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12518971531_qmc_derm..

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  • 1. 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 Cellulitis Knowledge:-Causes, antibiotic rationale, associated conditions Skills:-Differential diagnosis and treatment of the skin eg by nurses. Drug reactions 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 eg ophthalmology Acute cutaneous vasculitis Knowledge:-Causes and complications
  • 2. Skills:-Assessment of systemic involvement Out patient based scenarios Pruritus 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 Skin cancer 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, prevention strategies. 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.
  • 3. 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 dermatology. Example Timetable AM Lunchtime PM Monday Shadowing on call registrar Skin cancer clinic Tuesday Ward Round with PRHO followed by Dr Murphy OPD SML ward round1.00pm Minor ops list Wednesday Medical teaching Postgraduate Meeting PG centre Shadowing on call registrar Thursday Shadowing on call registrar Journal club Combined clinics and directorate meeting Friday Shadowing on call registrar Dermatology OPD 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
  • 4. 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.

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