Rotation Title: Dermatology
Faculty Chair: Clark Alves, MD
Additional Contacts: Andrew Ondo, MD; James Kerner, MD, PhD; Tiffany Autry, DNP
ACGME Program Requirements (see IV.C.)
IV.C.16. Residents must have experience in diagnosing and managing common dermatologic conditions.
Goal: The overall goal of the Dermatology curriculum is to provide residents with the necessary foundation for diagnosis and management of common skin conditions in both adults and children, including in patients of color. This foundation shall include competency in dermoscopy and the performance of cryotherapy, shave and punch biopsies. The resident should also have a firm understanding of how to perform a full body skin examination and when to refer for specialty dermatologic care.
Expectations for Residents and Faculty (if beyond those outlined in resident manual):
Deliverables (if applicable): The resident will read the AAFP articles listed below and submit three learning points from each article (there are 14 articles, residents are encouraged to ready 1 article per day during a 2-week rotation or 1 article every other day during a 4-week rotation). Residents must log at least 10 shave biopsies, 10 punch biopsies and 5 cryotherapy treatments in New Innovations by the end of the curriculum. The resident will watch the videos on proper performance of a shave and skin biopsy before the first day of the rotation. These procedures can be either observed or performed. The resident will also demonstrate competency in the use of dermoscopy for determining if a lesion requires biopsy for further evaluation of malignant potential. Finally, the resident will properly demonstrate systematic performance of the annual full body skin exam.
Competency-Based Education
ACGME Program Requirements (see IV.B.)
| Objective (competencies) | Educational Strategies | Assessments |
| By the end of the rotation, the resident will demonstrate adequate understanding of common dermatologic conditions (MK) | Reading AAFP articles listed below and submission of three learning points to the faculty chair from each of the AAFP articles. Clinical teaching by faculty. | Review of faculty evaluation of medical knowledge. |
| By the end of the rotation, the resident will demonstrate competency in performing punch biopsies, shave biopsies and cryotherapy, including discussion of risks and benefits of this procedure with the patient (PC, ICS) | Performance or observation of 10 punch biopsies, 10 shave biopsies and 5 cryotherapy treatments with the community preceptor (be sure to watch video on punch biopsies before the rotation). | Review of procedure logs in New Innovations. Review of faculty evaluation of patient care and interpersonal skills and communication. |
| By the end of the rotation, the resident will demonstrate competency in the use of dermoscopy for determining if a lesion requires biopsy for further evaluation of malignant potential (PC) | Performance of dermoscopy with the community preceptor and reading AAFP article on dermoscopy. | Community preceptor will complete and sign a competency evaluation of the resident’s ability to use dermoscopy to reliably determine need for biopsy. Resident will submit this evaluation to the faculty chair by the end of the rotation (see page 5 below). |
| By the end of the rotation, the resident will demonstrate competency in the systematic, thorough and professional performance of the annual skin exam, including proper draping of the patient and use of a chaperone (PRO, ICS) | Performance of annual full body skin exams with the community preceptor. | Community preceptor will complete and sign a competency evaluation of the resident’s ability to appropriately perform a full body skin exam. Resident will submit this evaluation to the faculty chair by the end of the rotation (see page 5 below). |
| By the end of the rotation, the resident will be able to articulate the role of health disparities in determining outcomes of dermatologic care, including the importance of management of common conditions by primary care providers in underserved communities (SBP) | Reading AAFP article on Common Dermatologic Conditions in Skin of Color. | Review of faculty evaluation of systems-based practice. |
| By the end of the rotation, the resident will demonstrate the ability to interact with medical assistants, nurse practitioners, physician assistants and physicians, and understand their respective roles within the specialty of dermatology (PRO, SBP, ICS) | Interaction with multiple health care professionals at the rotation site. | Review of faculty evaluation of professionalism, systems-based practice and interpersonal skills and communication. |
| By the end of the rotation, the resident will demonstrate a commitment to personal growth in the competencies listed above (PBLI) | Clinical teaching and feedback from the community preceptor. | Review of faculty evaluation of practice-based learning and improvement. |
Resources:
https://www.youtube.com/watch?v=nbdmmukko4s (video on shave biopsy, watch before first day of rotation)
https://www.youtube.com/watch?v=gd7j-wYwryY (video on punch biopsy, watch before first day of rotation)
Link to AAFP articles on Skin Conditions (read the articles listed below and submit three learning points to the faculty chair from each article by end of the rotation): https://www.aafp.org/pubs/afp/topics/by-topic.skin-conditions.html#aafp:publications/afp/topics/skin-conditions/nail-disorders
Dermoscopy for the Family Physician
Basal Cell and Cutaneous Squamous Cell Carcinomas: Diagnosis and Treatment
Clinical Diagnosis of Melanoma (Point-of-Care Guide)
Management of External Genital Warts
Treatment of Nongenital Warts (FPIN’s Clinical Inquiries)
Acne Vulgaris: Treatment Guidelines from the AAD (Practice Guidelines)
Common Skin Rashes in Children
Pruritis: Diagnosis and Management
Annular Lesions: Diagnosis and Treatment
Common Dermatologic Conditions in Skin of Color
Dermatologic Emergencies
Evaluation of Nail Abnormalities
Hair Loss: Common Causes and Treatment
Common Skin Conditions During Pregnancy
Resident Evaluation of Competency in Dermoscopy
How confident are you in the resident’s ability to consistently use dermoscopy to determine which skin lesions require biopsy for further evaluation of malignant potential? (a score of at least 4 is required to meet this competency)
1 2 3 4 5
Resident Evaluation of Competency in Performing an Annual Full Body Skin Exam
How confident are you in the resident’s ability to consistently use a systematic and thorough approach to the full body skin exam? (a score of at least 4 is required to meet this competency)
1 2 3 4 5
How confident are you in the resident’s ability to consistently use proper draping and an appropriate chaperone during the full body skin exam? (a score of at least 4 is required to meet this competency)
1 2 3 4 5
How confident are you in the resident’s ability to consistently identify lesions that require dermoscopy, close follow-up and/or biopsy during the fully body skin exam? (a score of at least 4 is required to meet this competency)
1 2 3 4 5
Community preceptor signature: __________________________________________
SNMFMRP Curriculum 