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  1. 1. DERM DERMATOLOGY – Parkland GOALS AND OBJECTIVES ROTATION DIRECTOR Madelyn Pollock, MD 6263 Harry Hines Blvd. Dallas, TX 75390-9067 214-648-1399 SPECIAL FACULTY Dr. William Abramovits 5310 Harvest Hill, Suite 160 Dallas, TX 75230-5893 972-661-2729 (ext) 231 972-661-0227 (fax) Jo Urquhart Residency Coordinator Dept. of Dermatology 214-648-8806 214-648-7678 (fax) PARKLAND ATTENDINGS Paul Bergstresser, MD Dept. of Dermatology UTSW 5323 Harry Hines Blvd. Dallas, TX 75390-9069 214-648-2969 214-648-9292 (fax) Dr. Cruz (same address as above) 214-648-8806 214-648-7678 (fax) CALL FREQUENCY No Call VACATION No vacation is allowed in this month ROTATION DAYS/HOURS MON TUE WED THUR FRI AM 8a-10a FM Challenger 10-11am Didactics, ND5.218 Dr. Abramovitz FMC Dr. Abramovitz FMC PM FMC CONF FMC Dr. Abramovitz Start: 1:30 12:00 Clinical Slide Conference JA5.110 1:00 PMH Clinic 6th Floor Revised June 17, 2009
  2. 2. DERM INTRODUCTION The dermatology rotation is a month long required experience spent at Parkland and with a private dermatologist. EDUCATIONAL GOALS Upon completion of this month a resident should be able to: Patient Care 1. Identify common skin lesions. 2. Document types of skin lesions and give appropriate differential diagnosis. 3. Discuss treatment plans for care of skin lesions. 4. Discuss when and how to biopsy, freeze, burn off, or topically treat skin lesions. Communication 1. Identify and document skin lesions to colleagues. 2. Explain skin procedures and care to patient and staff. Medical Knowledge 1. Identify and establish skin care for common skin lesions. 2. Discuss when to biopsy, treat, or refer dermatology case. Problem-Based Learning 1. Solve dermatology problem using EBM to improve patient care. System-Based Learning 1. Code all dermatology clinical cases. 2. Code all dermatology procedures. Professionalism 1. Work together with dermatology staff and consultants to improve patient care, decrease cost, promote wellness, provide patient education, and prevent disease. 2. Practice ethical, reasonable medical care for all. 3. Follow all the policies of the program at Parkland Hospital and respect the policies of UTSW and CMC. EDUCATIONAL ACTIVITIES To achieve these goals the resident will: Patient Care 1. Perform procedures of office based dermatology. a. Biopsy of a skin lesion b. Use of Wood’s lamp c. Destruction of skin lesion by cautery or cryosurgery d. Obtain adequate lab specimen with scraping and biopsy e. Minor lesion removal Revised June 17, 2009
  3. 3. DERM 2. Take an appropriate dermatology focused history, document exam, and make oral and written dermatology presentation. 3. Document a dermatology differential diagnosis, present a treatment plan, recommend appropriate follow-up and patient care information. Communication 1. Discuss dermatologic issues with patient and family in a practical and caring language. 2. Discuss and document dermatologic issues with staff, colleagues, residents, fellows, faculty, and community physicians. Medical Knowledge 1. Examine and interpret skin lesions. 2. Develop treatment plans and discuss with attendings and upper level Derm residents. 3. Complete four week reading assignments in Dermatology text book Habif. 4. Complete the MedChallenger “Dermatology” module. Practice-Based Learning 1. Use evidence based medicine to solve dermatology problems and assess current dermatology knowledge and recommendations. Systems-Based Learning 1. Code for dermatology services and dermatology procedures. Professionalism 1. Demonstrate being able to work together with dermatology staff and dermatology consultants to improve patient care, decrease cost, promote wellness, provide patient education, and prevent disease. 2. Practice ethical medical care. 3. Demonstrate responsible behavior with dermatology consultants and their patients. 4. Follow all policies of the program and Parkland Hospital and respect the policies of CMC and UTSW. METHODOLOGY The residents will see patients in the dermatology outpatient clinic at Parkland and the office of a private dermatologist. FAMILY MEDICINE CLINIC The resident will be in clinic 4 half-days a week during this rotation. EVALUATION PROCESS Residents will be evaluated by the faculty member of the dermatology department and Dr. Abramovitz using the standard evaluation forms. Satisfactory completion of the rotation will Revised June 17, 2009
  4. 4. DERM be determined by the Program Director of the Family Medicine Residency Program in consultation with the preceptor. READING LIST: Reading list is attached. PHHS FOUR WEEK ROTATION IN DERMATOLOGY FOR RESIDENTS ROTATING FROM PRIMARY CARE SPECIALTIES The course is designed to integrate clinical teaching in the dermatology clinics, ward rounds, and teaching conferences with standardized reading assignments, lectures, and discussion periods to provide primary care residents with adequate knowledge of common dermatologic conditions, therapeutics, and procedures. An examination at the end of the rotation will reinforce the material presented. The goal is to improve the diagnostic, therapeutic, and procedural skills of the primary care rotators in preparation for clinical practice. A. Reading Assignments All reading assignments are from: Clinical Dermatology, A Color Guide to Diagnosis and Therapy, 4th Edition by Thomas Habif. Comprehensive references on the assigned subjects and a reference for the more unusual dermatologic conditions that may be seen during the rotation is covered in: Cutaneous Medicine and Surgery, An Integrated Program in Dermatology by Arndt, Leboit, Robinson, and Wintroub or Dermatology in General Medicine by Fitzpatrick. Habif will be available to the residents and students to check out from Academic Reserve in the UTSWMC Library. [A copy is also on the shelf in the Family Medicine Clinic.]The primary care rotators and students are expected to read the assigned chapters and sections in a timely manner. In addition, they are expected to read the sections on the uncommon, but important dermatologic conditions (ie. vesiculobullous diseases, etc.) that they may encounter during the clinical rotation, to reinforce their knowledge beyond the clinical experience. WEEK 1 READING Monday: Habif Chapter 1, Principles of Diagnosis and Anatomy, p.1-24. Tuesday: Habif Chapter 12, Warts, Herpes Simplex, and Other Viral Infections, p. 368-406. Revised June 17, 2009
  5. 5. DERM Wednesday: Habif Chapter 13, Superficial Fungal Infections, p. 409-454. Thursday: Habif Chapter 9, Bacterial Infections, p. 267-297. Habif Chapter 15, Infestations and Bites, p. 497-510. Weekend: Habif Chapter 7, Acne, Rosacea, and Related Disorders, p. 162-205. Habif Chapter 10, Syphilis, p. 307-324. Habif Chapter 11, Sexually Transmitted Viral Infections, p. 336-365. WEEK 2 READING Monday: Habif Chapter 20, Benign Skin Tumors, p. 698-721. Tuesday: Habif Chapter 22, Nevi and Malignant Melanoma, p. 773-811. Wednesday: Habif Chapter 21, Premalignant and Malignant Skin Tumors, p. 724-767. Thursday: Habif Chapter 23, Vascular Tumors and Malformations, p. 814-832. Weekend: Habif Chapter 27, Dermatologic Surgical Procedures, p. 921-938. Habif Chapter 2, Topical Therapy and Corticosteroids, p. 23-40. WEEK 3 READING Monday: Habif Chapter 4, Contact Dermatitis and Patch Testing, p. 81-103. Habif Chapter 3, Eczema, p. 41-62. Tuesday: Habif Chapter 5, Atopic Dermatitis, p. 105-127. Habif Chapter 3, Eczema, p. 63-80. Wednesday: Habif Chapter 8, Seborrheic Dermatitis, p. 242-245.; Pityriasis Rosea, p. 246-249.; Lichen Planus, p. 250-256. Thursday: Habif Chapter 8, Psoriasis, p. 209-239. Weekend: Habif Chapter 6, Urticaria p. 129-161. WEEK 4 READING Monday: Habif Chapter 18, Hypersensitivity Syndromes and Vasculitis, Erythema multiforme, p. 626-634; Erythema nodosum, p. 635-636.; Vasculitis, p. 637-649. Tuesday: Habif Chapter 17, Connective Tissue Diseases, p. 587-622. Wednesday: Habif Chapter 26, Granuloma annulare, p. 898-899. Revised June 17, 2009
  6. 6. DERM Habif Chapter 24, Alopecia areata, Trichotillomania, and Traction alopecia, p. 855-858. Habif Chapter 19, Vitiligo, p. 684-688; Melasma, p. 692-693. Arndt, Ulcerative Disorders of the Oral Cavity, p. 1330-1334 (see attached) Thursday: Review Revised June 17, 2009
  7. 7. DERM Habif Chapter 24, Alopecia areata, Trichotillomania, and Traction alopecia, p. 855-858. Habif Chapter 19, Vitiligo, p. 684-688; Melasma, p. 692-693. Arndt, Ulcerative Disorders of the Oral Cavity, p. 1330-1334 (see attached) Thursday: Review Revised June 17, 2009