A review of current activities is of interest now that our Association is celebrating its 75th anniversary. Administration remains in the hands of the Executive Committee which, with its regional representation, is more than 20 strong; there are also co-opted and ex-officio members and some ten sub-committees and working parties. Officers are now elected by a postal ballot conducted in a way which satisfies cravings for electoral reform.
The dermatology "Manpower" situation has been kept under the wary eye of a succession of Advisers to the Chief Medical Officer at the Department of Health (H R Vickers, N R Rowell, J J Burton and B R Allen), and the training of the next generation of dermatologists has stimulated much anxious discussion. Current educational schedules are ever under scrutiny and occupy the Royal College of Physicians as much as ourselves. Our nominees to supervise and counsel the young have been first, H R Vickers then J S Pegum, I Sarkany, Janet Marks and John Savin.
The MRCP, no shibboleth but the benchmark for anyone about to study a medical speciality, has even come under criticism. Individual "log books", checked by teachers and maintained throughout a trainee's years of study, have now been introduced. Examinations at "the point of exit", (cf American Boards), are not yet favoured and we prefer to cling to our modified apprenticeship system. The inter-weaving with our counterparts from Continental Europe poses further difficulties, our pattern of training is longer and until recently excluded venereology.
Our Association's membership is healthy and growing. The academic content of our meetings is high-class and the reputation of our scientific and medical presentations, many think, remains unchallenged. The Special Interest and Affiliated Groups - the University Teachers (BAUTOD), Contact Dermatitis (BCDG), Nursing (BDNG), Photodermatology (BPG), Dermatopathology (BSD), Dermatological Surgery (BSDS), Investigative Dermatology (BSID), and Society for Paediatric Dermatology (BSPD) - all starting in a modest way, are now independent and flourishing bodies. Our Journal (the BJD) is an example of the very best type of medical publication and our handsome new home in Fitzroy Square69 is something which would surely have amazed our founder36. It will become the hub of scientific and academic endeavour for years to come.
As we approach the second millennium we have witnessed the creation of new academic departments and Professorial Chairs. Dermatology has made tremendous progress as the patterns of disease have changed. Chronic infections like tuberculosis and syphilis have largely been conquered, while acute and subacute pyococcal infections have submitted to modern antibiotics. The infectious fevers, meat and drink to Willan's generation, have been spirited away. Our most common problems now - the eczemas, psoriasis and acne, are easier to manage thanks to modern techniques. Admission to a precious hospital bed has become both difficult and rare.
Malignant changes in the skin can now be identified more precisely; esoteric markers and superb modern microscopes have enhanced the pathologist's scope. The increased frequency of UV-induced changes can readily be explained by changes in society's habits and fashions. More effective and prompt treatments are expected, indeed demanded.
The problems which puzzle the present generation of dermatologists are complex - the result of interactions between the environment, nutrition, genes and the inevitable ageing process. Disturbance of immune mechanisms, the upsurge of HIV infections, and the chemical insults from modern medication, all combine to create an array of disease patterns to intrigue and challenge today's specialists. The ability of the skin and its diseases to fascinate seems limitless.
The current problems within the National Health Service also impinge on dermatology but not necessarily to our advantage. We will need understanding, tolerance and co-operation to weather the changes being suggested, but weather them we will. Self-satisfaction is not an attractive trait but the "Celebration of Dermatology" mounted by Terence Ryan at the 1994 Oxford meeting struck the right note for us. The next 75 years will surely witness more exciting challenges for dermatology and for our Association, but we've made a good start.