Learning From a Leader: An Interview With Jean L. Bolognia, MD

As senior editor of the current seminal textbook in dermatology, Dermatology, Jean L. Bolognia, MD, has a special place in the hearts and minds of dermatology residents, both past and present. Early on in our training, we learn that a surefire way to quickly win a debate is to start your counterargument with, “Well, Bolognia says. . . .” This respect is well garnered, as Dr. Bolognia’s book has helped elucidate difficult diagnostic and therapeutic concepts to dermatology trainees with coherent diagrams and clearly written text. It is a must-read during one’s formative education. Dr. Bolognia currently serves as professor in dermatology and vice chair of clinical affairs at Yale University in New Haven, Connecticut. During her visit to the State University of New York at Stony Brook (Figure), I sat down with Dr. Bolognia for an interview.

^{State University of New York at Stony Brook residents with guest lecturer, Jean L. Bolognia, MD (left to right): Daniel Lozeau, MD; Nika Finelt, MD; Roman Bronfenbrener, MD; Jean L. Bolognia, MD; Sara Moghaddam, MD; Yoojin Lee, MD; Antonia Fthenakis, MD; and Lisa Anthony, MD.}

BRONFENBRENER: The dermatology textbook is broad and expansive. What inspired you to start this project?

BOLOGNIA: I’ll divide my answer into 2 parts: why I thought a new textbook was needed and how it came to be. At the time, I felt that many of the current comprehensive textbooks were too daunting for a first-year resident. I felt that in order to teach skin biology, for example, you needed to simplify it. The goal was simplification, at least in terms of how the content was explained to the novice reader, without sacrificing sophistication. I do believe that you need to understand basic science in order to understand the breakthroughs that will occur during your career. However, if the content is confusing or too many details are presented without schematics, at the end of the reading you are not learning. So, I wanted to teach concepts à la Scientific American, where an initial review of the schematics then makes the text much easier to understand. I thought that was a very important way to teach skin biology.

As for my early involvement in the book, I had previously organized a Web-based curriculum for medical students for the American Academy of Dermatology, which was divided into approximately 20 disease chapters, each 2 to 3 pages in length. I made sure the templates were simple and straightforward so that the authors could complete the assigned task within 2 to 3 hours. My invitation to be an editor came from the publisher based upon recommendations from some of those authors. Of note, that medical student curriculum has since been revised and is now much more refined than the original—we were version 1.0!

A few months earlier, Ron (Ronald) Rapini had approached [the publisher] with an outline for a comprehensive dermatology textbook and the publisher became interested in pursuing such a project. Joe (Joseph) Jorizzo was then asked to be the third editor. However, there was stiff competition, as we were going up against the established Fitzpatrick’s textbook. It was important to have a different approach and I was lucky that Julie Schaffer was a dermatology resident in our program at that time and she provided great critiques of the chapters.

BRONFENBRENER: When did you first realize the book was a hit?

BOLOGNIA: Well, it was fairly easy; I knew the sales numbers! That said, I think people were looking for something new and fresh. I remember one of the early reviewers likening us to USA Today! I think the Key Features were very important in making the book a success because they give first-year residents a sense of control when reading about a disease they have never heard about before. The first 6 months of dermatology residency are incredibly difficult because you need to incorporate words you never used before to talk about diseases you’ve never heard of before. I think one of my most meaningful experiences was when I visited South Africa and a young resident approached me who had photocopied the entire book and put it into individual binders so as not to desecrate his pristine original copy by writing in the margins, or underlining and highlighting. Something else I am proud of is that even if you are in a resource-poor country, you can read the book and can be on equal footing with any dermatologist from countries around the world, including ours. In other words, it is an educational equalizer.