Dermatology Curriculum

Department: Internal Medicine

Faculty Coordinator: Peter Hino, M.D.

Hospital: Texas Health Presbyterian Hospital Dallas

Periods offered: All

Length: 2 Weeks (unless otherwise approved by a dermatologist for a 4 week rotation)

Max no. of residents: 1

First Day Contact: Toni Essary - (214) 739-5821

First Day Time: 8:00 am

First Day Place: 8230 Walnut Hill Lane, Suite 500

Requirements: Hours: Monday thru Friday 8:00 am - 5:00 pm

Vacation: No Vacation (Unless it is approved for a 4 week rotation then you can request 1 week vacation)

1. Course Description:

Residents will participate in a busy office-based dermatological practice. During this time they will be exposed to the evaluation and management of a multitude of dermatology disorders. They will learn to appropriately use shave biopsy and cryotherapy. They will know when to appropriately refer patients for dermatologic consultation.

2. Course Goals and Objectives: (based on ACGME competencies for resident education)

Residents are expected to provide care that is compassionate, appropriate and effective for the promotion of health, prevention of illness, treatment of disease and at the end of life.

• Gather accurate, essential information from all sources, including medical interviews, physical examinations, medical records and diagnostic/therapeutic procedures. Examples: Residents are expected to take an accurate dermatological and medical history and perform and accurately describe the dermatological physical exam.

• Make informed recommendations about preventives, diagnostic and therapeutic options and interventions that are based on clinical judgement, scientific evidence, and patient preference. Examples: Residents are expected to accurately identify the lesion, form a diagnosis and recommend appropriate diagnostic and therapeutic options for the common dermatological disorders.

• Develop, negotiate and implement effective patient management plans and integration of patient care. Examples: Arrange for appropriate outpatient follow-up and treatment.

• Perform competently the diagnostic and therapeutic procedures considered essential to the practice of internal medicine. Examples: Perform skin biopsies and cryotherapy and know the indications and contraindications medications for each.

Residents are expected to demonstrate knowledge of established and evolving biomedical, clinical and social sciences, and the application of their knowledge to patient care and the education of others.

• Apply an open-minded, analytical approach to acquiring new knowledge. Examples: Read about dermatological disease seen in the clinic the day prior.

• Access and critically evaluate current medical information and scientific evidence. Examples: Use web-based information systems.

• Develop clinically applicable knowledge of the basic and clinical sciences that underlie the practice of internal medicine. Examples: Resident will demonstrate understanding the biology of the skin, the physiology of the skin and the pathophysiology of diseases of the skin.

• Apply this knowledge to clinical problem-solving, clinical decision-making, and critical thinking. Examples: Knowing the pathophysiology and natural history of a dermatological disease such as psoriasis, prepar an appropriate management plan.

Residents are expected to be able to use scientific evidence and methods to investigate, evaluate, and improve patient care practices:

• Identify areas for improvement and implement strategies to enhance knowledge, skills, attitudes and processes of care. Examples: Implement a strategy to facilitate the chronic care of patients with chronic skin conditions such as psoriasis and eczema.

• Analyze and evaluate practice experiences and implement strategies to continually improve the quality of patient practice. Examples: Education of patients regarding skin cancer and prevention.

• Develop and maintain a willingness to learn from errors and use errors to improve the system or processes of care.

• Use information technology or other available methodologies to access and manage information, support patient care decisions and enhance both patient and physician education. Example: Use of information technology to maintain up-to-date management of skin disorders including melanoma, other dermatological neoplasms, and psoriasis.

Residents are expected to demonstrate interpersonal and communication skills that enable them to establish and maintain professional relationships with patients, families and other members of health care teams.

• Provide effective and professional consultation to other physicians and health care professionals and sustain therapeutic and ethically sound professional relationships with patients, their families, and colleagues.

• Use effective listening, nonverbal, questioning, and narrative skills to communicate the patients.

• Interact with consultants in a respectful, appropriate manner.

• Maintain comprehensive, timely, and legible medical records. Use of pictures and documentation of skin disorders and progression.

Residents are expected to demonstrate behaviors that reflect a commitment to continuous professional development, ethical practice, an understanding and sensitivity to diversity and a responsible attitude toward their patients, their profession, and society.

• Demonstrate respect, compassion, integrity, and altruism in relationships with patients, families, and colleagues. Examples: Demonstrates desire to evaluate the patient, develop a differential, plan a treatment course and communicate it to the patient.

• Demonstrate sensitivity and responsiveness to the gender, age, culture, religion, sexual preference, socioeconomic status, beliefs, behaviors and disabilities of patients and professional colleagues.

• Adhere to principles of confidentiality, scientific/academic integrity, and informed consent.

• Recognize and identify deficiencies in peer performance.

Residents are expected to demonstrate both an understanding of the contexts and systems in which health care is provided, and the ability to apply this knowledge to improve and optimize health care.

• Understand, access and utilize the resources, providers and systems necessary to provide optimal care.

• Understand the limitations and opportunities inherent in various practice types and delivery systems, and develop strategies to optimize care for the individual patient. Examples: Using allied health personnel to help manage the patient with dermatological disease in an efficient and professional manner.

• Apply evidence-based, cost-conscious strategies to prevention, diagnosis, and disease management. Examples: Prevention of skin cancer; management of chronic skin conditions.

• Collaborate with other members of the health care team to assist patients in dealing effectively with complex systems and to improve systematic processes of care. Examples: Use of nurse educators to educate patients regarding their dermatological condition.

III. Methods of instruction:

1. Didactic (schedule, topic, faculty)

Daily residents conference 12:00-1:00 p.m. - IM Training Room
Wednesday mornings 7:30-8:00 a.m. - Clinical Ground Rounds - IM Training Room
Wednesday afternoons 12:15-1:00 p.m. - Internal Medicine Update - Haggar Hall
Friday mornings 7:30 - 8:00 a.m. - Coffee with Cardiology - IM Training Room

2. Clinical