The dermatology
experience is conducted in the PGYIII year and is comprised of a
two-week rotational block with a clinical faculty member on the
dermatology service in an outpatient private-practice clinic setting.
The rotational goal is to familiarize the resident physician to the most
common diseases of the skin that are encountered in an outpatient
clinical setting and to instruct the resident on the principles of
treatment of these common disease states. Residents in all three years
of training will also receive a longitudinal experience in the diagnosis
and management of common skin maladies in their continuity clinics
within the FMC and will gain experience in common dermatologic
procedures during the monthly Dermatologic Clinics taught by Dr. James
Wharton at his outpatient clinic and the weekly Surgical Clinics
instructed by Dr. Wayne Hudec at the FMC's.
Goal
I: To achieve competence in
diagnosing and managing common dermatological conditions as appropriate
for the Family Physician
Goal II: To achieve competence in
recognizing and referring complex dermatological disorders
Patient Care
Goal
Residents must be able to provide patient care that is
compassionate, appropriate, and effective for the treatment of health problems
and the promotion of health. Residents are expected to:
Competencies
Learn to diagnose and treat a variety of common skin diseases.
Advocate common practices to prevent the development of dermatologic disease.
Learn procedural techniques used in diagnosing and treating skin disorders.
Objectives
The resident physician will:
Learn to distinguish and classify skin lesions based on
appearance; including papular, macular, pustular, vesicular, bullous, and
urticarial lesions by the end of the rotational block.
Learn to recognize and diagnose benign, pre-malignant, and
malignant neoplasms of the skin including: actinic keratoses, seborrheic
keratoses, basal cell carcinomas, squamous cell carcinomas, malignant melanoma,
and metastatic skin lesions.
Become familiar with various infectious diseases of the skin
including: fungal, bacterial, viral, and parasitic disease entities.
Become familiar with both systemic and topical drug delivery
methods to treat skin disorders.
Demonstrate proficiency in basic principles of skin biopsy
techniques and have the opportunity to perform such procedures under the
supervision of their Dermatology preceptor.
Learn the proper technique of incision and drainage of a skin
abscess.
Educate their patients regarding preventative measures to reduce
the incidence of skin diseases (such as use of sunscreen, avoiding tanning beds
to prevent skin cancer) during health maintenance visits.
Provide patients with a thorough skin examination during health
maintenance visits.
Medical Knowledge
Goal
Residents must demonstrate knowledge of established and
evolving biomedical, clinical, epidemiological, and social-behavioral sciences,
as well as the application of this knowledge to patient care. Residents
are expected to become familiar with:
Competencies
Psoriasis
Pityriasis Rosea
Acne Vulgaris
Acne Rosacea
Fungal infections of the
skin (Candida, Tinea)
Lichen planus
Impetigo
Varicella/Herpes zoster
Herpes Simplex
Urticaria
Cellulitis/ Skin Abcess
Actinic Keratoses
Seborrheic Keratoses
Basal Cell Carcinoma
Squamous Cell Carcinoma
Malignant Melanoma
Drug eruptions
Parasitic disease of the skin (scabies)
Atopic Dermatitis
Contact Dermatitis (poison ivy)
Objectives
Learn to recognize and
treat common papulosquamous disorders: Psoriasis, Pityriasis Rosea,
Acne vulgaris, Lichen planus, Miliaria, seborrheic dermatitis, and
fungal infections of the skin (candida, tinea).
Learn to recognize and
treat common vesiculobullous disorders: Impetigo, Herpes simplex,
Herpes Zoster, Varicella.
Learn to recognize and
treat Dermatitis/Eczema including: contact, atopic, exfoliative,
nummular, stasis, diaper rash.
Learn to recognize and treat Pre-malignant and Malignant skin disorders:
Actinic Keratoses, basal cell carcinoma, squamous cell carcinoma, and malignant
melanoma.
Learn to recognize skin lesions due to systemic medications or treatments.
Recognize and treat
cutaneous infections: bacterial (impetigo, erysipelas, lymphangitis,
cellulitis,
Recognize and treat hair
disorders including: fungal infection, non-scarring alopecia,
scarring alopecia, and hypertrichosis (local and generalized).
Practice- Based Learning and Improvement
Goal
Residents must demonstrate the ability to investigate and
evaluate their care of patients, to appraise and assimilate scientific
evidence, and to continuously improve patient care based on constant
self-evaluation and life long learning. Residents are expected to develop
skills and habits to be able to :
Competencies
Identify strengths, deficiencies and limits in one's knowledge and expertise;
Objectives
The resident will recognize the need for proper referral and consultation to a
specialist for those dermatological diseases that are beyond his/her
capabilities.
Systems Based Practice
Goal
Residents must demonstrate an awareness of and responsiveness
to the larger context and system of health care, as well as the ability to call
effectively on other resources in the system to provide optimal health
care. Residents are expected to:
Competencies
Work effectively in various health care delivery settings and systems relevant
to their clinical specialty
Objectives
The resident will gain and understanding of the delivery of care to the
dermatology patient and be able to recognize and perform measures that will
expedite the care of the patient within the healthcare delivery system.
Specifically, the resident will become familiar with diagnostic procedures
(such as skin biopsy) to confirm the diagnosis and expedite the care of
patients with confirmed skin malignancies.
Professionalism
Goal
Residents must demonstrate a commitment to carrying out
professional responsibilities and an adherence to ethical principles.
Residents are expected to demonstrate:
Competencies
Compassion, integrity, and respect for others
Objectives
The resident will be sensitive to concerns by their patients
regarding skin disorders and address all concerns in a timely manner. The
resident is expected to take time to educate their patients about the
prevention of skin disorders in their continuity practice.
Interpersonal and Communication Skills
Goal
Residents must demonstrate interpersonal and communication
skills that result in the effective exchange of information and teaming with
patients, their families, and professional associates. Residents are
expected to:
Competencies
Communicate effectively with other physicians, staff, patients, and families.
Teaching Methods
Direct preceptor-resident interaction which may involve
didactic lectures, role-modeling, and case-based learning. Also, monthly
Dermatologic Clinics are taught by Dr. James Wharton at his outpatient clinic
and the weekly Surgical Clinics are instructed by Dr. Wayne Hudec at the FMC's.
Assessment Method
At the conclusion of each resident rotation, the residency coordinator sends a formative-type, rotation-specific performance evaluation form to the rotations' supervising physician. When the completed evaluation is returned, the resident physician and the resident's faculty advisor review the evaluation and attest to reviewing it by signing/initialing the form. Next, the program director reviews and attests to the document. Once all three have reviewed and attested the evaluation, it is included in the resident's permanent file.
Each resident is asked to evaluate the rotation and supervising physician(s) at the end of the rotation. The resident's faculty advisor and program director review the evaluation and attest to reviewing it by signing/initialing the form. These evaluations are filed together by resident year.
