EtiUCATION
DERMATOLOGY RESEARCH AT THE NATIONAL STUDENT RESEARCH FORUM, 1960-1991 RICHARD F. WAGNER Jii, M.D., KAREN DINEEN WAGNER, M.D., PH.D., AND EDGAR B. SMITH, M.D.
Since 1960 the University of Texas Medical Branch (UTMB) has been hosting the National Studetit Research Forum (NSRt"). The NSRF was originally established to provide medical students with an opportunity to present their own research amotig peers and medical school faculty. Today the NSRl' is a well-recognized annual conference that includes medical students, graduate students, and postgraduate students from all basic and clinical science areas. Currently, participants have an opportunity to present their research, attend lectures by intertiationally recognized researchers, and interact socially with their peers from other medical schools and with tJTMB faculty.
s.^'^ The mean age was 35.1 years (range 24-55) and 71.4% were men. Of the respondents who presented in the dermatology section of the NSRF while medical students, 87.5% were interested in a dermatology career at that time. Respondents indicated that 33 publications resulted from the research presented at the NSRF, of which 48.5% were basic science studies and 45.5% were clinical studies. The remaining 6% of presentations were either surveys or clinical series. Respondents reported that since their participation in the NSRF, 89.3% had published abstracts, atid 89.7% had published case reports, clinical series, reviews, or basic science articles; 62.1% completed dermatology residencies, and of these 94.4% were certified by the American Board of Dermatology. Seventeen percent of additional respondents were currently in dermatology residency programs. One quarter of respondents who completed trainitig worked primarily in an academic dermatology setting, while 65.0% were in private dermatology practice.
The careers and academic accomplishments of tnedical students and resident physicians who made research presentations on dermatologic topics at the NSRF from 1960 to 1991 were studied.
REVIEW
Review of the archival materials from all 32 NSRFs revealed 62 dermatology research presentations. Of dermatology research presentations from 1960 to 1989, 81.5% were tnade from 1 980 to 1989 (Fig. 1). Fifty-two tnedical students and resident physicians frotn 26 medical schools who tnade research presentations on dermatology subjects were identified. Several researchers made multiple presentations. A survey that addressed career development was tnailed to these presenters. No attempt was made to reach nonrespondents.
DISCUSSION
A relatively large percentage (25%) of the respondents who had cotnpleted training indicated that they were principally involved in an academic career. While this nutnber could be inflated due to self-selected respondents, it indicates that a tninimum of 9.6% NSRF dermatology participants selected careers in acadetnic dermatology. This finding is important at a time when the specialty of dermatology is suffering the highest percentage of vacant full-time academic positions (9.6%) among all clinical sciences.^ This vacancy rate is about twice that of overall faculty vacancies at medical schools.^ The current shortage of academic dermatologists may be worsening because statistics for the 1989-1990 academic year indicate the highest number of unfilled full-time dermatology academic positions in 5 years.^ It appears that participation in the dermatology section at the NSRF as a medical student or resident or both may be one of the better early predictors of physicians who will choose careers in academic dermatology. Dertnatology academic career selection is
RESPONSE
Twenty-nine responses (55.8%) to the questionnaires were returned, an expected response rate among dermaFrom the Department of Dermatology and the Division of Child and Adolescent Psychiatry, University of Texas Medical School at Galveston, Galveston, Texas. Address for correspondence: Richard F. Wagner, M.D., Division of Dermatologic Surgery and Cutaneous Oticology, University of Texas Medical Branch, Mail Route G-83, Galveston, TX 77555-0783. 866
Dermatology Rcscirch Wagner, Wagner, and Smith 50
Medical student involvement in the dermatology section of the NSRF is strongly associated with interest in a dermatology career and later achievement of this goal. The enormous increase in NSRE dermatology section participation during the past decade probably reflects current interest in dermatology careers among medical students. Regardless of career path, NSRF dermatology section presentation by medical students and residents is highly correlated with later research and publication. Participation in the NSRF dermatology section is a strong indicator of future academic success in dermatology.
30
10
6
4
(6)
1960-1969
(6)
1970-1979
44
(0)
1980-1989
Figure 1. Number of dermatology presentations at the National Student Research Forum, 1960-1989. The numher outside parenthesis indicates the number of dermatology research presentations, and the number inside the parenthesis indicates the numher of years without any dermatology research presentations.
REFERENCES
strongly associated with awardees of Dermatology Foundation fellowships;'"'^ however, despite this knowledge little is known about what factors and motivations propel and retain individuals in academic dermatology. Further attention should be directed toward investigation in this area so that accurate predictions can become possible.
3.
f. 2.
4. 5.
Sebben JE. Survey of sterile techniques used hy dermatological surgeons. J Am Acad Dermatol f988; fS: 1107-1113. Freeman WE, Chalker DK, Smith JG. Use of gloves among dermatologists, f Am Acad Dermatol 1987; 17:320-323. Jonas HS, Etzel SI, Barzansky B. Undergraduate medical education. JAMA 1990; 264:801-809. Malkinson FD. The dermatology foundation: its fellowship program and the career patterns of fellowship awardees. IntJ Dermatol 1987; 26:650-652. Malkinson F. Report on the DF fellowship awards: new survey shows accomplishments. Dermatology Focus 199f; 10:16.
Dermatomyositis or Polymyositis and Cancer An increase in the incidence of cancer in patients with polymyositis, first noted in 1916, has been reported in many studies from different countries, but this relation is not uniform. Estimates of the associated risk vary widely (between 6 and 60 percent), probably because of the small size of the studies and the selected nature of the groups of patients studied at referral centers. The possible effects of the length of follow-up and age at diagnosis are also unclear. In addition, it is uncertain whether any particular sites of cancer are involved. To provide more accurate estimates of the risk, we studied a population-based cohort of 788 patients who received a diagnosis of dermatomyositis or polymyositis in Sweden between 1963 and 1983. Follow-up was complete through 1987, and observation time thus ranged from 5 to 25 years after a patient's first evaluation for dermatomyositis or polymyositis. Our findings demonstrate that patients with polymyositis have a moderately higher risk of cancer than the general population. The mortality data makes it questionable whether the higher risk is real or the result of increased surveillance among such patients. On the other hand, patients with dermatomyositis have a definite increase in the risk of cancer, a finding supported by the data on mortality from cancer. In patients with dermatomyositis, a search for cancer at regular intervals is therefore warranted. From Sigurgeirsson B, et al. Risk of cancer in patients with dermatomyositis and polymyositis. N Engl J Med 1992; 326: 363-367. 867
DERMATOLOGY RESEARCH AT THE NATIONAL STUDENT RESEARCH FORUM, 1960-1991 RICHARD F. WAGNER Jii, M.D., KAREN DINEEN WAGNER, M.D., PH.D., AND EDGAR B. SMITH, M.D.
Since 1960 the University of Texas Medical Branch (UTMB) has been hosting the National Studetit Research Forum (NSRt"). The NSRF was originally established to provide medical students with an opportunity to present their own research amotig peers and medical school faculty. Today the NSRl' is a well-recognized annual conference that includes medical students, graduate students, and postgraduate students from all basic and clinical science areas. Currently, participants have an opportunity to present their research, attend lectures by intertiationally recognized researchers, and interact socially with their peers from other medical schools and with tJTMB faculty.
s.^'^ The mean age was 35.1 years (range 24-55) and 71.4% were men. Of the respondents who presented in the dermatology section of the NSRF while medical students, 87.5% were interested in a dermatology career at that time. Respondents indicated that 33 publications resulted from the research presented at the NSRF, of which 48.5% were basic science studies and 45.5% were clinical studies. The remaining 6% of presentations were either surveys or clinical series. Respondents reported that since their participation in the NSRF, 89.3% had published abstracts, atid 89.7% had published case reports, clinical series, reviews, or basic science articles; 62.1% completed dermatology residencies, and of these 94.4% were certified by the American Board of Dermatology. Seventeen percent of additional respondents were currently in dermatology residency programs. One quarter of respondents who completed trainitig worked primarily in an academic dermatology setting, while 65.0% were in private dermatology practice.
The careers and academic accomplishments of tnedical students and resident physicians who made research presentations on dermatologic topics at the NSRF from 1960 to 1991 were studied.
REVIEW
Review of the archival materials from all 32 NSRFs revealed 62 dermatology research presentations. Of dermatology research presentations from 1960 to 1989, 81.5% were tnade from 1 980 to 1989 (Fig. 1). Fifty-two tnedical students and resident physicians frotn 26 medical schools who tnade research presentations on dermatology subjects were identified. Several researchers made multiple presentations. A survey that addressed career development was tnailed to these presenters. No attempt was made to reach nonrespondents.
DISCUSSION
A relatively large percentage (25%) of the respondents who had cotnpleted training indicated that they were principally involved in an academic career. While this nutnber could be inflated due to self-selected respondents, it indicates that a tninimum of 9.6% NSRF dermatology participants selected careers in acadetnic dermatology. This finding is important at a time when the specialty of dermatology is suffering the highest percentage of vacant full-time academic positions (9.6%) among all clinical sciences.^ This vacancy rate is about twice that of overall faculty vacancies at medical schools.^ The current shortage of academic dermatologists may be worsening because statistics for the 1989-1990 academic year indicate the highest number of unfilled full-time dermatology academic positions in 5 years.^ It appears that participation in the dermatology section at the NSRF as a medical student or resident or both may be one of the better early predictors of physicians who will choose careers in academic dermatology. Dertnatology academic career selection is
RESPONSE
Twenty-nine responses (55.8%) to the questionnaires were returned, an expected response rate among dermaFrom the Department of Dermatology and the Division of Child and Adolescent Psychiatry, University of Texas Medical School at Galveston, Galveston, Texas. Address for correspondence: Richard F. Wagner, M.D., Division of Dermatologic Surgery and Cutaneous Oticology, University of Texas Medical Branch, Mail Route G-83, Galveston, TX 77555-0783. 866
Dermatology Rcscirch Wagner, Wagner, and Smith 50
Medical student involvement in the dermatology section of the NSRF is strongly associated with interest in a dermatology career and later achievement of this goal. The enormous increase in NSRE dermatology section participation during the past decade probably reflects current interest in dermatology careers among medical students. Regardless of career path, NSRF dermatology section presentation by medical students and residents is highly correlated with later research and publication. Participation in the NSRF dermatology section is a strong indicator of future academic success in dermatology.
30
10
6
4
(6)
1960-1969
(6)
1970-1979
44
(0)
1980-1989
Figure 1. Number of dermatology presentations at the National Student Research Forum, 1960-1989. The numher outside parenthesis indicates the number of dermatology research presentations, and the number inside the parenthesis indicates the numher of years without any dermatology research presentations.
REFERENCES
strongly associated with awardees of Dermatology Foundation fellowships;'"'^ however, despite this knowledge little is known about what factors and motivations propel and retain individuals in academic dermatology. Further attention should be directed toward investigation in this area so that accurate predictions can become possible.
3.
f. 2.
4. 5.
Sebben JE. Survey of sterile techniques used hy dermatological surgeons. J Am Acad Dermatol f988; fS: 1107-1113. Freeman WE, Chalker DK, Smith JG. Use of gloves among dermatologists, f Am Acad Dermatol 1987; 17:320-323. Jonas HS, Etzel SI, Barzansky B. Undergraduate medical education. JAMA 1990; 264:801-809. Malkinson FD. The dermatology foundation: its fellowship program and the career patterns of fellowship awardees. IntJ Dermatol 1987; 26:650-652. Malkinson F. Report on the DF fellowship awards: new survey shows accomplishments. Dermatology Focus 199f; 10:16.
Dermatomyositis or Polymyositis and Cancer An increase in the incidence of cancer in patients with polymyositis, first noted in 1916, has been reported in many studies from different countries, but this relation is not uniform. Estimates of the associated risk vary widely (between 6 and 60 percent), probably because of the small size of the studies and the selected nature of the groups of patients studied at referral centers. The possible effects of the length of follow-up and age at diagnosis are also unclear. In addition, it is uncertain whether any particular sites of cancer are involved. To provide more accurate estimates of the risk, we studied a population-based cohort of 788 patients who received a diagnosis of dermatomyositis or polymyositis in Sweden between 1963 and 1983. Follow-up was complete through 1987, and observation time thus ranged from 5 to 25 years after a patient's first evaluation for dermatomyositis or polymyositis. Our findings demonstrate that patients with polymyositis have a moderately higher risk of cancer than the general population. The mortality data makes it questionable whether the higher risk is real or the result of increased surveillance among such patients. On the other hand, patients with dermatomyositis have a definite increase in the risk of cancer, a finding supported by the data on mortality from cancer. In patients with dermatomyositis, a search for cancer at regular intervals is therefore warranted. From Sigurgeirsson B, et al. Risk of cancer in patients with dermatomyositis and polymyositis. N Engl J Med 1992; 326: 363-367. 867
