I read with interest the cover story for the November issue of Skin & Aging titled “Pediatric Dermatology Comes of Age.”

As a practicing pediatric dermatologist of 22 years, I would like to point out that the “grandmothers” and “grandfathers” of pediatric dermatology who are not board certified are ineligible to sit for the pediatric dermatology boards. This is not because of perceived lacunae in knowledge or training but instead because the new boards are offered under the aegis of the American Board of Dermatology, and not pediatrics.

Although fully trained in dermatology, I chose not to take the boards many years ago, believing that two board certifications (pediatrics and medical genetics) were enough for anyone’s curriculum vitae or budget.

If a board examination is truly a meaningful indicator of fitness to practice, then any physician should be able to sit for it, irrespective of training. If training is the issue, then a board examination should be superfluous.

Pediatric dermatology boards are looking to fix a problem that isn’t broken. Although I applaud the efforts of my colleagues to establish themselves in a recognized subspecialty because there are some benefits, I am concerned that some of us “baby doctors” are at risk to go out with the bath water.

Virginia P. Sybert, M.D., Clinical Professor
Division of Medical Genetics
Department of Medicine, University of Washington
Staff Physician, Dermatology
Group Health Permanente

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