Developing dermatopathology in Cambodia

Advancing Dermatopathology in Cambodia: The Residency Program at Preah Kossamak Hospital

 Introduction

 Cambodia’s healthcare system has made significant strides in recent decades, yet specialized fields like dermatopathology remain underdeveloped. Preah Kossamak Hospital in Phnom Penh has emerged as a pivotal institution in addressing this gap, establishing the country’s only dermatology residency program. Under the leadership of Professor Sithach Mey, the hospital has become a cornerstone for dermatological education and care in Cambodia.  

 The Dermatology Residency Program

 Established in 2008 with support from German institutions, the dermatology department at Preah Kossamak Hospital offers a comprehensive training program. Residents undergo a structured curriculum that includes rotations in various departments, such as the National Centre for HIV, AIDS, Dermatology and STDs, and the Leprosy Rehabilitation Centre Khien Khleang. Some residents also have opportunities for further training in France and Vietnam.  

 The program emphasizes both theoretical knowledge and practical skills, preparing graduates to address the diverse dermatological needs of Cambodia’s population. However, the subspecialty of dermatopathology is still in its nascent stages, with no formally trained dermatopathologists in the country. Currently, there is a basic light microscope with integrated camera that produces low-resolution digital images. This severely limits collaboration with volunteer dermatopathologists around the globe. 

 The Need for Enhanced Dermatopathology Infrastructure

 Accurate diagnosis of skin diseases often relies on histopathological examination. Currently, the lack of advanced equipment hampers the ability to provide precise diagnoses and limits educational opportunities for residents. Upgrading the dermatopathology infrastructure is essential for several reasons:

1. Improved Diagnostic Accuracy: Modern microscopes and imaging systems enable detailed examination of skin biopsies, leading to more accurate diagnoses.
2. Enhanced Educational Experience: High-quality imaging allows residents to study a wide range of dermatopathological conditions, fostering deeper understanding and expertise.
3. Facilitated Collaboration: Digital scanning software enables the sharing of cases with international experts, promoting collaborative diagnosis and learning.

 Proposed Equipment Upgrades

 To achieve these goals, the following equipment upgrades are proposed:

• Advanced Microscope: A high-resolution microscope with digital capabilities will allow for detailed examination and image capture.
• Digital Camera System: Integrating a camera with the microscope will facilitate the documentation and sharing of cases for educational and consultative purposes.
• Slide Scanning Software: This software will enable the digitization of slides, allowing for remote consultations and the creation of a digital archive for teaching. Microvisioneer is a pioneer in the field. There scanning software and supporting hardware off resolution and transmission on par with fixed slide scanners at several times the price.

 Impact on Dermatology and Pathology in Cambodia

 Implementing these upgrades will have a profound impact on both dermatology and general pathology in Cambodia:

• Elevated Standards of Care: Enhanced diagnostic capabilities will lead to better patient outcomes through accurate and timely diagnoses.
• Strengthened Education and Training: Residents will gain hands-on experience with advanced tools, preparing them for independent practice and potential subspecialization.
• Foundation for Fellowship Training: With improved infrastructure, the hospital will inspire residents to pursue fellowship training in dermatopathology abroad. A returning fellow would be able to coordinate with existing pathology resources and further develop this specialized area of diagnostics in the Kindgom of Cambodia.