- Contact and Occupational Dermatology Clinic
- Cosmetic Dermatology Clinic
- Cutaneous Lymphoma Clinic
- Dermatology/Rheumatology Clinic
- Mohs and General Dermatologic Surgery Clinic
- Pediatric Dermatology Clinic
- Pediatric Dermatology CHAD Pain Free
- High Risk Skin Cancer Clinic
First year residents have a smaller number of patients in their continuity clinic in the beginning of the year (4 patients), and increased number of patients by mid-year (6 patients) and end of year months (8 patients). First year dermatology residents also spend time in the patch testing clinic, pediatric dermatology, high-risk skin cancer and cutaneous lymphoma clinics. The first year residents attend and work in continuity clinic at the Veteran’s Administration Medical Center. Towards the final portion of the first year, the resident spend 2 months on a procedural rotations which incorporates cosmetic, surgical and lasers patients.
Second year residents spend six months on the dermatopathology service which is joined with the inpatient service. In the mornings, time is spent reviewing and discussing current pathology slides from the heater road clinic as well as outlying clinics. The afternoon is spent in consensus conference discussing difficult pathology cases with multiple attendings. The resident is responsible for any new and old consults patients as they are called in and rounds with the attending in the late afternoon. Second year residents also spend 2 months on the Mohs service, where they are incorporated into the clinic and have an immersive team experience. The Float rotation is also a part of the second year and is intended to be used for away rotations, filling in gaps in education and completing QI projects.
The third year residents spend time on three main rotations. The clinic rotation offers an ideal opportunity for them to excel in the tasks of addressing chief complaints, performing a physical examination, providing counseling and education, and development of an appropriate management plan. Faculty supervision/preceptorship and nursing assistance are readily available during each clinic session. Early in the rotation the preceptor monitors the third year resident’s schedule and case mix carefully to ensure that the more complicated or difficult patient visits are directly staffed. As the year advances, third year residents tend to seek less direct staff involvement so that they can achieve those “last bits” of readily available structured learning opportunity. However, the third year resident is encouraged to present cases involving more complicated or high-risk medical or surgical dermatologic problem, or any sort of evaluation or management question to them. At this point in their training the third year resident has achieved the training, experience and competence to manage most dermatologic presentations without the director preceptor involvement. We strongly advise our third year residents to seek the attending involvement for all visits presenting more challenging problems, diagnosis or management questions, patients being treated with major immunosuppressive therapy and biologics, patients with numerous nevi or questionable pigmented lesions. This allows for appropriate independence in the third year, while providing the resident with teaching or guidance when needed, and also a clarification of the types of cases the faculty expects even third year residents to consult on. The attending encourages the residents to discuss cases with them while the patient is in clinic; all resident patient care notes are reviewed by the responsible precepting attending. Two months are spent on the Mohs service where they take on a more advanced role within the team. Four months are spent on the outpatient consult service where the resident spends the morning seeing continuity patients and the afternoon is scheduled to allow same day appointments. The resident is responsible for phone calls from clinics and physicians interested in having patients seen urgently. The final few months are spent on the float rotation which allows for filling in gaps that might have come about due to schedule changes or absences and allows for completion of QI projects and manuscripts.
At all resident training levels, the attending encourages the resident to involve them in any or all aspects of their care. All documentation of visits is reviewed by the precepting staff. Feedback on documentation or other visit detail is given either directly or by written comments electronically routed back to the resident for their consideration.