Dermatology - Working across Kent, Surrey and Sussex

The HEE KSS training programme in Dermatology is a four year programme, based either in Sussex or Kent. The programme is led by Nik Patel, Head of School, and Dr Emma Topham, Training Programme Director. To find out more about their roles visit the Meet the Team webpage.

Skin cancer rates are increasing nationally and it is especially prevalent on the south coast. Trainees will have a wealth of clinical experience to enable them to develop the expertise to manage patients with skin cancer, with a detailed knowledge of surgical and non-surgical approaches. Trainees will all work as part of a multidisciplinary skin cancer team. Trainees will also attend a wide range of general and specialist clinics, to develop the skills required to manage patients with rashes and inflammatory skin disease.

Trainees who opt to train in HEE KSS will benefit from a broad and varied clinical exposure across regional hospitals, with access to excellent supra-regional educational opportunities based in London.

KSS trainee rotations are based in hospitals across two counties:

Kent

Sussex

To find out more about each training location, please visit the Local Education Provider webpage.

Structured Training

The regional training programme for HEE KSS trainees is outstanding. Trainees are released to attend educational activities every Thursday afternoon. These are based in London three weeks per month and held locally in the training department on the fourth Thursday of the month.

The St John’s Dermatology meeting, based at St Thomas’ Hospital is an excellent clinical case meeting, followed by a lecture. Pan Thames SpR training, based at St Thomas’ hospital, is held on the second Thursday of the month. This is a mixture of clinical case training, histopathology teaching and lectures to cover the dermatology curriculum. The Royal Society of Medicine Dermatology Section meeting is a national clinical case meeting on the third Thursday of the month.

The South West Thames Dermatology meeting is held on the second Thursday of the month, five times per year, and Sussex trainees attend this in preference to the Pan Thames teaching. The clinical case meetings are an unrivalled opportunity to learn about unusual or challenging dermatological presentations, as well as an opportunity to meet colleagues. All trainees will have an educational supervisor to support and advise them during their training. Annual interim reviews and ARCPs are arranged at the LETB to ensure satisfactory progress through training. Training requirements are clearly laid out in the ARCP decision aid and the dermatology curriculum. Trainees are encouraged to sit the Specialty Certificate Examination in Dermatology in their second or third year of training. There is a trainee representative from both the Sussex and Kent rotations, who sit on the regular Specialty Training Committee meetings held to discuss training.

Sussex Rotation

The Sussex rotation is centred on Royal Sussex County Hospital, Brighton; Princess Royal Hospital, Haywards Heath; Worthing Hospital, Worthing and Eastbourne District General Hospital, Eastbourne.

The dermatology department is based in Brighton with additional clinics at Princess Royal Hospital, Haywards Heath. It is a large department offering a full range of general and specialist Dermatology services. There are nine consultant dermatologists, three SpRs, two clinical fellows, a core medical trainee and two plastic surgeons, as well as a dedicated team of specialist and general dermatology nurses.

Trainees will benefit from a broad training experience, including general dermatology clinics, dedicated skin cancer two-week wait clinics, specialist clinics and skin surgery training. Specialist clinics provided by the department include biologic, hair, iontophoresis, paediatric, patch test, phototherapy, psoriasis, skin cancer multidisciplinary and vulval clinics.

Inpatient referrals are seen at the Royal Sussex County Hospital in Brighton and Princess Royal Hospital in Haywards Heath. Brighton hosts the weekly Sussex specialist skin cancer multidisciplinary meeting, with network links to Worthing, Eastbourne, Hastings and East Grinstead hospitals.

The dermatology department at Worthing and Southlands has a high volume of skin cancer referrals and opportunities for basic and advanced surgical training alongside the maxillofacial team. Specialist clinics include connective tissue, paediatric, biologics and psoriasis, vulval, patch test and phototherapy clinics. There is a bimonthly complex cases clinic supported by the knowledge resource team from Worthing Medical Library. Two SpRs are based in Worthing, supported by a team of five consultants, specialist nurses and a clinical fellow.

The dermatology department in Eastbourne offers a range of general, skin cancer and paediatric clinics, and advanced surgical training alongside the maxillofacial team. Brighton trainees attend Eastbourne on a day release during their training.

There is a team of consultants dedicated to teaching, and all trainees will have regular meetings with their clinical and educational supervisors. Training is reviewed at Local Faculty Group meetings, attended by all trainees and consultant staff.

Trainees have protected teaching time on Thursday afternoon. The local meeting on the fourth Thursday of the month comprises interesting clinical cases, a journal club, audit presentation and lecture. Trainees are also encouraged and supported to select interesting cases to present at South West Thames meetings, St John’s meetings and the Royal Society of Medicine, as well as submitting oral or poster presentations to the British Association of Dermatology annual meeting or medical dermatology meetings.

Trainees have a study leave allowance and are encouraged to attend courses relevant to their training. The British Association of Dermatology has an excellent educational programme of events and training courses.

Clinical research is actively promoted in the dermatology department and trainees will be encouraged to identify patients to recruit to the portfolio of commercial and non-commercial dermatology trials. There is a dedicated dermatology research nurse and strong links with the CLRN.

Undergraduate and postgraduate teaching is a key priority for the dermatology department. Undergraduate medical students have their dermatology rotation in year four and trainees are encouraged and expected to contribute to medical student training.

Sussex sub rotations

All rotations have two years in Brighton and two years in Worthing. During the Brighton rotation, trainees will attend clinics in Eastbourne for one or two days/week.

Kent Rotation

The Kent rotation is now centred at the Kent and Canterbury Hospital Dermatology Departmental Hub in East Kent, following closure of secondary care dermatology at Medway, making it the only hospital-based dermatology department in Kent.

East Kent Hospitals University NHS Foundation Trust is one of the largest Trusts in the UK with acute centres at William Harvey Hospital, Ashford and Queen Elizabeth The Queen Mother Hospital, Margate and some specialist services centred at Kent & Canterbury Hospital and Buckland Hospital, Dover. The dermatology team consists of five consultants, six associate specialists/speciality doctors, three/four SpRs and a large dedicated specialist nursing team.

Similar to the Sussex rotation, trainees will receive a broad training in all aspects of general adult and paediatric dermatology, two week cancer screening clinics plus specialist clinics including patch testing, male and female genital dermatology, and biologics. The departments have a strong surgical unit including Mohs surgery. Trainees have extensive opportunities to develop their surgical skills and the majority complete their training competent in performing flaps and grafts on the head and neck.

There is a local Kent dermatology academic half-day session on the fourth Thursday of the month, consisting of departmental business meeting, academic talks/audits/ journals and interesting cases plus histopathology and discussion. Trainees attend the regional training programme on the other Thursdays of the month. Trainees also benefit from dedicated histopathology training and can be involved in digital teledermatology case-reporting and ‘advice and guidance’ service.

The department is active in research, recruiting patients to commercial and non-commercial trials. Additionally, from 2020, the new University of Kent medical school, based in Canterbury, will potentially lead to the development of new opportunities for teaching or research.

The weekly Specialist Skin Cancer MDT is run across all sites by high resolution video conferencing and trainees are encouraged to be involved. Emergency referrals are generally managed by the trainees with senior supervision as are inpatient ward referrals with regular ward rounds at William Harvey Hospital.

For any curriculum super-specialist topics that are not available within the department or local trust environment, trainees will be encouraged to make their own arrangements with our established contacts at St John’s or other appropriate centres to attend clinics/educational events.

Other opportunities

Trainees are encouraged to develop subspecialist interests during their training and are supported to make use of OOP opportunities. Previous HEE KSS trainees have successfully applied for highly competitive specialist post-CCT fellowships in surgical, medical or paediatric Dermatology.