AROUND THE WORLD IN 80 DAYS
Dr. Nancy Emmanuel is originally Lebanese and studied medicine at the Lebanese American University in Beirut. After graduating, she moved to Brazil where she is a second-year dermatology resident at Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo. In addition to being a dermatology resident, she is also a PhD candidate, and her thesis is about genetic profiling of melanoma patients with a higher skin Fitzpatrick phototype and no other risks for melanoma.
Q. Why did you choose to pursue dermatology? What excites you about it?
I love dermatology because of how diverse it is in terms of practice. During the same working day, a dermatologist might attend to severe bullous pemphigoid and admit them to the hospital, apply botulinum toxin or hyaluronic acid fillers on a 26-year-old who wants to prevent ageing and feel more confident about her looks, diagnose leprosy from a hypopigmented lesion that could have gone unnoticed, surgically excise a skin cancer, suspect internal cancer due to paraneoplastic skin manifestations, biopsy a lesion to elucidate diagnosis, etc.
From challenging and severe cases that need multidisciplinary care, to simply attending to aesthetic complaints and making people feel better in their skin, a dermatologist can play an essential role in patients’ lives, no matter their age or gender!
I also love the fact dermatologists can accompany patients throughout their life stages, and although their main tools to make a change are their eyes and memory, dermatologists also have so many technologies to rely on, from laser to radiofrequency and more! What truly excites me about this speciality is how fast it is evolving and how broad it is! There is so much to learn, so many research areas to contribute to and a huge difference to make!
Q. What does a day in the life of a dermatologist in Brazil look like?
As a dermatology resident, I am always rotating in different subdivisions of the dermatology department at Hospital das Clínicas of the University of São Paulo, the institution where I’m training. Because this is the biggest hospital complex in Latin America and a reference centre for dermatology ranks 16th worldwide, our experience is not that of typical dermatology residencies. Our department has more than 25 subdivisions in its outpatient clinics, and an average of 300 patients circulate daily in these subdivisions, so it can get very busy and hectic for us as residents!
For example, in my current rotation, I attend patients in the Contact Dermatitis subdivision on Monday mornings, Lymphomas on Tuesday mornings, Autoimmune Bullous Diseases on Wednesday mornings, and so on. We are assigned to different subdivisions throughout the week depending on our rotation. We usually attend to patients in one subdivision in the morning and another in the evening. We also have our histopathology subdivision during which we perform our patients’ biopsies, process them and read them as well as our surgical subdivision with simple as well as complex surgeries including Mohs micrographic surgery. Moreover, we yearly rotate in our dermatology wards which have a bed capacity of 30 patients so we can provide care to more complicated cases that often need multidisciplinary attention. During our last year of residency, we must provide care to patients admitted in other wards through our hospital consultation system and attend to patients with dermatology complaints in a hospital complex with more than 3000 beds! It can be very demanding but is so rewarding in terms of our education! On top of all that practical experience, we have almost daily lectures and regular exams to test our knowledge constantly as well as weekly department meetings where we discuss more challenging cases along with all our professors and our chairmen.
Q. You are the founder of the Medical Students’ Advisory Board (MSAB) under the International Journal of Clinical Research. What motivated you to expand the idea of undergraduate research at a global level?
When I was a student, it was hard to secure research opportunities, and as someone who wanted to get into dermatology which is a competitive speciality, I needed to enrich my curriculum vitae. The International Journal of Clinical Research gave me a chance to make the life of medical students easier, by founding the Medical Students Advisory Board. The idea wasn’t mine, but as soon as I heard about it, I wanted to be part of it!
Q. Can you take us through the expansion of MSAB through the years?
The MSAB went from 6 students and one chapter to more than 150 students from more than 40 countries divided into more than 10 chapters, thus providing an enriching experience for medical students all over the world, from educational webinars to networking opportunities, regular journal clubs and most importantly a research skills course along with valuable research opportunities. It grew so fast due to all the hardworking people contributing daily to making it better.
Q. We’d love it if you could share a fond memory or any event that you considered a milestone in your career as a dermatologist till now.
Well, I have to say that my first milestone was learning a whole new language and being able to get into such a competitive program of dermatology! When I was a medical student, it was important for me to train in an institution where I will get the chance to see a huge number of patients. Confucius said “I hear, and I forget. I see and I remember. I do and I understand”, so I wanted to make sure that the building blocks of my career are based on doing and not just studying. Since Lebanon, my country of origin is such a small country, I wouldn’t have had anything close to this experience there, so I am very grateful to be here every day. Another milestone is one of our recent successes at MSAB, which was getting six of the abstracts which I’ve mentored and were written by more than 20 MSAB students, accepted at the conference of the European Academy of Dermatology and Venereology. I felt so happy that I contributed to such an important international event in my field but even more so to see all those bright medical students shine and grow!
Q. What message would you want to give to an aspiring dermatologist?
Getting into dermatology may feel challenging, but if you love this speciality and cannot see yourself in any other field, do not give up on your dream. When there is a will, there is a way! Keep your eyes open to opportunities that can help you stand out among applicants, and feel free to reach out for any advice! Not very long ago, I was in your shoes, I know you’re fighting, trust me, it’s worth it!
Soon after I got accepted into residency, standing in front of the Faculty of Medicine of the University of São Paulo USP.
The Edurank of USP for Dermatology
Presenting one of my challenging cases in the weekly department meetings
At my first-ever dermatology conference
The 6 studies which were accepted at the EADV conference