Introducing public health themes in Clinical Dermatology

摘要

The ACGME’s Core Competencies comprise six domains, which in turn contain dozens of often overlapping milestones. Several competencies explicitly invoke public health topics – but if one wears the right set of lenses, nearly every milestone, nearly every aspect of health and medicine, can be viewed from a public health perspective. Why then is Dermatology generally taught – and practiced – in an Intensive Care manner, where seemingly unlimited diagnostic & therapeutic efforts focus on single individuals, not the community? In this presentation, I argue that topics of public health concern should not be relegated to the minor leagues of GME. Instead, dermatology educators can don those public health lenses and identify aspects of clinical cases, common and unusual, that introduce themes that point to larger issues for the public weal. We will review actual events where dermatologists and dermatologic issues were involved in major public health themes of the day. The presentation explores ways that dermatologists serve as sentinels to monitor emerging infectious diseases (such as HIV & Kaposi sarcoma, Zika, monkeypox in the Midwest, terrorism-associated anthrax) and acute outbreaks of noninfectious diseases (such as those due to environmental changes, drug manufacturing processes, changing trends of human behavior). From these examples, we will explore ways to re-introduce the basic sciences of public health, including epidemiology and biostatistics, into the daily practice of dermatology.