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ePaper created 2014-09-15, 12:31:02 | version 1.32.01
The importance of venereology was noticeable in the academic output in the early days of the department. During the professorship (1919-1943) of the first ordinarius, professor dr. van Leeuwen, thirteen PhD theses were published. Six of them dealt with VD’s. And from the 126 scientific publi- cations in this period, 51 dealt with VD’s. In the second half of the last century, we observe a steady growth in attention to inflammatory disorders and oncology, while the interest in VD’s declines. The output of VD research is greatly diminished. Venereal diseases, nowadays in a broader concept referred to as Sexually Transmitted Infections (STIs) have also almost entirely disappeared out of sight of the practical working dermatologist. What happened? With the emergence of antimicrobial therapy it was thought in earnest that STIs would disappear - worldwide. The interest of dermatologists in venereal diseases diminished and their attention was increasingly taken up by the impressive developments in the diagnosis and treatment of skin diseases. Moreover, the government began to see STIs explicitly as a task for general practitioners (GPs) and as public health issue. Today, some 70% of all STIs in the Netherlands are diagnosed and treated by general GPs and around 30% are dealt with in special - government supported - STI outpatient clinics. In these specialized STI clinics patients can make an appointment without a referral from their GP and the diagnosis and treatment are offered anonymously and free of charge. To make an appointment at these clinics the patients have to meet certain criteria, like a high number of sexual partners and/or being part of a known risk group like males who have sex with males (MSM), or having symptoms. There were specialized STI clinics in the Netherlands’ larger cities: one in Amsterdam, two in the Hague, one in Rotterdam and one in Utrecht. All of these were operated by dermatologists in academic and community hospitals in close collaboration with the municipal health services. Amsterdam’s clinic has always been run by the city’s municipal health services while, today, the same city bodies carry out STI care all over the country with finance direct from government and varying degrees of involvement by dermatologists. In summary, academic medical centers have little interest in STI research anymore, and the diagnosis and treatment of STIs in the Netherlands - no longer in the hands of the average dermatologist - comes under the purview of municipal health services. Education Around the turn of the 19th century it was common practice in most specialisms, including dermatology, to train for two years as a volunteer or assistant with a professor and private lecturer in their relevant area. When residents were considered able to practice independently, they received a certificate of competence, enabling them to start working as a medical specialist. Specialists establishing themselves without sufficient experience could not count on support from their colleagues or the referring general practitioner (GP). Training in dermatology initially involved additional internships with professors and private lecturers abroad such as Ricord, Cazenave, Besnier and Vidal in Paris, Köbner and Jadassohn in Breslau, Hebra and Kaposi in Vienna and, most famous of all, Unna in Hamburg. As more chairs were established in the Netherlands, one could train to become a dermatologist not only in Amsterdam, but also in Utrecht, Groningen and Leiden. Because they laid down their own conditions for membership, it made sense for the NVDV to develop some initiative to legitimize the dermatology qualification. Some fifteen to twenty years after the turn 20 BWEADVSMGFINCORR:Opmaak 1 21-07-2014 17:39 Pagina 20