Development of Dermatology in the US

The first department of Dermatology in the USA was established at the University of Pennsylvania in the late 1800s. Throughout the following century, Dermatology programs were established across the country as extensions of Internal Medicine. In the last several decades, there has been an increasing emphasis on surgical techniques so that now approximately one half of all dermatologic visits involve surgical procedures. As Dermatology evolved into a distinct discipline of cutaneous medicine and surgery, academic programs increasingly achieved departmental status to the extent that now approximately two-thirds of all Dermatology training programs exist in departments of Dermatology. Among top ranking research medical schools, this proportion is even higher. For example, Dermatology is a department at all of the following schools: Harvard, Yale, Columbia, Penn, Johns Hopkins, Stanford, UCSF, Michigan, Case Western Reserve, North Carolina, Pittsburgh, Alabama, Baylor, Texas Southwestern, Minnesota, Colorado, Albert Einstein, Iowa, Rochester, NYU and Cornell. In the Midwest these include Minnesota, Mayo Clinic, Medical College of Wisconsin, Iowa, Northwestern, Illinois, Rush, Michigan and Indiana. In July 2002 Dermatology at the University of Wisconsin-Madison also became a department.

In addition to the standard three-year dermatology residency that follows a clinical internship, there are fellowships available for dermatologists in the following areas: dermatopathology, pediatric dermatology, dermatologic/Mohs surgery, dermatologic cosmetic surgery, dermatopharmacology, cutaneous oncology and immunodermatology. There is also a combined 5-year internship/residency in Dermatology and Internal Medicine and the newest ACGME approved fellowship program is in Procedural Dermatology. A similar program is anticipated that will lead to double board-certification in Dermatology and Pediatrics. At UW-Madison we offer a three year residency in General Dermatology following the clinical internship. There is an optional fourth year. We also offer a five year Medicine-Dermatology residency and a one year Procedural Dermatology fellowship encompassing Mohs and other dermatologic procedures.

As a consequence of this century-long evolution, Dermatology has become a well-defined discipline in terms of medical school curricula, residency training, scholarly research and clinical practice. This has been reflected by the concomitant growth of professional societies, journals, specialty boards, government agencies and funding organizations that focus specifically on dermatologists and the research and treatment of skin diseases. These developments are all indicators that Dermatology has "come of age."