All Dermatopathology fellows, regardless of prior training, complete the following rotation:
The fellow spends, on average, one half of each weekday, during the first eight months, evaluating dermatopathology specimens and reviewing these specimens with a faculty dermatopathologist from 9:00am-12:00pm. Ample time is allotted for the fellow to preview cases in the afternoon and morning. During the last four months, the fellow devotes their entire time to dermatopathology, honing their ability to draft concise, clinically actionable final reports.
The fellow works with all dermatopathology faculty members in developing an original research project with the goal of publishing the results as a manuscript in a peer-reviewed journal. The fellow is responsible for collecting and interpreting data, presenting an abstract as a platform at a national meeting, drafting the manuscript, and making the appropriate revisions to ensure that it is acceptable for publication. Fellows, regardless of their career plans, have the option to present their research to the department(s) in an expanded lecture format. The fellow, while drafting the final manuscript, will temporarily be excused from all activities besides tumor boards, teaching, and grand rounds at the discretion of the program director.
The curriculum path for the dermatopathology fellow is based on whether the fellow has completed residency in Pathology or Dermatology.
The pathology-trained fellow shadows our experienced dermatologists with the aim of seeing a wide variety of dermatologic disease manifestations. The fellow gains insight into the clinical diagnosis and treatment of specific dermatologic illnesses by shadowing specialists in general adult dermatology, pediatric dermatology, Mohs micrographic surgery, melanoma and pigmented lesions, high risk non-melanoma skin cancers, cutaneous lymphoma, contact dermatitis and occupational dermatology, rheumatologic dermatology, and inpatient consultations.
The dermatology-trained fellow shadows highly subspecialized pathologists with the aim of seeing a variety of disease manifestations across all organ systems. There is often one-on-one time spent at the microscope with expert diagnosticians in the fields of breast, cardiothoracic, ENT, gastrointestinal, genitourinary, gynecologic, pediatric, hematologic, and bone and soft tissue pathology. The fellow will observe gross dissection of a variety of anatomic pathology specimens; however, their aim is to see as much and as diverse an array of cases under the microscope as possible. Study sets, reference materials, and quizzes are also available to gauge knowledge and progress.
Hematopathology and Flow Cytometry
The dermatology-trained fellow assists in the interpretation of bone marrow biopsies and aspirations, blood smears, and Wright's stained body fluids. Fellows also gain exposure to flow cytometry, which is integrated into the diagnosis and interpretation of the daily hematopathology sign-out. Study sets, reference materials, and quizzes are also available to gauge knowledge and progress.
The dermatology-trained fellow gains experience in preparation and interpretation of gynecological and non-gynecological cytopathology specimens in order to appreciate the importance of cytomorphology in the general practice of pathology. The fellow is required to review 200 cases.
Histology and Immunohistochemistry Laboratory
The dermatology-trained fellow familiarizes with the operation of a large histology and immunohistochemistry laboratory, which includes developing an appreciation for laboratory workflow, tissue processing machines (e.g. automated staining procedures), quality assurance, quality control, and quality improvement.
The dermatology-trained fellow receives a general introduction to bacteriology, mycology, parasitology, virology, serology, and automation in a clinical microbiology setting. Topics include the interpretation of growth on various media, smear interpretation, automation, antibiotic sensitivity testing, quality assurance, and serologic testing. A set of case-based study questions are provided to guide reading. Daily laboratory rounds with the Medical Director and Supervisor include the discussion of interesting findings and their clinical correlations.
The dermatology-trained fellow gains exposure in our Clinical Genomics and Advanced Technologies (CGAT) laboratory to the basic techniques associated with nucleic acid-based diagnostic testing, including but not limited to: DNA isolation, restriction enzyme analysis, electrophoresis, Southern blotting, polymerase chain reaction, DNA sequencing, and hybrid capture. Fellows learn how molecular testing is used to diagnose oncologic, infectious, and genetic diseases.
The dermatology-trained fellow develops exposure to gross and microscopic post-mortem pathology by observing in the techniques of autopsy dissection, preparation of sections, evaluation of microscopic slides, and interpretation and clinico-pathologic correlations.
Sample block schedule
The Dermatopathology Fellow participates in regularly scheduled lectures, tutorials, seminars, and conferences.
|Cutaneous Lymphoma Tumor Board||Monthly|
|Dermatology Grand Rounds||Bi-Monthly|
|Melanoma Tumor Board||Bi-Monthly|
|Pathology & Laboratory Medicine Grand Rounds||Monthly|
|Anatomic Pathology Didactic Conference||Weekly|
|Clinical Pathology Seminar||Weekly|
Successful and qualified candidates may apply to combine their fellowship with the Dartmouth-Hitchcock Leadership Preventive Medicine Residency (DHLPMR) leading to a Master’s in Public Health from The Dartmouth Institute for Health Policy and Clinical Practice (TDI) and to gain knowledge and skills in the measurement of outcomes and the leadership of change and improvement in healthcare systems. For more information visit Leadership in Preventative Medicine Residency.