LAUSR

Never before has the National Health Service (NHS) been under such pressure to deliver quality healthcare, with increasing referral numbers, finite resources and a dwindling workforce. Of course, the COVID-19 pandemic has contributed to the perfect storm, which is currently still raging. The lines are frequently blurred between service provision and training, with the pandemic having a significant impact on medical education. The majority of trainees have experienced disruption to their training, and dermatology trainees have not been spared. Operating within a predominantly outpatient-based speciality with an ever-increasing workload, a common dermatology trainee experience has been the need to prioritize the throughput of patient consultations over the learning and reflection potential from each case, with little opportunity to witness first-hand consultations from senior colleagues and to hone techniques under their guidance. As Plato once said in his account about the life of the Greek philosopher Socrates, ‘One thing only I know, and that is that I know nothing’ and in dermatology this cannot be truer, with more than 2000 potential diagnoses and a relatively short training period. With the pandemic hastening changes in the traditional outpatient model, the current hybrid model of face-to-face (F2F) and remote consultations has become commonplace. Although this practice brings some benefits, it has also fundamentally reduced exposure to F2F pathology, curtailing recognition of physical signs and patterns, as well as the interpersonal skills required to become a well-rounded physician. Medical students and junior doctors are often inspired by individuals or mentors in their field of choice, either at university or during their specialty training. Knowledge, charisma, skill, ability to adapt under pressure and to find solutions are some of the common reasons given, and this inspiration can ultimately shape the careers of future generations. In dermatology, depending on the size of the hospital department, mentorship can vary depending on the availability and enthusiasm of both mentor and mentee. Larger units can often mean a trainee feeling like a small cog in a very large wheel, with frequent rotations meaning that the onus is on trainees to find their ownmentor. Mentors are role models who act as guides for trainees’ personal and professional development over time, and they may not always realize the full impact of their influence until years later. Brilliant clinicians can be humble in nature and can therefore be an untapped resource. In dermatology, the clinical gems and invaluable hands-on practical advice provided by colleagues can be priceless. Especially important are those clinicians who have retired from the field but continue to nurture and educate the next generation of dermatologists. There is a written curriculum that all trainees need to work through, with reinforcement by academic teaching, but there is also a ‘hidden curriculum’, which is learnt subconsciously by observing senior colleagues and absorbing their professionalism, ethics, values and the art of medicine, and this is less easily learnt from textbooks or revision guides. Aside from curricula, the emotional support and reassurance regularly provided by mentors during training are particularly valuable during challenging times. Investing in and mentoring the next generation of dermatologists is crucial to ensure that our specialty thrives. There is an emergent body of literature that recognizes the benefits of mentorship, including increased research productivity, faster academic promotion and greater staff retention and career satisfaction. Mentoring can occur formally as part of the Educational or Clinical Supervisor Correspondence: Dr Khawar Hussein, Department of Dermatology, Chelsea andWestminster Hospital NHS Foundation Trust, London, UK. E-mail: [email protected]