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of the century the NVDV began using the two-year training period as an unconditional criterion for society membership. What this training entailed was of less concern. This situation did not change until 1931, when specialist registration was introduced nationwide. A year on, the Specialist Registration Committee asked the NVDV for advice on the expected duration of dermatological training and on other requirements. While the NVDV did not exactly leap into action, it was eventually deter- mined that the training programme should last three years. The drift towards specialization continued after the Second World War. In 1949, calls were made for a four-year course, which was eventually implemented in 1954. A special arrangement was made with the Radiological Society regarding radiotherapy, which dermatologists had become used to carrying out themselves. Dermatology, together with internal medicine areas, was traditionally considered a more theoretical, rather than a hands-on specialism. For this reason, little attention was paid to the surgical aspect of the profession for many years. This outlook has changed significantly over the last 20 years. With the development of - among others - dermato-oncology and phlebology, another year was added to the four-year training in the year 2000. For the last fifty years, the demands laid out for dermatological training have become clearer and more concrete in a dermatology training charter. In order to gain first-hand experience, the resident has training practices in key subjects. These consist of clinical internships with the resident caring for patients on the ward, as well as various outpatient internships. In the eighties special hands-on courses were started, organized for the first time by Willem van Vloten (Utrecht), in dermatosurgery and dermatopathology. During the outpatient internships, additional courses are taken, such as photodermatology, allergology, phlebology and sexually transmitted infections (STIs). At present, the five-year period of training is once again under discussion. Scientific and technological progress in dermatology have made knowledge and experience so complex, that it is not any longer possible for an individual to gain familiarity with the entire field, let alone keep track of new developments. It has become a challenge for a dermatologist to keep up with the developments. Hence it has been decided to maintain a four-and-a-half year training programme with the option of further specialization in particular areas. Nowadays dermatology is one of the 29 recognized specialisms in the Netherlands. Access to specialist training is limited to prevent a sudden influx of medical specialists. Knowledge exchange Knowledge exchange is essential for the development of science. Dermatology in the Netherlands has evolved and continues to do so as a process of knowledge exchange with neighbouring European countries and beyond. The basis for modern dermatology was laid in Western Europe in the 18th- and 19th centuries, the main branches being the English, French and German schools with Willan, Alibert and Von Hebra as leading figures, respectively. These have all had their impact on the development and evolution of Dutch dermatology. In terms of academic dermatology, the German school in particular has been of influence on the early development of Dutch dermatology. Several German physicians held the post of dermatology professor at Dutch universities in academic dermatology’s early years: Siemens was professor in Leiden from 1929 to 1962, Zurhelle in Groningen from 1931 to 1945, and Happle in Nijmegen from 1986 to 1991. The Dutch Kerkhof, dermatology 22 BWEADVSMGFINCORR:Opmaak 1 21-07-2014 17:39 Pagina 22