors of each placement for a unique educational opportunity.

These were awarded to Dr Catriona Sinclair and Dr Donal O’Kane.

Donal O’Kane: ST6 trainee Dermatology, Belfast

My BSMD National Medical Dermatology Fellowship was an outstanding experience. Having had prior training in rheumatology and undertaken a PhD in scleroderma I was keen to gain further clinical experience in connective tissue disease, which was not available locally in Belfast. I arranged a four-week fellowship which was carried out between Royal Victoria Infirmary, Newcastle (Dr Simon Meggitt) and Royal Free Hospital, London (Dr Cate Orteu). This fellowship focused on sub-specialty clinics in scleroderma, lupus, and dermatomyositis. Several of these clinics were run jointly with other specialties. At the Royal Free Hospital, I also observed several systemic sclerosis and Raynaud’s clinics run by rheumatologists and complex psoriasis clinics led by Dr Sandy McBride.

I am very grateful to the BSMD for the experience that I gained during my Fellowship. In addition to enhancing my clinical experience in areas of personal interest, the BSMD fellowship provided me with insight on how to establish effective sub-specialty clinics with other specialties, and enabled me to develop important collaborations for my new career as a Consultant Dermatologist in Belfast.

Catriona Sinclair: ST5 trainee Dermatology, Edinburgh

My fellowship so far has involved an inspiring week spent shadowing the medical dermatology team at Guys and St. Thomas hospitals. This involved sitting in on a number of tertiary referral clinics in sub specialties such as hidradenitis suppurativa, immunobullous diseases, severe eczema and psoriasis. Having an opportunity to see patients with severe disease and the treatment options available to them from the multidisciplinary team has given me a great insight into optimal management of these complex patients.

I have also spent time with Dr. Simon Meggitt in the joint dermatology/rheumatology connective tissue disease clinic and the skin lupus clinic. Again, I saw a large variety of patients with a spectrum of disease severity. This gave me a great chance to see how joint clinics can function in practice as well as furthering my knowledge and increasing my confidence in the management of these complex diseases.

I am still to attend Dr. Lovell’s connective tissue disease clinic in Bath and will attend the ‘psoriasis from gene to clinic’ training course in December 2014.