History of Latin American Dermatology

Historical sketch of Chilean DermatologyThe third step was taken by intensive work carried out by the SCDV which, in the absenceof records of members affiliated with the SCDV since its founding, in 1986 begana rigorous inspection of backgrounds, in accordance with the bylaws of 1985, for a validationof physicians as dermatologists and hence as members of the SCDV, which endedin November 1987 with an official list of 130 full members. With this, members formallyrecognized one another as peers.The fourth step was taken in 1988 when the SCDV accepted an invitation of the NationalSpecialized Medical Fields Accreditation Corporation (CONACEM) — an autonomous,private institution formed by the Chilean Medical Association, the diversesocieties of Chilean specialized medical fields and the Association of Chilean MedicalSchools (ASOFAMECH) — to launch a formal process for the accreditation of physicians inDermatology and Venereology based on the general guidelines established by CONACEM,thus joining other medical societies which had already begun such an accreditation. Tothat end, a specific, five-member commission was formed by Rubén Guarda as president,appointed by the CONACEM board, Juan Honeyman and Daniel Villalobos, appointed byASOFAMECH, and Manuel Melis and Julia Oroz, appointed by SCDV.In 1990, after several proposals and modifications, this commission and theCONACEM board agreed on the final statement of requirements for that accreditation in“Dermatology and Venereology.” The main working problems faced by the commissionwere: 1) adaptation to the national reality of limited regular training of specialists; 2) theincorporation of the word “Venereology” to the field (since doctors from other branchesof medicine treated patients with STDs); 3) the ranking of Dermatology and Venereologyas a “primary specialized medical field”; 4) the implementing of requirements in termsthat would allow the accreditation of doctors with a lengthy, proper and knowledgeablepractice in the field (especially in the provinces) yet lacking in formal training within it,and at the same time would prevent the undeserved accreditation of physicians with insufficienttraining. In sum, it was determined that the following would qualify for accreditation:a) accredited ordinary Professors of Dermatology at recognized MedicalSchools; b) those holding titles from official graduate programs in Dermatology andVenereology from accredited Medical Schools; c) doctors having five years of on-the-jobtraining at Chilean dermatological centers complying with certain stipulated requirements,and d) physicians trained in this specialized field at foreign Medical Schools havingsimilar programs to those of Chilean Medical Schools. The physicians who qualifiedfor one of the latter two groups only submitted to a five-day practical exam, until in 2002a theoretical exam was added to pre-qualify for the practical exam.The CONACEM certification process for specialists in Dermatology and Venereologywas launched in 1991 and continues to this day. It is carried out through a technicalgroup known as the Dermatology and Venereology Commission which analyzes the voluntaryapplications of the physicians seeking accreditation, sent to it by the CONACEMboard. This commission is formed by five members: one (the president) appointed by theCONACEM board, two by SCDV and two by ASOFAMECH. Three dermatologists haveformed part of this commission from its outset and to this day: Rubén Guarda as president,Manuel Melis for SCDV and Juan Honeyman for ASOFAMECH. The other two membershave rotated and have been, for SCDV, Julia Oroz and Félix Fich, and forASOFAMECH, Daniel Villalobos, Mirtha Cifuentes and María Luisa Pérez-Cotapos. Up toSeptember 2004 this commission had accredited 179 doctors as specialists in Dermatologyand Venereology.As no law on specialized fields exists in Chile, accreditation by CONACEM is the onlyprocess attaining legitimacy vis-à-vis private health institutions, universities and tradeand scientific medical associations. Only the Health Ministry has been reticent to legitimatethese accreditations and to demand them to fill the posts of specialists at publichospitals, mainly due to a contingent policy, namely that of retaining the possibility of167