History of Latin American Dermatology

RUBÉN GUARDA TATÍNones, the immense majority is currently less than 50 years old and represents potentialcapital for the progress of Chilean Dermatology.Meanwhile, while before 1960 there were no female physicians in this field, at thepresent time a clear majority of dermatologists are women, not only because they oftensurpass males in undergraduate grades and so gain access to scholarship/residency quotas(several have been the best students at their respective medical schools), but also because,as already pointed out, the practice of this specialized field is very compatible withtheir family responsibilities. Many have stood out in diverse areas of Dermatology andalso in executive roles: four of the last six presidents, six of the last seven vice-presidentsand the last eight secretaries-general of the SCDV have been women.Estimative legitimization as a specialist in the pastThe lack of legal guidelines to define the branches of medicine and their practices iscommonplace in South American countries and certainly so in Chile. Any physician canclaim any specialization, even if it becomes daily more difficult to maintain the claim visà-vishis or her peers, patients and the community. Nowadays patients’ rights and certainlegal reasons (lawsuits for malpractice or errors of any kind) justify and demand ofconsistent and solid training in a specialized field.Since, in Dermatology, there was no graduate training with scholarships/residencyuntil 1966, nor any other national system of trustworthy accreditation until 1991, theranking of physicians as capable and knowledgeable in dermatology was essentially onlyestimative and informal. Their legitimization was until that time mediated by their backgroundincluding affiliation, with or without pay, with a Dermatology service or unit atpublic or university hospitals, within a system that in Chile has been called “trainingthrough practice.” De facto acceptance as qualified dermatologists was given to all thosewho had worked for several years at the Dermatology units of large hospital centers suchas the St. Louis, St. Vincent de Paul (later José Joaquín Aguirre), St. John of God, BarrosLucas, the Concepción Regional Hospital and others, the more so if the latter were associatedwith medical teaching. Nevertheless, in some cases, the period of permanence atdermatological centers to allow a self-description as a dermatologist reached as low asone to six months, and, in other — not very frequent — cases only entailed occasionalvisits to those centers. As has already been mentioned, other doctors were self-legitimatedas dermatologists only by virtue of the fact of treating dermatological ailments orSTDs in the provinces or big-city neighborhoods.Formal accreditation as a specialist in the immediate pastSeveral direct and indirect steps have been taken for the accreditation of a doctors asspecialists in Dermatology and Venereology in Chile. The first step was constituted by thefounding of the Chilean Society of Dermatosyphilology (SCDS), afterwards called ChileanSociety of Dermatology and Venereology (SCDV), in 1938. Its members were then naturallylegitimated before their peers and before the members of the Medical Society ofSantiago, of which the SCDS was an affiliate from the outset. Nevertheless, before theother institutions and the national community, that affiliation only represented an estimationby consensus (but not a codified one) of the condition of specialist. We do notknow the requirements to be a member of the SCDS (later SCDV), during its first historicalperiod (1938-1980) (vide infra).The second step was constituted by the launching of the graduate training programfor specialist in Dermatology awarded by the UCH as of 1966. However, at least until1990, only a minority of the dermatologists practicing in Chile were graduates of thisprogram; in recent years, on the other hand, their number has been significant.166