General medicine SHO Description for Dermatology Component.
Summary of Learning Objectives
1. To be able to assess and initiate management of patients presenting with skin
disease as outlined below. In particular to gain knowledge and skills to:-
assess symptoms and signs
formulate a differential diagnosis
select appropriate investigations and accurately interpret the results
communicate the diagnosis and prognosis
2. On take and ward based scenarios
Skin failure , eg toxic epidermal necrolysis, erythroderma
Knowledge:-causes, emergency management, complications
Skills:-Assessment of mucosal involvement, systemic effects & fluid
requirements, start initial treatment rapidly and recognise when to call
dermatology ophthalmology or Burns Unit.
Urticaria angioedema and anaphylaxis
Knowledge:-Precipitants, associated conditions, complications
Skills:-assess and manage airway initiate rapid treatment
Knowledge:-Causes, antibiotic rationale, associated conditions
Skills:-Differential diagnosis and treatment of the skin eg by nurses.
Knowledge:-Patterns and common precipitantsc, complications
Skills:-Assessment of mucosal involvement
Herpes zoster and disseminated simplex
Knowledge:-Clinical patterns, complications and treatment options
Skills:-recognise high risk patients, severe infections, when to involve others
Acute cutaneous vasculitis
Knowledge:-Causes and complications
Skills:-Assessment of systemic involvement
Out patient based scenarios
Knowledge:-Causes, infestation, skin disease, systemic disease.
Skills:-Initiate investigations and know who and when to contact infection
control team for infestations
Psoriasis and eczema
Knowledge:-Patterns and clinical variants, indication, contraindications and
complications of first line therapies
Skills :-Describe and record patterns and understand the role of dermatology
nurses recognise the psychological impact
Manifestations of systemic disease in the skin hair or nails
Knowledge:-Cutaneous signs of endocrine, metabolic, GI, malignancy,
connective tissue disease, immunosuppression, TB and sarcoidosis
Skills:-recognise the underlying disease
Knowledge:-Effects of UV exposure on the skin, risk factors for skin cancer,
features and initial management of basal cell carcinoma, melanoma and
squamous cell carcinoma
Diffentiation from benign lesions, when to consult another specialty,
3. To become competent in the performance of skin biopsies and simple skin
excisions, cryotherapy and destructive techniques (C&C).
The Dermatology directorate
The SHOs working in the Dermatology department see the full spectrum of skin
disease. There are general and specialised clinics for both inflammatory and
neoplastic skin diseases in adult and paediatric dermatology clincs. The department
has a minor procedures area with 2 theatres and facilities for surgical and laser
training. In patients are based on ward C51 and patients attend for outpatient and
daycase treatments both to the Dermatology Day Treatment Unit (DDTU) and to the
outpatient area. Outreach activities in the community include the GpwSI clinic and
specialist nurses chronic disease management clinics in primary care.
There are 10 Consultants and 1 nurse consultant with varying specialist interests:
Dr Jan Bong Medical education.
Dr John English Contact dermatitis and occupational dermatology.
Dr Sheelagh Littlewood Vulval diseases.
Dr Ruth Murphy Paediatric dermatology and mucocutaneous disease.
Dr William Perkins Skin cancer, Lasers, hyperhidrosis.
Dr Jane Ravenscroft Paediatric dermatology.
Dr Eric Saihan Urticaria
Prof Hywel Williams Paediatric dermatology.
Dr Sandeep (Sunny) Varma skin cancer, Lasers.
Sandra Lawton Nurse consultant chronic disease management and paediatric
AM Lunchtime PM
Shadowing on call
Skin cancer clinic
Tuesday Ward Round with
PRHO followed by
Dr Murphy OPD
Minor ops list
Wednesday Medical teaching Postgraduate
Meeting PG centre
Shadowing on call
Thursday Shadowing on call
Journal club Combined clinics
Friday Shadowing on call
with Dr Bong
Achievement of Learning Objectives
A structured programme of ward and outpatient experience within the dermatology
department will provide a wealth of exposure to skin disease. There will be
opportunities to see patients in the acute and routine setting with the support of
consultants or SpRs in dermatology. A particular emphasis has been placed on the
acute presentations and shadowing the SpR on call in seeing these presentations.
In addition the registrar will learn about indications for hospital admission through
their experience on the Acute Medical Admissions Unit.
Appraisal and Feedback
Appraisal and feedback will be via the educational supervisor assigned to the trainee.