Annual Scientific Meeting wrap up

The Australasian College of Dermatologists. Issue 113. Winter 2017.

> From the Secretary’s desk > President’s message > Chief Executive Officer’s message> Farewell to Rosie > Congratulations to Tony and Bob > Fellows’ achievements

> Annual Scientific Meeting wrap up > ADNA Meeting > ASCD Meeting > Patch Test Training Day > 5th Rural Dermatology Meeting > World Congress on Cancers of the Skin > Education matters

> An essay on fees > CPD report > In brief > Forthcoming events

Welcome to the Winter edition of The Mole

FROM THE SECRETARY’S DESK

WE WELCOME DR ANDREW MILLER, THE NEW PRESIDENT OF THE COLLEGE.

CONGRATULATIONS

Congratulations to Associate Professor Samuel Zagarella, Dr Monisha Gupta and Dr Ian Hamann for providing a packed four day College meeting in Sydney. The new format seemed to work well, opening on Saturday morning. The dinner was also a fabulous night with wonderful speeches given by Dr Alan Watson, Dr Bill Regan and Dr Ivan Simmons. Associate Professor Alan Cooper bid farewell to Rosie Cavaleri who received a standing ovation by Fellows and trainees, recognising Rosie’s dedication to the College.

GRADUATION AND CONFERRING CEREMONY SUCCESS AND THANKS

The Graduation and Conferring Ceremony was a stunning success, held in the Great Hall at the University of Sydney, as it was at the inauguration of the College 50 years ago. We were privileged that His Excellency General The Honourable David Hurley AC DSC (Ret’d), Governor of New South Wales and Mrs Hurley attended, joining the procession and speaking about our progress over the last 50 years.

It was a special honour that The Honorable Michael Kirby AC CMG gave the John Reid Oration. Not convinced that the graduands had actually taken the College oath, which was somewhat mumbled, he asked the graduands to stand and repeat loudly, “I do.”

Thank you to Iris Hui, Assistant to Tim Wills, and The Association Specialists, for making the 50th Conferring Ceremony such a memorable evening.

A QUESTION OF FEES

An unfortunate and unforeseen consequence of the tightly packed Annual Scientific Meeting was the brief time allocated for questions from Fellows to the incoming president Dr Andrew Miller and the Board. In this edition of The Mole, we address a question sent in by a Fellow regarding the cost of applying and training at our College compared with other colleges.

Dr Andrew SatchellHonorary Secretary

The Honourable Michael Kirby AC CMG

Procession walks onto stage at the Conferring Ceremony

The crowd at the Conferring Ceremony

The brass band

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PRESIDENT’S MESSAGE

This will be the first of my missives in The Mole as President. Perhaps firstly I should warn that my writing style was described by one of my teachers in school as genial waffle; and I am not sure that it has changed much over the years. I have always harboured abiding interests in medical workforce planning, health economics and professional collegiality; and if circumstances allow I will make these the focus of my tenure.

Sadly the medical profession has not covered itself with glory when it comes to respectful behaviours and our College is not immune from the problems of bullying and harassment. Our internal survey demonstrated that our problems are really no less, but thankfully no more, than others. The College has launched its Bullying and Harassment Policy; and is now firming up the processes that the Policy informs. There is no excuse for disrespectful, intimidating or harassing behaviour and it is every Fellow’s responsibility to ensure that they and their colleagues set an example. The “norm” is no longer acceptable, we must all embrace the cultural shift necessary to secure appropriate standards.The former Taskforce on Bullying and Harassment has been re-tasked to develop a new Code of Conduct, a Complaints Policy and a Training Charter. These will complement the Bullying and Harassment Policy as well as underline a focus on ethical behaviours in our professional relationships. The College has also just put in place a suite of new policies, including a new Appeals Policy. These have been published on the website.The College has a complex network of committees. I am aware that as a small College, we ask a great deal of our members and frequently. It is time, I think, to address the committee structure and consider streamlining it. My experience of other organisations has highlighted that ad hoc taskforces often facilitate a more nimble organisation and we may work towards this model for some of the tasks previously undertaken by standing committees. The process will involve consultation with the existing committees, who will be asked to reflect on their purpose and produce Charters to direct their activities.I am aware that there are limited opportunities for consultation with the broad Fellowship. The new Representatives Committee has amongst its duties the task of acting as a conduit between the Faculties, the Fellowship and the Board. Another opportunity is the Annual General Meeting (AGM). I must now apologise for the truncated AGM this year, which prevented an open discourse on a number of issues. I have discussed the matter with our Chief Executive Officer and we have agreed that there will never again be another session booked to directly follow the AGM and that more time will be allowed for the meeting

itself. Further, we will change the reporting format so that rather than reading the Board Report onto Hansard so to speak, it will be included with the notice of meeting allowing the President to talk to the report instead. Separate Education and Nomination Committee reports will also be presented and the Audit Committee report will continue to be presented as previously. This will allow time for a freer exchange of views at the meeting.The 2017 Annual Scientific Meeting (ASM) has been a great success. The registrations were at a record level and the meeting exceeded the best-case scenario planning case budgeted by the Board. We are still awaiting the outcome of the attendees’ survey and are keen for evaluation of the new format (Saturday to Tuesday) and early morning/evening session structures. The ASM is our premier event, it provides essential opportunities for us to come together as a Fellowship in every sense of the word. The ASM marked our 50th anniversary as a College, and the Conferring Ceremony in the Great Hall at Sydney University was a memorable occasion, enhanced by the attendance of His Excellency General The Honourable David Hurley AC DSC (Ret’d), Governor of New South Wales, the John Reid Oration delivered by The Honourable Michael Kirby AC CMG and a large congregation of Fellows and their families.The 5th Rural Dermatology Conference is taking place in Broome this year. The conference combines clinical, scientific and workforce planning sessions. The meeting will enable a discussion of workforce planning issues with contributors from each Faculty. Workforce planning is an essential task for College, and we have recently undertaken a project with the Commonwealth Department of Health to model our workforce. We are now engaged with the National Medical Training Advisory Network (NMTAN) to develop strategies and leverage influence in expanding and adjusting our training to fit the community need. The 2021 International Society of Dermatology (ISD) International Congress of Dermatology is scheduled for Melbourne and preparations are underway. The College has also launched a bid for the 2023 International League of Dermatological Societies (ILDS) World Congress of Dermatology. The World Congress of Cancers of the Skin will also be hosted in Sydney in 2018. These conferences represent unmissable opportunities to showcase Australian dermatology not only to the world, but to also raise the profile of our craft domestically.Finally, The College is now undergoing Australian Medical Council (AMC) accreditation. Over the coming weeks the AMC accreditation team will be interviewing staff, trainees and Fellows; and conducting site visits at training centres around the country. The accreditation process and report will occupy much of our agenda for the rest of this year. AMC accreditation serves as the foundation for College’s continuing role in medical education and is essential to the future of our specialty. I look forward to visiting state Faculties throughout the next two years to catch up with you and will always welcome your opinions and advice.

Dr Andrew MillerPresident

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CHIEF EXECUTIVE OFFICER’S MESSAGE

THANKS TO THE OUTGOING DIRECTORSThe dedication by Associate Professor Chris Baker as President and Dr Anne Lewis as Director was recognised at the last Board meeting. As Chief Executive Officer, I get to work extremely closely with the President. I greatly valued his thoughtful and determined effort. Members may have no real concept of the workload residing with the President. This is not to diminish that workload falling on all other Directors or Fellows, but the number of issues for the President seems to have steeply risen in the last year or so.

ROSIEWell it is odd in the office now to not see Rosie on Tuesdays, Wednesdays and Fridays. The thank you to Rosie at the College dinner by Dr Alan Cooper and by all who gave her a standing ovation, was truly moving. I can report that Rosie is extremely happy. I think she felt the time was right, she was ready and she had left us in good hands. However, we will hear “Rosie will know” for a while yet. You can’t replace 28 years of knowledge, no matter how good the handover.

AUSTRALASIAN JOURNAL OF DERMATOLOGY ABSTRACTS SITE Wiley and the College have built an abstracts web page. You will now have access to the abstracts of the 2017 Annual Scientific Meeting and those for five years prior. Searching and finding that abstract is now simpler than flipping through the supplement.

FACULTY MATTERSThere are now new Faculty Regulations in the revised College Regulations. All Faculties now have a succession plan that will see the Chair shadowed by a Chair Elect, or equivalent, who assumes the Chair in time. This enables continuity of Faculty matters and issues at the Representatives Committee.

ANNUAL SCIENTIFIC MEETINGThe post event feedback was overwhelmingly positive, but we have the formal survey feedback due now. We have received many improvement ideas. Many of these have already been passed on to Professor H Peter Soyer and Dr Salvatore Scuderi who are the Convenors of the 2018 meeting on the Gold Coast.

PROJECTSThere is a whole lot of work in progress:• College advocacy (with Government) is nearing conclusion with a consultant, Allison Henry from Millwood Consulting. This is vital

in better positioning College and raising our profile and visibility• The marketing campaign through Viva Communications and overseen by the Public Affairs Committee is gathering momentum• The Trainee Online Portfolio/Portal-based Online Databases for Fellows and trainees continues to be improved• College is scoping a records management approach through a consultant.

COLLEGE LEASEThe College has been located at Rhodes since 2006. Our lease expires February 2018. We could be better located to help raise the College profile and be more accessible to Fellows, trainees, health bureaucrats and the political leaders of the country. At Rhodes, is to be largely unnoticed, but space is cheaper in the suburbs. To move inwards to the city will come with expense.College headquarters staff are actively seeking solutions and asking should we not purchase? A College of 50 years with no defined real estate of our own seems suboptimal. To own will take a concerted financial effort. Refer to the Annual Financial Statements you recently received and you will see we hold equity. What we are holding this for? Our equity may not buy us premises or even a floor in a strata, but it will leverage borrowings. Do we rent for the next 50 years and be subject to having to move around with our funds funding other owners’ finances, or could we find an owner-based solution that sets College up for more stability? I’d be interested in your views.

Tim WillsChief Executive Officer

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CHANGES AT THE COLLEGE:

RETI

RING

COL

LEGE

STA

FF

Rosie at the CollegeWe never thought the day would comeWhen we would lose dear Rosie.Since 1989 you see,She’s made this office cosy!

A ‘team of one’ for many years,(“Ring Rosie at the College!”)She offered sound and sage adviceTo all, a font of knowledge.

She knew the names of members:Every registrar and Fellow.Her reputation recognisedAs open, warm and mellow.

There’s not a single admin taskThat Rosie cannot do.From ASMs to Fellowship,She’ll manage all for you.

Amongst her many strengthsOur Rosie harbours great compassion.Her faith runs deep, she knows no bounds,Her love she’ll never ration.

When College history books are writ’Recorded for the ages,Let Rosie Cavaleri’s nameShine bright amongst the pages.

Happy retirement, dear Rosie. Thank you for your amazing contribution to College.

ROSIE CAVALERI HAS RETIRED AFTER 28 YEARS OF WORKING AT THE COLLEGE, MOST RECENTLY AS THE EVENTS COORDINATOR. SHE WAS INSTRUMENTAL IN THE PLANNING OF THE ANNUAL SCIENTIFIC MEETING (ASM) AND FITTINGLY RECEIVED A STANDING OVATION AT THE ASM DINNER IN SYDNEY THIS YEAR.BELOW IS A POEM WRITTEN BY FELLOW STAFF MEMBER, TONY MOORE, WHICH SUMS UP ROSIE’S CONTRIBUTION TO COLLEGE.

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ACHIEVEMENTS

CONG

RATU

LATI

ONSCongratulations to Bob and Tony

Congratulations to College staff members Bob Corderoy and Tony Moore for celebrating 10 years’ service with the College. Both Bob and Tony received a Certificate of Service at the College Graduation Oration and Ceremony for Conferring of Diplomas and Awards this year for their efforts.

Dr Bob Corderoy began his career as an educator in the late 1960s. He spent 27 years teaching the physical sciences across the Senior Secondary School and TAFE sectors before taking up various academic positions within the university sector.When Dr Corderoy joined the College in May 2007, his brief was to consolidate the College web presence and to this end he headed the implementation and ongoing development of the College e-Learning Portal. The e-Learning portal now supports a wide range of teaching and learning resources for trainees and Fellows as well as external clients, such as undergraduate medical students.Under Dr Corderoy’s leadership as Director, Educational Development, Planning and Innovation, the College has achieved International Organization for Standardization (ISO) Quality System Registration, accreditation as a Registered Training Organisation (RTO): Vocational Training Sector and most recently registration as a Higher Education Provider by the Tertiary Education Quality Standards Agency (TEQSA) along with its first accredited course, Master of Dermatology.

Tony Moore joined the College in April 2007. He was employed initially as the Training and Examinations Officer. Prior to this, Tony spent three years at the Royal College of Pathologists of Australasia where he fulfilled an almost identical role. His background is in commercial aviation where Tony’s final years were spent as a procedural

specialist (Senior Business Analyst) with Qantas. Upon his retrenchment in 2003, he found his way into medical education. Tony is currently the Senior Academic Support Officer. He is a pivotal interface and College point–of-contact for trainees. Tony emigrated from Fiji to Australia in 1974 and is married with three adult sons, one grandson, two dogs, one cat and a rescued lorikeet.

New International Medical GraduateDr Ebrahim Abdool Kader Abdulla is a new International Medical Graduate with the Australasian College of Dermatologists. He graduated with a Bachelor of Medicine, Bachelor of Surgery from the University of Natal on 1986 and a Master of Medicine (Dermatology) from the University of Stellenbosch in 1999.

Dr Abdulla is from South Africa and was required to undertake 12 months upskilling at the Skin and Cancer Foundation Australia, Westmead before he was eligible for specialist recognition with the Medical Board of Australia and Fellowship of the College.Dr Abdulla is currently practicing at the Skin and Cancer Foundation Australia in Westmead, Sydney. His interests are general and paediatric dermatology.

New Associate ProfessorCongratulations to Fellow Alvin Chong who is now an Associate Professor with the Department of Medicine at The University of Melbourne. It’s an appointment that recognises his contributions to clinical leadership, dermatology education and research over the past 14 years.For most of his career, A/Prof Chong has focussed on two key

areas - transplant dermatology and education. He has been involved in the education of post-graduate dermatology trainees and is currently the Victorian censor for the Australasian College of Dermatologists.“I was surprised but deeply honoured to receive this accolade and very pleased to be recognised,” says Associate Professor Alvin Chong.

Order of Australia Congratulations to Associate Professor Rosemary Nixon who was awarded Member (AM) of the General Division of the Order of Australia in 2017 for significant service to community health in the field of occupational dermatology, as an academic and researcher, and to professional standards.Apart from her extensive work

with the Australasian College of Dermatologists and The Skin and Cancer Foundation, A/Prof Nixon is also a spokesperson on contact dermatitis and Founding Member of the Asia-Pacific Occupational and Environmental Dermatology Association.

Congratulations to Dr Roderick Peek who was awarded Medal of the Order of Australia (OAM) in the General Division in 2017 for service to medicine as a dermatologist. His service includes dermatologist, Dr Rod Peek Surgery, Tamworth, for over 30 years and visiting Doctor, Tamworth Base Hospital, for many years.

Dr Peek’s awards and recognition include Recipient, Mervyn Gold OAM Award, Australasian College of Dermatologists, 2015 and Fellow, since 1980.

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THE 50TH ANNUAL SCIENTIFIC MEETING (ASM) WAS A SPECIAL ONE FOR COLLEGE THIS YEAR, BEING 50 YEARS SINCE ITS INCEPTION. AS SUCH, THE CONFERRING CEREMONY WAS HELD AT THE GREAT HALL, SYDNEY UNIVERSITY- BACK WHERE IT ALL BEGAN IN 1967.

CONFERENCES, MEETINGS AND WORKSHOPS

NEW SOUTH WALES, AUSTRALIA SATURDAY 6 MAY TO TUESDAY 9 MAY 2017

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The Annual Scientific Meeting (ASM) was held on 6 to 9 May at the new International Convention Centre in Sydney.

The program was packed more than ever before with the opening of the conference occurring on Saturday, 7:30 am starts for scientific sessions and the shortening of many presentations to 15 minutes with a focus on updates and new material.

The four international speakers, Professor Alex Anstey from the United Kingdom and Professor Ronald Rapini, Dr Ashfaq Marghoob and Dr Scott Fosko from the United States of America; all delivered interesting plenary sessions giving insights into dermatology overseas.

Many of College’s Australian Fellows and experts from other Australian medical colleges also delivered presentations on new insights of topics important to our field in Australasia.

The exhibition area was nicely spread out in the larger venue with impressive displays from sponsors, exhibitors and support groups.

The College dinner on Saturday night included a special program on the history of the College, acknowledging the authors of the new history book “It started from scratch”, Jill Barnard and Sonia Jennings; and Rosie Cavaleri who retired to a standing ovation after 28 years working at the College.

Fellows Dr Alan Watson, Dr William Regan and Dr Ivan Simmons all gave accounts of their time with College which added to the historical event.

Convenor Associate Professor Samuel Zagarella, along with Co-Convenors Dr Monisha Gupta and Dr Ian Hamann, are to be congratulated on putting together a great program and a fabulous event befitting of 50 years of College Annual Scientific Meetings.

Professor Alex Anstey

Professor Ronald Rapini

Dr Ashfaq Marghoob

KEYNOTE SPEAKERS

Dr Scott Fosko

ANNUAL SCIENTIFIC MEETING WRAP UP

Associate Professor Christopher Baker

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EXHIBITION

Jannet Farley and Samuel Williams on the College stand

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Convenor Associate Professor Samuel Zagarella and Co-Convenor Dr Ian Hamman

Dr Alan Cooper and Rosie Cavaleri

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History display

Tim Wills with historians Jill Barnard and Sonia Jennings

Dr Ivan Simmons

Dr Alan Watson Dr Bill Regan

CONFERENCE DINNER

This year, College graduates and award winners were treated to a wonderful Graduation Oration and Ceremony for Conferring of Diplomas and Awards at the University of Sydney on Sunday.

The Vice-Regal Couple, His Excellency General The Honourable David Hurley AC DSC (Ret’d), Governor of New South Wales and Mrs Linda Hurley attended the ceremony as guests of honour and The Honourable Michael Kirby AC CMG was the John Reid orator.

More awards than usual were presented at the event, recognising those that may have been missed over the last 50 years. Following the ceremony, the Founders’ Cocktail Party was held in the beautiful MacLaurin Hall at Sydney University.

Media attention for the ASM was considerable with trade media attending the event and mainstream media picking up the College media releases from the event. Sentiment towards the College is overwhelmingly positive and the most popular topics were skin ageing, Botox, melanoma blood tests, make-up and nails. Twitter was the most popular social media channel with good discussions prompted by Fellows.

Thank you to our sponsors, without whom the ASM would not be possible; Lilly, Novartis, Celgene, Janssen Immunology, Sanofi Genzyme and Galderma. Thanks again to our Professional Conference Organiser, The Association Specialists, who handled every aspect of the event in a professional manner contributing to another successful College ASM.

ANNUAL GENERAL MEETING

Associate Professor Christopher Baker handing over the predidency to Dr Andrew Miller

New President Andrew Miller The Association Specialists

Congratulations to all our new College graduates and award winners at the Graduation Oration and Ceremony for Conferring of Diplomas and Awards and the Annual Scientific Meeting.

SILVER MEDALS AWARDED FROM BOARD OF DIRECTORS (BOD) MEETING Dr James Butler AM Associate Professor Rosemary Nixon AM Dr John Sippe Associate Professor Stephen Shumack OAM

CERTIFICATE OF MERITORIOUS SERVICE AWARDED FROM BOD MEETING Dr Pamela Brown Dr Judith Cole Dr David Cook Dr Alan Donnelly Dr Timothy Elliott Associate Professor Greg Goodman Dr Jeremy Horton Dr Gillian Marshman Dr Jennifer Menz Dr Catherine Reid Dr Michael Rich Dr Ivan Robertson Clinical Associate Professor Duncan Stanford Dr Clare Tait Dr Lachlan Warren

BELISARIO AWARD FOR ACADEMIC DERMATOLOGYProfessor Gary Halliday

MERVYN GOLD, OAM, AWARD FOR 2016 Dr Neville Collins Dr Ian McCrossin

INTERNATIONAL OUTREACH AWARD Dr Tim O’Brien

HONORARY FELLOWSProfessor Jean Bolognia Professor John Hawk Professor John McGrath

CERTICATE OF SERVICE Ms Rosie Cavaleri (28 years of service) Dr Bob Corderoy (10 years of service)Mr Tony Moore (10 years of service)

FELLOWS ADMITTED TO ACD APPROVED REGISTER OF MOHS MICROGRAPHIC SURGEONS Dr Peggy Chen FRACP Dr Dougal Coates

Graduates and Award Winners

Professor Gary Halliday

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NEW FELLOWS ELECTED UNDER CLAUSE 3.2Dr Mark Darling Dr Lior Sagi Professor Werner Sinclair Dr Ritva Vyas Dr Ebrahim Abdool Kader Abdulla

MEMBERS ELECTED FOLLOWING THE 2016 EXAMINATIONSDr Austen AndersonDr Friyana BhabhaDr Melissa CarrollDr Mark CicchielloDr John FrewDr Daniel GaffneyDr Dallas GrampDr Amy KlineDr Lena LyDr Georgina LyonsDr Emma MooneyDr Rebecca NguyenDr Christopher RossDr Salvatore ScuderiDr Deshan SebaratnamDr Devita SurjanaDr Bonnie SwanDr Matthew WarrenDr Annaliesa Wright

AUSTRALASIAN COLLEGE OF DERMATOLOGISTS TRAVELLING FELLOWSHIP FOR 2016Dr Georgina Lyons

FOUNDERS’ MEDAL FOR PROCEDURAL DERMATOLOGY FOR 2016Dr Rebecca Nguyen

KEN PAVER MEDAL FOR MEDICAL DERMATOLOGY FOR 2016Dr Georgina Lyons

PRESIDENT’S MEDAL FOR PHARMACOLOGY FOR 2016Dr Sarah Smithson

ADRIAN JOHNSON AWARD FOR 2016Dr Casey Rowe ‘Clinical and biological determinants of melanoma progression: Should all be considered for clinical management?’

EILEEN COLLINS MEMORIAL PRIZE FOR 2016Dr Andrew Lee ‘Paediatric psoriasis is associated with increased waist to height ratio in the absence of obesity: A multi-centre Australian study’

2017 AWARDS

F & E BAUER FOUNDATION PRIZE FOR BEST RESEARCH PAPER READ AT THE ASMDr Rashi Minocha ‘Nicotinamide for skin cancer chemo prevention: Effects on tumour immune infiltrates and melanoma biology.’

BEST PAPER IN REGISTRARS’ FORUM SPONSORED BY GALDERMADr Flora Poon ‘The impact of neck lymphadenectomy on head and neck cutaneous melanoma recurrence and survival: A 10 year retrospective study.’

BEST POSTER PRIZES GRANTED BY ALOPECIA AREATA FOUNDATIONDr Nikki Adler ‘Clinical and molecular characteristics and metastatic pathway in patients with cutaneous melanoma.’

Dr Brent Doolan ‘Management of primary cutaneous melanoma: A retrospective audit of 349 cases and literature review of current clinical guidelines.’

EILEEN COLLINS MEMORIAL PRIZE FOR BEST PAPER/POSTER PRESENTATION BY A NEW SOUTH WALES REGISTRARDr Shelley Hwang ‘Cutaneous manifestations of melanoma immunotherapy.’

JOHN FEWINGS MEMORIAL FUND FROM SKIN AND CANCER FOUNDATION VICTORIA FOR BEST PAPER IN CONTACT DERMATITISDr Danit Maor ‘Intradermal testing for auto immune progesterone dermatitis.’

MEN’S AND LADIES TENNIS TOURNAMENTWomen- Dr May TanMen- Dr Alan Donnelly and Dr Robert Salmon

GOLF TOURNAMENTCollege trophy- Dr Alan DonnellyAssociates trophy- Mitch Palm

TRADE EXHIBITION PRIZES9sqm- Bio-Oil18sqm- Lilly36sqm- Abbvie

EXHIBITOR PASSPORT COMPETITIONFirst Place- Dr Eshini PereraSecond Place sponsored by Wiley- Dr Jill CargnelloThird Place sponsored by Wiley- Dr Andrew Chen.

Graduates

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His Excellency General The Honourable David Hurley

AC DSC (Ret’d), Governor of New South Wales

Founders’ cocktail party in MacLaurin Hall

The Honourable Michael Kirby AC CMG

Procession

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Joseph Rothnagel, Convenor, 2017 ASDR ASM, reports… The 2017 Australasian Society for Dermatology Research (ASDR) Annual Scientific Meeting (ASM) was held at the Novotel, Sydney Central from 9 to 10 May 2017 to coincide with the Australasian College of Dermatologists Annual Scientific Meeting. The venue was only a short walk from the Sydney International Convention Centre and from numerous other attractions and transport. Some 60 registrants participated in our Annual Scientific Meeting, who were both entertained and intellectually stimulated by the oral and poster presentations. We hosted three international speakers from Singapore, Taiwan and Japan, as well as local speakers from across Australia.The program consisted of eight sessions, including melanocyte biology, stem cells, cutaneous biology, melanoma, skin cancers and skin disorders; with 32 oral presentations and 12 posters. The proceedings were kicked off with a superb presentation by Professor Tony Weis from the University of Sydney on tropoelastin- the precursor of the elastin. Prof Weis has been working on extracellular matrix proteins for many years and he provided a fabulous insight on how this particular protein could be harnessed for tissue repair and perhaps for mitigating and reversing aging. The first of our invited international speakers was Dr Oliver Dreesen from the Institute of Medical Biology, Singapore, who gave a wonderful presentation on the molecular and cellular biology of aging from the viewpoint of the nuclear protein, lamin B1. His group found that decreased levels of lamin B1 correlated with cellular senescence and that levels of lamin B1 were found to decrease upon Ultraviolet (UV) exposure and during chronological ageing of human skin.Dr Eric Cheng-Che Lan from Kaohsiung Medical University, Taiwan, presented his groups recent findings on the impact of photon density on UVB photocarcinogenesis. In a surprising result, they found that low irradiance UVB treated mice developed skin tumours faster and

This year’s conference at the Sydney International Convention Centre was fantastic. The nurses officially began the weekend with a welcome from the Australasian College of Dermatologists and a ‘Welcome to Country’ followed by several excellent speakers on drug rash, acne and hydradenitis suppurativa (HS), by Dr Sarah Smithson, Dr Phillip Artemi and Clinical Associate Professor Saxon Smith respectively.

After a quick morning tea we were straight into our international speaker from the United States of America, Lakshi Aldridge RN, who was mind-expanding with the policies the American nurses have helped change to better the health of their patients. The Australian Dermatology Nurses Association (ADNA) constitution was summarised by Camille Smith RN with the intention of voting on a change; however, circumstances made this unachievable. Nicholas Stewart amused everyone with his personal encounters with the media and an update was given by Pat Faga RN on vitiligo transplant followed by the ever interesting Dr Margot Whitfield saving the Fijians from scabies. Who knew impetigo was related to scabies, along with glomerular nephritis and rheumatic fever and if left untreated in the tropics death can ensue? Speaking of parasites, Associate Professor Sheryl van Nuen was spellbinding with the Northern Beaches tick anaphylaxis. The day ended with a solution for one failed melanocyte transplant patient by offering him excimer ultraviolet light. It is great to see collaboration.

After a wonderful evening catching up with old friends and some new ones late into the night, thanks to Ego Pharmaceuticals, we wandered to our beds to sleep quickly just in time to restart in the morning. Acne was again on the list at the early breakfast seminar, followed by another ADNA morning of learning. There was so much that included metabolic diseases

and dietary change, especially how they influence other disease states like acne and HS, as well as hair and sebum production. Dr Elizabeth Dawes-Higgs gave a clear four-step lookout for vulval diseases before we began our heated Annual General Meeting, which resulted in a new President as well as a new Secretary and some new state representatives.

The aim now will be to closely follow the previously discussed constitution and advance dermatology nursing as a profession, which I am sure we all want to see happen in Australia.

Dr Lior Sagi gave a compressed talk on psoriasis, like signs and symptoms and tests used to detect true psoriasis- not to be tried at home, which fit nicely with the well-timed talk by our American guest speaker on the same. Associate Professor Gayle Fischer noted skin conditions that look like child abuse. Dr Schifter spoke about oral cancers that are sometimes misdiagnosed and the tragedy of the lives it affects.

Our overseas sisters from the British Dermatological Nursing Group again visited us and showed how the Association advances the profession. The meeting closed with some mixed emotions, but overall this was yet another great conference.

We would like to add a huge thank you to the dermatologists who volunteer their time to come and present to the ADNA nurses at our State education days and National Conferences.

AUSTRALIAN DERMATOLOGY NURSES ASSOCIATION NATIONAL CONFERENCE 6 to 7 MAY 2017

Lakshi Aldredge, from Dermatology Nurses’ Association America (DNA)

ASDR

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had a larger tumour burden compared to animals that received high UVB irradiance. Moreover, the low irradiance group had many more epidermal keratinocytes with p53 mutations, accounting for the observation that these mice had more cells with DNA mutations that continued to undergo cell division. These findings have implications for the use of sunscreens that may not effectively reduce the amount of low irradiance UV arriving on the basal layer keratinocytes.Our third international speaker was Dr Riichiro Abe from Niigata University, Japan, who represented our sister society in Japan. The Japanese Society of Investigative Dermatology (JSID) and the ASDR have an agreement to send representatives to the each other’s meetings to strengthen our relationships and to build collaborative activity. Dr Abe gave an informative presentation on the pathogenesis of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). His group found that keratinocyte death can be initiated by the interaction of annexin A1 and formyl peptide receptor (FPR) and they are now searching for an FPR1 antagonist as a possible therapeutic intervention for SJS/TEN.The JSID also sends one of its junior members to our meetings to give a presentation of their work who receives the Ross Barneston Travel Award supported by a generous donation from Professor Ross Barneston. This year’s winner was Dr Mika Murai from Kyushu University, Japan and she presented her

work on the endogenous tryptophan UV photo-metabolite, 6-formylindolo [3,2-b] carbazole (FICZ). In her PhD studies, Dr Murai is looking to see if downregulation of FICZ could be a potential methodology to protect skin from photo-aging.The social aspects of conferences are often derided as frivolous, but they serve as an important conduit for the advancement of ideas and collaboration. It is also possible to judge the vibe of a meeting by observing the participants at these events. From the vantage point of this Convenor, the tea and lunch breaks and the conference dinner were a buzz of conversation and joie de vivre. I think this positive mood carried on through the whole meeting, which was characterised by insightful, yet non-combative, exchanges between the presenters and the audience.There are many people that need to be acknowledged for their contribution to this meeting. This includes the members of the ASDR board, the society’s secretariat (ASN), the venue staff, and the session Chairs who kept their sessions running on time. The ASDR and the organising committee thank our sponsors for their support, without which we would not have been able to run this meeting. Many of our sponsors came on board and gave generously at what was a relatively short notice. We are therefore very grateful for their backing of the 2017 ASDR ASM. Finally, I thank the members of the organising committee, for their outstanding efforts in putting together a wonderful meeting.

Associate Professor Joe Rothnagel and Professor Dedee Murrell

Dr Melissa Radjenovic with University of New South Wales student Brendon Lee and Professor Dedee Murrell

Dr Riichiro Abe from Niigata University, Japan

Morning tea with posters

Ross Barneston Award winner Dr Mika Murai from Kyushu University, Japan

AUSTRALASIAN SOCIETY FOR DERMATOLOGY RESEARCH ANNUAL SCIENTIFIC MEETING 9 to10 MAY 2017

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Associate Professor Rosemary Nixon AM, reports…

Once again, we were thrilled with the success of the 4th Annual Patch Test Training Day (PTTD), held on Friday 5 May, the day before the College Annual Scientific Meeting. Over 100 people attended, and the feedback from dermatologists, registrars and nurses has been extremely positive. This year’s program included a regional approach to common skin conditions, highlighting which allergens are important and relevant for particular areas of the body. There were also many interesting case presentations, and we were particularly pleased to welcome a presentation from Dr Rob Granger, who patch tests in southern Western Australia using our Contact Allergen Bank, where we send out pre-prepared patch tests that are individualised for patients. One of the major topics at the 2016 European Society of Contact Dermatitis meeting was the increasing frequency of allergic contact dermatitis in nail technicians and beauty therapists and this area was highlighted as well.

We are so fortunate to have Faculty of the calibre of Dr Adriene Lee, Dr Jenny Cahill, Dr Mei Tam, Dr Bruce Tate, Dr Emma Hiscutt and Dr Nishan Amerasinghe, as well as Occupational Dermatology Research & Education Centre (ODREC) research Fellow Dr Danit Maor- thanks to all of you.

And yet again, ODREC stalwart Mandy Palmer did a wonderful job in all aspects of organisation, including finding an appropriate venue for the meeting and organising excellent catering. All participants at the PTTD receive a booklet including the slides of every talk, meaning that Mandy exerts a fair bit of pressure on the presenters to have their talks done in a timely fashion. Should anyone wish to purchase one of these booklets, just email apalmer@occderm.asn.au.

And now it’s all about 2018. Please put Friday 18 May in your diary, Gold Coast, exact venue to be decided. We have collated all the feedback from this year and have commenced planning for next year. The theme will be ‘Patch Testing Practical’ including a video presentation demonstrating the assessment of a patient with contact dermatitis and the difficult tasks of deciding what to test with and interpreting the results. We will also have several presentations concentrating on the important allergens of the Australian Baseline Series.

We are thrilled that our Contact Allergen Bank has facilitated patch testing all over Australia, but we also feel the responsibility of making sure that dermatologists have the knowledge to patch test appropriately. Attendance at our annual Patch Test Training Day is a great opportunity to hone one’s skills in contact dermatitis and all are warmly invited.

Dr Ian Hamann, Chair, Rural Committee, reports…

The biannual Rural Dermatology Meeting has become an integral part of the Australasian College of Dermatologists (ACD) calendar. In the past we have enjoyed a variety of destinations including the Sunshine Coast, Clare Valley, the Southern Highlands of New South Wales and Queenscliff on Victoria’s Bellarine Peninsula.

These meetings have proved popular with an emphasis on relaxation and time to explore different parts of Australia. Delegates are encouraged to bring their partners and children.

This year, we are taking advantage of the beautiful tropical winter of the North West coast of Western Australia to meet in Broome from 11 to 13 of August. This is a perfect opportunity for many of us to explore this iconic region at the most ideal time of year.

Dr Prasad Kumarasinghe, from our Western Australian Faculty, has produced an outstanding program, both academically and socially. The conference will be based at the Mangrove Hotel in the heart of Broome. The conference dinner will be held at the famous Cable Beach Resort.

The conference has traditionally offered an opportunity for rural and regional dermatologists to meet and share their experiences, socialise and brainstorm the critical problem of our workforce shortage. This is the time when we can encourage our College to address these issues in face-to-face discussion, with an emphasis on solutions, both short and long-term.

The academic program is always stimulating with a unique rural and regional flavour. This year is no exception with presentations from a broad range of invited speakers covering indigenous health, tropical and other infectious diseases and the problems of rural health from the perspective of other College’s.

The keynote speaker is Professor Bart Currie, a Darwin based infectious diseases specialist and highly regarded worldwide as an expert in his field.

This will be a special meeting, in a very special place and it is not too late to join us for what is always tagged as the ‘most fun’ of any clinical meeting on the ACD calendar.

M A N G R O V E H O T E L , B R O O M E , W E S T E R N A U S T R A L I A • F R I D A Y 1 1 A U G U S T T O S U N D A Y 1 3 A U G U S T 2 0 1 7

5th Rural Dermatology Meeting

Program, registration and accommodation information includedRegistration for this meeting is available online

https: / /www.dermcol l .edu.au/events/5th-rural-dermatology-meeting/

5th Rural Dermatology Meeting

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–––––––––––––– PROGRAM

–––––––––––––– The meeting program is being organised by Associate Professor Prasad Kumarasinghe (Western Australia Faculty), supported by Dr Clare Tait and Dr Bernadette Ricciardo also from the WA Faculty and the Rural and Regional Services Committee of College.

The meeting will commence at 1.30pm on Friday 11 August 2017. A buffet lunch will be available at 12.30pm.

The sessions will finish at 5.30pm on Friday and will be followed by a Welcome Cocktail Party in the Mangrove Hotel.

There will be a half-day session on Saturday 12 August 2017, with the afternoon free for social events. The Conference Dinner will be held at Cable Beach Resort on Saturday night.

Likewise, there will be a half-day session on Sunday 13 August 2017, after which the meeting will close at lunch time allowing the afternoon free for social events or for delegates to return home.

INVITED SPEAKERSThe College is honoured that the following local, distinguished specialists, have agreed to participate in the conference:

KEYNOTE SPEAKER

Professor Bart Currie Global and Tropical Health Division, Menzies School of Health Research Infectious Diseases Department, Royal Darwin Hospital, Northern Territory

On moving to Darwin more than 25 years ago, Professor Bart Currie was initially head of the Menzies Clinical Division and now leads the Tropical and Emerging Infectious Diseases team within the Global and Tropical Health Division. Concurrently, he is head of the infectious diseases physicians at the Royal Darwin Hospital and since 2000 Professor in Medicine at the Northern Territory Medical Program, Flinders University. Prof. Currie is also Adjunct Professorial Fellow, Charles Darwin University and Adjunct Professor, College of Public Health, Medical and Veterinary Sciences, James Cook University. In late 2012 he took over as director of Rheumatic Heart Disease Australia, based at Menzies. Prof. Currie’s collaborations across Central and Northern Australia and with clinical and scientific colleagues elsewhere in Australia and overseas have resulted in over 500 peer-reviewed publications.

GUEST SPEAKERS

Clinical Associate Professor Christopher Heath Professor Christopher Heath is an infectious diseases physician and clinical microbiologist (PathWest Laboratory Medicine)

at both Royal Perth Hospital (RPH) and Fiona Stanley Hospital in Perth, Western Australia. He has been the Head of Infectious Diseases at RPH since 1997. Prof. Heath has extensive experience in a broad range of clinical and diagnostic laboratory activities (plus, co-linked research interests) including: clinical mycology, mycobacterial infections (including Hansen’s disease), infections in the immunocompromised host, tropical infectious diseases, hospital epidemiology and infection control programs, and the diagnosis and management of multi-resistant organisms. He is an adjunct Clinical Associate Professor of Medicine at the University of Western Australia, and has over 65 original peer-reviewed publications.

Dr Lydia Scott Community Physician, Western Australia Country Health Service – Kimberley, Western Australia

Dr Lydia Scott is a general medical consultant with the Kimberley Regional Physician Team. She completed her physician training in South Australia with rotations in the Kimberley and Alice Springs, and moved back to the region to start in this role in 2015. The team employs four consultants on fractional appointments, and each week there is a consultant based at Broome Hospital and another on the road doing clinics throughout the region. There are also two registrar positions for advanced trainees to work with the team. Although everyone on the team works across the broad range of medical problems in the region, Dr Scott particularly enjoys co ordinating care for patients with infectious diseases, diabetes and rheumatological diseases. She also has a Masters of Public Health and Tropical Medicine and enjoys teaching medical students with the local University of Western Australia/Notre Dame Rural Clinical School.

Dr Casey Parker

Dr Casey Parker, MBBS, DCH, FRACGP (Graduate Diploma Rural), is a general practitioner by training but has worked as a hospital proceduralist in the Northwest of Western Australia since 2003. He currently practices in emergency medicine, internal medicine, paediatrics, anaesthesia and whatever else is required in Broome. Dr Parker’s interests include point-of-care ultrasound, obstetric anaesthesia, evidence-based medicine and paediatrics.

Dr Casey has a passion for education both at the bedside and online. He has been publishing the popular “Broomedocs” blog (broomedocs.com) and podcasts since 2011 as a free, open-access medical education resource (FOAMed). Dr Parker and his wife also run a private general practice clinic in Broome. He can be contacted on Twitter @broomedocs.

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PATCH TEST TRAINING DAY, 5 MAY 2017

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17TH WORLD CONGRESS ON CANCERS OF THE SKIN® (WCCS 2018) , 15 to 18 AUGUST 2018, SYDNEY, AUSTRALIA

IT IS WITH GREAT PLEASURE THAT WE EXTEND AN INVITATION TO FELLOWS AND TRAINEES OF COLLEGE TO PARTICIPATE IN THE 17TH WORLD CONGRESS ON CANCERS OF THE SKIN®.

This exciting Congress is to be held for the first time in Australia at the Sydney International Convention Centre (ICC), the venue for the College’s successful 50th meeting this year. The Congress will cover all aspects of skin cancer diagnosis and management including treatment updates on radiotherapy, surgery and cutting edge new and novel therapies.

The World Congress on Cancers of the Skin® endeavours to bring over 1,000 attendees together from across the world and has become a major interdisciplinary and influential Congress for clinicians and basic scientists working in the challenging fields of melanoma and non-melanoma skin cancer including the best possible speakers worldwide.

Since 1983, the Congress has enabled physicians to interact with distinguished international faculty and learn about breakthrough discoveries in the prevention, diagnosis, and treatment of all types of skin cancer. The World Congress not only brings together doctors from the international community, but also alerts the host country’s local media to help spread the message about skin cancers.

The World Congress on Cancers of the Skin® is held in a different country every two years, under the auspices of The Skin Cancer Foundation, in conjunction with dermatological organisations from the host country. This year the Congress

is sponsored jointly by The Skin Cancer Foundation and The Skin & Cancer Foundation Australia as an integral part of the Foundation’s international efforts to combat the disease.

As the organisers of this meeting, we cordially invite you to share with us several days of scientific communication in the beautiful city of Sydney. We feel privileged and honoured that many of the world’s leading experts in the field will be in attendance to actively participate and inspire attendees.

We encourage you to save the following dates in your calendar and register your expression of interest today to be kept up to date with the latest information and program news:

ABSTRACT SUBMISSIONS OPENNow

REGISTRATION OPENS August 2017

ABSTRACT SUBMISSIONS CLOSE3 November 2017

EARLY BIRD REGISTRATION CLOSES16 March 2018

CONGRESS DATES15 to 18 August 2018

For further information visit www.wccs2018.com.

WE LOOK FORWARD TO WELCOMING YOU TO WCCS 2018 IN SYDNEY.Dr Alan Cooper, Dr Greg Crosland, Associate Professor Stephen Shumack and Dr David WongOn behalf of the Organising Committee

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THE

ART OF DERMATOLOGY

Paracelsus stated “medicine is not only a science, it is also an art. It doesn’t consist of compounding pills and plasters; it deals with the very processes of life, which must be understood before they may be guided.”There is an art to dermatology. In 50 years of clinical practice, I have witnessed colleagues noted for finesse in patient management. They all display adherence to a motto: Humanitas, Aequanimitas and Gravitas – compassion, cool detachment and a solemnity of manner. These are an elite, superior cadre of our profession. They display the erudite art of knowing: know yourself, know your patient, know your disease and know your drugs. Diagnosis requires the peerless art of looking, the acrobatic art of questioning and the silent art of thinking. In therapy, they show balance, neither over, nor under, promising. Artistry is therefore a complex combination of gift, faculty, talent and experience which embraces the mastery of dermatologic knowledge and skills with the ethical principles of honesty, responsibility and respect. I am convinced the art can be acquired. The innate, creative parts of our personalities have been influenced by exams-needing patience, persistence and perseverance. With these, we can acquire the art.This essay concerns experience and confidence, patient maintenance, diagnosis, therapy and knowing yourself.EXPERIENCE AND CONFIDENCE are absolute prerequisites. The Latin experientia means knowledge gained by repeated trial. Experience gives confidence, considerable experience brings expertise.Confidence is a special attribute-quite wonderful and very personal. When we have assurance and conviction about what we do, we have faith and will perform well.Le traitement-c’est moi. This statement by Henri Gougerot displays self-confidence. Confidence concerns self-efficacy and self-esteem. Self-efficacy is mastering dermatologic skills and achieving dermatologic goals. Self-esteem comes from competence, being competitive when required and behaving virtuously always. It shows as composed self-assuredness.We don’t learn from doing the same thing repeatedly. We learn from trying new things and making mistakes. What you learn to do, you learn to do by doing. Developing the art then is not easy, but there is a charming inevitability in gradualness.

WHY IS THE ART IMPORTANT?The essence of a practice is patient maintenance. We need to attract, keep and help our patients. To do this, we should:

1 Select office staff for their courtesy, cheerfulness, efficiency in office practice with a welcoming telephone manner

2 Sit down with patients: taking time, taking notes, listening carefully. Patients then know you know about their problems

3 Use gadgets. Measure, draw, photograph. The hand lens and dermatoscope are invaluable

4 Be confident. Smile, use the patient’s name and reassure the unexpressed fears. Allay fears about cancer as soon as possible

5 Be a therapist. Prescribe a drug- a prescription gives authority. Samples are worthwhile- an authoritative gift. Give specific instructions

6 Be astute. Don’t let patients anger or intimidate you. Accept that the patient’s friends may be competing with you, as well as Dr Google

7 Each visit, be impatient for improvement. Don’t procrastinate

8 Respond judiciously. When the patient says “I’ve been waiting an hour”, a short, sincere apology is sufficient

9 If the patient says repeatedly “nothing has helped”, best help them find another dermatologist

10 Be yourself

11 If there is a fracture in therapeutic relations, it is best to refer on to another dermatologist, physician, surgeon or psychiatrist.

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DIAGNOSIS LOOKING

Yet, despite all this, patients can dismiss us. Why? How do we redress this? When do you acknowledge the best treatment is finding another dermatologist?

Patients will dismiss you:

1 For lacking empathy-the most common reason. It is not sympathy-feeling pity for the unfortunate. Empathy involves understanding patients’ emotions, feeling them and responding properly. Training improves empathy, so:

(a) Practice identifying others emotions; feeling these and discussing them (b) Watch others empathic responses when interviewing (c) Practice showing it. Learn it early in your career and habitually repeat it (d) Look for other signs-facial expressions, posture, sighs and tone of voice. Imagine

yourself in that position.

2 Lacking respect “Doctor is often late, doesn’t respect my time.”

3 Lacking engagement “Doesn’t explain themselves, doesn’t listen.”

4 Lacking professionalism “Doctor is rude and staff are objectionable.”

5 Lacking chemistry “I’m uncomfortable.”

6 Lack of follow-up. “Doctor doesn’t correspond with my General Practitioner, doctor is uncontactable.”

More mistakes are made by not looking than by not knowing.Always think as you are looking and inspect without prejudice. The diagnosis, if you know it, is instantaneous.You need excellent light. Take a second look after the history, lab tests, previous therapy, other diagnoses are revealed.What else?

1 View overall. The patient with non-specific hand dermatitis can have scabetic nodules on the penis

2 Use hand lenses and dermatoscope. Wood’s lamp and diascopy are sometimes useful

3 Touch the rash and palpate it

4 Use a hair-blower for the scalp

5 Take a photo. With permission, this can be shared with others for their opinions

6 The microscopic look. “If you can’t diagnose a rash in 30 seconds, do a biopsy.”

7 Know where to look. In generalised pruritus, check scalp for nits. With excoriated lesions on the arms, check mouth for lichen planus. In all cases of erythema multiforme, look for herpes simplex. Dyshydrotic eczema? Look for tinea pedis.

Diagnosis must be taught. Search for a master diagnostician as a mentor. See as many diseases as possible: the exotic, the rare and the variations.

The right diagnosis gives intellectual joy. It involves:

1 The erudite art of knowing

2 The peerless art of looking

3 The acrobatic art of questioning

4 The silent art of thinking.

Knowing has been discussed.

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QUESTIONING THINKING THERAPY

The flash of instant recognition is in the art. What a brilliant repertoire the consultant has to take one look and say: “Woringer -Kolopp disease.”

But, without instant recognition, what to do? One must think, think and think. Now, reduce the differential to less than four. Focus on a few major features and challenge yourself. Is it lues? Add to the differential? Leprosy. Allow a little time-the diagnosis can come in a flash.

The best approach is to master a small but adequate armamentarium. Then stick to it. Don’t be a therapeutic butterfly. There is a case for unfounded, baseless therapy-use it rationally. Ideal therapy depends on diagnosis.

Sell your prescriptions with vigour and enthusiasm. The erosion of enthusiasm, usually with time, accounts for the loss of the placebo effect.

Patient problems, with or without diagnosis need identifying. History, in the absence of instant recognition, is essential. Take it carefully. Take time and take notes. Question the patient alone.

In the presence of parents, spouses, friends or relatives, the patient is tempted to tell untruths. A good history reveals the patient’s ideas, concerns and expectations plus the diagnosis. “Listen to your patient, they’re telling you the diagnosis.”

Use all your senses to observe facial expressions, body language etc. Keep questions open- keep an open mind. Question yourself. Are you assuming a diagnosis? Be prepared to reconsider.

KNOWING YOURSELFIt is not enough to know your patient and the disease. Self-honesty is vital. “Know yourself, be yourself, love yourself” is a penetrating saying.

1 Know your personality

2 Know your core values

3 Don’t compromise on virtues such as patience, loyalty, courtesy and cheerfulness

4 Know your likes and dislikes

5 Know your dreams.I have discussed the need for experience and confidence, why patients dismiss you, arts of diagnosis knowing, looking, questioning and thinking, as well as therapy and knowing yourself.

In conclusion, the importance of the art is in the result. It shows itself in good judgment. One can be a poet and not a puppet. Kindness is more important than wisdom. There is beauty in dermatology.

Humanitas, Aequanimitas,Gravitas.

Dr Malcolm Lane-Brown

With acknowledgement to Professor T.B. Fitzpatrick, Professor Walter B. Shelley and Professor Milton Roxanas for permission to use his excellent motto: Humanitas Aequanimitas Gravitas.

Thanks to my stepchildren Ms Xanthe Marshall and Dr Julian Marshall for their penetrating assistance and to Dr Bill Land for continued advice.

References

#1 in first paragraph. After Gravitas (line 4): The personal motto of Professor Milton Roxanas, Associate Professor of Psychiatry, The University of Sydney. Included with Associate Professor Roxanas’ permission.

#2 in fourth paragraph (line3). After Gougerot (line3): Personal communication. Professor Shelley, Walter B.1986

#3 in fourth paragraph #6 The microscopic look. After biopsy (line11): Personal communication. Professor Fitzpatrick, Thomas B.1971.

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EDUCATION MATTERS

WHAT’S HAPPENING IN EDUCATION?

Mr Brett O’Neill, Director of Education Services, reports…

Kapil Dev, the great Indian cricketer once said “Selectors can’t please everyone, but I am OK if they are working for the benefit of Indian cricket. It’s an administrative decision to appoint a selection committee, and I would like to let them do their job”.

Whether it be cricket, rugby, or the workplace, selection of people into a team always brings a variety of views and opinions based on a range of facts and experiences. In my short time at the College, one of the most hotly discussed topics in education has centred on selection into the training program. Who gets in, who doesn’t get in and why one person got in over another etc. It is clearly an important issue for Fellows and a review of the history of the selection process sees a number of attempts by College to improve the process by modifying and adjusting it from being state based to national based, externally and internally led, as well as different interview formats and techniques. Several studies have been undertaken and experts engaged to provide advice- all in the name of improving the process. Through all this, one thing is clear - Fellows see the selection process as a critical element of the profession to ensure the right people get into the program. And that is great.

College has recently completed the first round of the selection process. Ninety applications were received in 2017 and these have been assessed by two Fellows from each state and ranked for the Faculties to short-list for interviews in August.

Applications in 2017 are down from previous years. The last time applications were below 90 was in 2011. College has averaged 115 applications between 2012 and 2016. While it is unclear why we have received fewer applications, anecdotal evidence points to the ‘four strikes and you’re out’ rule introduced in 2015 being one of the reasons, with some potential candidates stating they want to improve and strengthen their applications before submitting due to this rule. However as the table below highlights, first time applicants have decreased over the past five years while second and third time applications have slightly increased over this time. This could be interpreted differently from the attempts rule and point to other issues. While the application fee have not changed since 2013, further investigation on why applications are decreasing may be warranted.

Table 1: Percentage of applications 2012-2016

2012 2013 2014 2015 2016

1st application 70 66 51 58 46

2nd application 20 26 33 24 32

3rd application 5 5 12 10 15

4th application 3 1 3 6 2

5th application 2 2 1 2 5

Total 100% 100% 100% 100% 100%

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Of the successful candidates 32% were applying for the first time, 40% for the second time and 20% for the third time. Only 4% were successful if it was their fourth or fifth attempt. Do these statistics point to better performance after having been through the system once and gaining ‘process or interview experience’? We know from trainee reports that some candidates undertake interview training to improve their chances of getting into the program, sometimes at a high cost. College is working to ensure variety of questioning to decrease this effect.

Of further interest is that of the 238 first time applicants who were unsuccessful between 2012 and 2015, 112 (47%) have failed to submit a second application thus far. Unsuccessful candidates receive little or no feedback on their performance in the selection process and College is reviewing this in an effort to provide useful feedback to unsuccessful candidates.

These statistics provide only a small insight into the selection process and provide a snapshot of candidate behaviour in relation to applications. It doesn’t go into detail about who is more likely to gain selection based on their experience, qualifications or demonstrated interest in

dermatology. It doesn’t consider issues of state preferences and available positions in each state, nor does it consider likelihood of success in the program. This is data that requires further investigation. An article by Selber et al in 2014 on ‘Correlation Between Trainee Candidate Selection Criteria and Subsequent Performance’ states that “training experience and academic potential were better predictors of performance than any subjective information ascertained during the interview”. Another article by Patterson et al in 2015 on ‘How effective are selection methods in medical education?’ states that “multiple mini interviews, aptitude tests, situational judgement tasks and selection centres are more effective selection methods and are generally fairer than traditional interviews, references and personal statements.” Each Specialist College uses a range of tools to select the best candidates and all continue to look at ways to select the best candidates.

College, to date, has not spent extensive time exploring the experience of candidates throughout the selection process, nor fully analysed interview and progression data. The above statistics may provide guidance on the types of questions to ask and the type of data to collect to better improve the process.

If I return back to Kapil Dev’s comments, the Selection Committee now has representatives from each state working together to develop and refine the selection process for the benefit of the profession. They are dedicated to working towards finding the best candidates for the training program. In the short time they have been working together they have introduced measures that the dermatologists have greater control of the process and that people who progress through the selection process have clear experience, interest and dedication to the profession of dermatology. College appreciates feedback from Fellows on the selection process, so please feel free to contact me at the College or your Faculty representative on the Selection Committee.

On the other end of the scale to selection, but not unrelated, College wishes all candidates sitting the Fellowship examinations in August the best.

BETWEEN 2012 AND 2016 COLLEGE

RECEIVED 557 APPLICATIONS FROM 357

INDIVIDUALS FOR 113 POSITIONS.

55% WERE SUBMITTING THEIR FIRST

APPLICATION28% THEIR SECOND

APPLICATION12% THEIR THIRD

APPLICATION

5% IT WAS THEIR FOURTH

OR ABOVE APPLICATION

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AN ESSAY ON FEESCollege received questions from a Fellow unable to ask these at the Annual General Meeting (AGM). The issues concern “the magnitude of the current application fee levied on young people seeking a career in dermatology and the magnitude of current registrar training fees”. The Board commends the member for writing to the Honorary Secretary and raising the issues set out below. The Board always prefers to have concerns aired. This enables a transparent dialogue.

SELECTION FEES AND MESSAGES IN FEES SET

The questioner asks:

“The current fee for the College selection process is $1,600, far exceeding that of other Colleges. This fee applies to all applicants, including the majority, who do not progress to interview. This is objectively a substantial expense for people receiving junior medical officer salaries. Current application fees levied by other Australasian Colleges include $990 for obstetrics and gynaecology, $550 for surgery, $670 for anaesthetics and $450 for ophthalmology.”

College response:

Comparing our fees to large College’s like obstetricians and gynaecologists, surgeons or anaesthetists is fraught with problems. In 2015 these three colleges’ total trainees in training numbered 541, 1094 and 1207 respectively. They each select several hundred new trainees every year and may attract a thousand applicants annually. They run processes in every state, ours is centralised. Finally, it isn’t clear if revenue they earn recovers cost, generates profit to cross subsidise education cost or if their members absorb a loss.

Comparing with ophthalmology who have similar numbers in training to us (144 in 2015) has merit. However again, without knowing their process, costs, fee principles and willingness to cross subsidise this activity, comparison again is difficult. But clearly we ARE expensive.

The questioner asks:

“That College consider the message we are sending to prospective future dermatologists, whom we hope will one day staff our hospital positions, contribute to research and take over from us in teaching and mentoring. It is in my view, very likely, that setting fees well outside those of other specialties will adversely impact the “self-selection” of dermatology trainees.”

College response:

College Board will consider the messaging implied here. But is price a factor? We hold no evidence. And what message is it sending? We hold no evidence on this either.

One of the tasks of the Audit & Risk Committee is to consider all fees and charges levied by the College. Because of our small size, and limited revenue streams, a decision regarding one fee will inevitably impact other fee decisions and the annual bottom line result.

Experience has led the College to hold a coordinated CV assessment and in order to ensure a level playing field the assessors are brought together to assess CVs in committee to a rigorously applied rubric. The interviews are conducted in a similar manner and for the same reasons.

The CV weekend and the interview weekend policy means that we fly about 10 Fellows to Sydney, accommodate them, transport and cater.

After a review of the selection process the College has been able to identify savings and improvements. The College no longer employs an external Human Resources consultant. The 2017 process will be reviewed and costs incurred analysed. It is anticipated that fees will be able to be reduced substantially for 2018, but to discount them to the Royal Australian and New Zealand College of Ophthalmologists (RANZCO) levels would nevertheless mean incurring a significant loss.

A lower fee may well attract more candidates, but we would not be able to predict if they are better candidates until the process is complete. College may end up earning additional revenue because there would be more unsuccessful candidates than we have in the current process. If a lower fee has no impact on numbers applying we will at least know price is not a factor. Clearly these matters are highly hypothetical and the answers will only become evident as they are tested. It is not recommended the fee be set so low as to not recover costs.

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TRAINING FEES

The questioner asks:

“I am also concerned by the training fees now faced by our registrars. Our first years pay more than $7,500 from their registrar salaries (plus exam fees). This is double that paid by registrars in surgery ($3,405), physician training ($3,370), anaesthetics ($2,999), obstetrics and gynaecology ($3,300) and ophthalmology ($3,500).”

Fact: Our registrars are charged more in years one and four; and less in years two and three.

College response:

In November 2013, the Board received a comprehensive costing study that showed the training program ran at a loss with heavy member cross-subsidisation. The Board made a clear decision then. The cost of education should be recovered from the fees charged.

In 2015, fees charged to trainees went up $1,500. In 2016, the Trainee Representatives Committee did a study of fees of Colleges and sub specialty societies’ training fees, which was welcomed by the Board. Our total fees were the second highest.

The Board is acutely aware of trainees’ concerns about making ends meet in 2016. In 2016, College staff reassessed what is being costed as ‘education’. This resulted in the reallocation of some cost items away from this cost centre. In mid-2016 the Board reviewed this and agreed not to raise fees further leaving a gap between revenue received and cost. Staying with the principle that trainees must pay for their education, the Board agreed payment of that gap could be deferred until trainees became Fellows. The arrangements put in place now enable a grace period of three years before payments are due and then they can be made over two years.

The Board was keen not to add stress on to registrars due to fees. The Board believes it has struck the right balance of responsible management of this matter.

FEES AND WHAT WE SPEND REVENUE ON

The questioner asks:

“It was noted at the 2017 AGM that training fees and revenue had recently increased and also that there are planned increases in expenditure in other, non-education related areas, such as Marketing and Communications.”

College response:

There is no connection between increased training revenue and marketing expense. College has increased the training fees to progressively recover the cost of education that Fellows are currently cross subsidising.

In the 2015 Member Survey, Fellows made an unequivocal call for the Board to do more to market and position our College as the expert body it is; and by association, our specialty. The Board responded by funding the in-housing of marketing and communications and funding policy, advocacy and engagement initiatives through new staff and consultancies. These are costed as a member activity and compared with member fee generated revenue. The Board has made a choice to spend any operating surplus to achieve these member desired activities. There is no connection between increased training revenue and marketing expense.

CONCLUSION

Your College has a really excellent handle on what are our strategic priorities today and what everything costs. We set, with the Board, through its Audit & Risk Committee, the fees in these contexts.

The College Chief Executive Officer is prepared to have further discussions on any of these matters with Fellows. Perhaps a College headquarters session at a future Annual Scientific Meeting could enable both literacy and debate going forward?

We thank the Fellow for raising the questions and issues. This comprehensive response would not have been possible at the AGM. We hope this is of utility to all Fellows of current registrar training fees. The Board commends the member for writing to the Honorary Secretary and raising the issues set out below. The Board always prefers to have concerns aired. This enables a transparent dialogue.

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Continuing Professional Development ReportTHE CONTINUING PROFESSIONAL DEVELOPMENT (CPD) COMMITTEE HAS RECENTLY WELCOMED A NEW MEMBER TO THE COMMITTEE. DR MICHAEL PITNEY WAS PREVIOUSLY A MEMBER OF THE COMMITTEE, BUT RETIRED WHILE HIS DAUGHTER SOUGHT TRAINEE SELECTION. THE CPD COMMITTEE WELCOMES HIS RETURN AND INPUT IN MANAGING THE COLLEGE’S CPD PROGRAM TO ENCOURAGE AND FOSTER CONTINUOUS IMPROVEMENT WITHIN DERMATOLOGY.

100% of Fellows have now met compliance for the 2013 to 2015 triennium. College is committed to encouraging dermatologists’ participation in CPD activities and continues to work with members to ensure compliance is met. A revised policy for ‘Unsatisfactory CPD Performance by a Fellow’ has been published on our website and will be implemented for the 2016 to 2017 reporting period. The two most notable improvements with the updated policy are the set dates for actions in supporting and encouraging Fellows to meet areas of deficiency and the removal of their name from the College Dermatologist Directory if compliance hasn’t been met by 31 July (of the reporting period) without having to go to the Board.

We are now past the halfway mark of the 2016 to 2017 CPD Program. To be compliant for the biennium, Fellows need to obtain 200 points with a minimum of one Category 1 activity, six Category 2 points and six Category 3 points over the two year period. In accordance with the updated unsatisfactory CPD Performance by a Fellow Policy, College is taking a more active role in monitoring the progress of Fellows in attaining the minimum yearly credit point accumulation. Since the start of the current Continuing Professional Development Program (CPDP), two lots of six monthly CPD progress reporting has been conducted. The first six month report showed 40% of Fellows were on track with their CPDP, having met or exceeded the recommended monthly target. Reporting for the July to December period showed 43% of Fellows were on track with their CPDP. Fellows were informed of their CPD progress in late December 2016. The next six monthly report will be conducted at the end of June 2017.

100% OF FELLOWS

HAVE NOW MET COMPLIANCE FOR THE 2013 TO 2015

TRIENNIUM

PAST HALFWAY

MARK OF THE 2016 TO 2017

CPD PROGRAM

43% OF FELLOWS

ARE ON TRACK WITH THEIR

CPDP AT END DECEMBER 2016

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In Brief

DERMATOLOGIST CAREER OPPORTUNITY - QUEENSLAND

A contemporary inner north Brisbane dermatology clinic is offering a multifaceted career opportunity for a qualified dermatologist.

With a growing data base of referrers and patients; and modern well equipped rooms, South East Dermatology Stafford offers:

• Friendly, professional, clinical, administration support and management staff

• Experienced dermatologists for mentoring and support (if required)

• Opportunities to visit our satellite clinics, such as North Lakes and Rockhampton

• Convenient inpatient theatre sessions at all our locations (if required)

• Easy parking

• Prospective partnership proposition.

If you are interested or to make further inquiries, please contact our Business Manager Sharon as per below.

Business Hours: 07 3856 5007

After Hours: 0414 539 750

Email: Sharon@sebderm.com.au.

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26

Forthcoming EVENTS...

11-13 August 20175th Australasian College of Dermatologists Rural MeetingBroome, Western Australiawww.dermcoll.edu.au

16-19 August 2017New Zealand Dermatology Society Incorporated Annual ConferenceQueenstown, New Zealandwww.nzdsi.org

25-27 August 201738th Annual Scientific Meeting for the Dermatopathology SocietyMelbourne, Victoriahttp://www.aderms.com/

1- 3 September 2017Australasian Society of Cosmetic Dermatologists Annual ConferenceMelbourne, Victoriahttp://ascd.org.au/

13-17 September 201726th European Academy of Dermatology and Venereology CongressGeneva, Switzerlandhttp://eadvgeneva2017.org/

14-16 September 2017Australian Doctors Health ConferenceSydney, New South Waleshttp://adhc2017.org.au/

20-23 September 2017Australian Indigenous Doctors Association ConferencePokolbin, New South Waleshttps://www.aida.org.au/conference/

18-21 October 2017

9th World Congress of Melanoma and 14th International Congress of the Society for Melanoma Research Brisbane, Queenslandwww.worldmelanoma2017.com

18-21 October 201710th World Congress for Hair ResearchKyoto, Japanhttp://www.congre.co.jp/wchr2017/

12-15 November 201722nd Australian and New Zealand Prevocational Medical Education ForumBrisbane, Queenslandhttp://prevocationalforum2017.com/

24-26 November 2017Dystrophic Epidermolysis Bullosa Research Association International CongressWellington, New Zealandwww.debra.org.nz

4-8 February 2018World Congress of PhlebologyMelbourne, Victoriahttp://www.uip2018.com/

18-22 May 201851st Australasian College of Dermatologists Annual Scientific Meeting Gold Coast, Queenslandwww.dermcoll.edu.au

15-18 August 201817th World Congress on Cancers of the SkinSydney, New South Waleswww.wccs2018.com

10-15 June 201924th World Congress of DermatologyMilan, Italyhttp://www.wcd2019milan.org/

17-19 November 2019 10th World Congress of ItchSydney, New South Wales

10-13 November 2021XIII International Congress of Dermatology Melbourne, Victoriawww.dermcoll.edu.au

Please note the following for your diary:

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The Australasian College of Dermatologists

Suite 2A, Level 2 9 Blaxland Road Rhodes NSW 2138, Australia

PO Box 3785 Rhodes NSW 2138, Australia

Telephone: 1300 361 821 or 61 2 8765 0242 Facsimile: 61 2 9736 2194 Email: admin@dermcoll.edu.au Web: http://www.dermcoll.edu.au

Editorial Team Editor Andrew Satchell, Honorary Secretary

Editorial Personnel Tim Wills and Roshan Riddell

Disclaimer:The Australasian College of Dermatologists wishes to encourage debate and exchanges of ideas amongst Fellows through The Mole. Nevertheless, the opinions expressed in articles in The Mole are those of the authors and are not necessarily those of the College.© Copyright – Australasian College of Dermatologists All rights reserved