Dermatology

New Application: Dermatology

Review Committee for Dermatology

ACGME

515 North State Street, Suite 2000, Chicago, Illinois 60654  312.755.5000  www.acgme.org

P ROGRAM P ERSONNEL AND R ESOURCES

Program Director

1. How does the program director select, supervise, and evaluate the teaching staff and other program personnel at each site participating in the program? Has a local site director been identified in each site? How does the director monitor resident supervision at each site? [CPR II.A.4.]

Click here to enter text.

2. Has the program implemented procedures regarding resident grievances during the last five years?

If yes, provide a concise summary. [CPR II.A.4.h)]


3. How does the program director monitor resident duty hours and, if applicable, the demands of athome call, according to sponsoring institutional policies, with a frequency sufficient to ensure compliance with ACGME requirements; and how does he or she adjust schedules as necessary to mitigate excessive service demands and/or fatigue? [CPR II.A.4.j).(2)-(4)]


4. Provide the following information for each participating site listed in ADS.

Site #1 (The institution that sponsors the program.) a) In the absence of the program director, who is responsible for the residency? [PR II.A.5.]


b) During the last 12 months, how many weeks was the program director away from the program?

[PR II.A.5.a).(1)]


c) Describe how and when the local site director was appointed and the nature and extent of her/his responsibilities for the residency.


Site #2 a) Name of person responsible for dermatology education.


b) Approximately how many hours per week does he/she devote to the residency program?

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c) Describe how and when he/she was appointed and the nature and extent of his/her responsibilities for the residency.


Site #3 a) Name of person responsible for dermatology education.


b) Approximately how many hours per week does he/she devote to the residency program?


c) Describe how and when he/she was appointed and the nature and extent of his/her responsibilities for the residency.


Other Program Personnel

Concisely summarize the technical, clerical, and other non-physician personnel who provide support for the administrative and educational conduct of the program. Is the support of the program in this area satisfactory at all program sites? [CPR II.C.]


Resources

1. Describe the projection equipment and facilities for reviewing and taking clinical photographs at each site. [PR II.D.1.]


2. Describe the space that is utilized for program conferences. Is this space dedicated for dermatology didactic activity? [PR II.D.2.]


3. Describe the clinical material that will allow experience in diagnosis and management of the broad array of diseases seen by the practicing dermatologist. [PR II.D.3.]


Outpatient Information

1. Provide the following information from a recent 12-month period for the dermatology outpatient clinics, subspecialty clinics, etc. where residents will be assigned. (Note: Do not include

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phototherapy sessions or nurse-only visits.)

12-Month Period Covered by

Statistics

From: Click here to enter a date.

To: Click here to enter a date.

Site #1 Site #2 Site #3 Site #4

Row

Total

Total # of Dermatology Outpatient Department

(OPD) Visits

# of New Patients

Estimate % of Patients who are Pediatric

Patients

Avg. # of Patients per Clinic Session

# of Residents per Session

#

#

#

% #

#

#

% #

#

#

% #

#

#

% #

#

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%

#

#

#

#

#

#

#

#

#

#

# of Faculty per Session # # # # #

2. Outpatient and Inpatient Clinical Dermatology a) Describe the organization of the OPD at each program site.

Click here to enter a text.

b) Describe the residents’ continuity of care clinic. Is a resident able to follow a core group of patients throughout residency? Are residents able to follow patients seen as inpatients, consults, and from night or week end call? [PR IV.A.6.c).(1)]


c) Describe the inpatient consult service. Are patients routinely admitted to the dermatology service? Do residents maintain lists of their inpatient consults? [PR IV.A.6.c).(1)]


3. Medical Dermatology and Topical/Systemic Pharmacotherapy a) Summarize resident education and experience in contact dermatitis. [PR IV.A.6.c).(2)]


b) Summarize resident education and experience in immunologic diseases (e.g., immunobullous diseases and collagen vascular diseases). [PR IV.A.6.c).(2)]


Inpatient Information


Statistics




Row

Total

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Number of Dermatology Inpatient Consults


# # # #

Row

Total

#

R ESIDENT A PPOINTMENTS

Funding and Institutional Oversight

1. Is the funding mechanism reviewed and approved by the sponsoring institution's GMEC?

................................................................................................................................... ☐ YES ☐ NO

2. Are any residents required to complete more than three years of dermatology education, research, or service? ................................................................................................................... ☐ YES ☐ NO

If yes, explain.

Click here to enter a date.

Appointment of Fellows and Other Learners

List any fellows or other physician learners appointed or engaged by the dermatology service or department. Under "type of training offered" indicate research, special teaching, or other activity. Add rows as necessary. [CPR III.D.]

Type of Training Offered Number of Fellows or Other Learners

E DUCATIONAL P ROGRAM

Didactic Sessions

1. Describe the required basic science curriculum. [PR IV.A.3.a)]


2. Describe the program’s pediatric dermatology clinical experience and pediatric dermatology curriculum. [PR IV.A.3.a); IV.A.6.c).(3)]


3. Describe all regularly held conferences, indicating where each conference is held, the frequency it is offered, and the individual(s) responsible for the conference. [PR IV.A.3.c)]


Dermatologic Surgery

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1. Who is the director of dermatologic surgery education? [PR II.A.1.]


2. Provide the number of dermatologic procedures performed in each participating site during the last academic year.

Category 1

Residents must become competent in the performance of the following procedures.

[PR IV.A.5.a).(2).(a)]

Excision - benign lesion

Excision - malignant lesion

Site #1

#

#

Site #2

#

#

Site #3

#

#

Site #4

#

#

Row

Total

#

#

Nail procedures

Repair (closure) simple/intermediate/complex

Grafts (Spilt or full)

Flaps

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

Category 2

Significant exposure to the following procedures through direct observation is critical (either as the resident surgeon or as an observer). [PR IV.A.6.b).(2)]

Mohs micrographic surgery

Mohs micrographic surgery (complex/large)

Laser procedures (including intense pulsed light)

Site #1

#

#

#

Site #2

#

#

#

Site #3

#

#

#

Site #4

#

#

#

Row

Total

#

#

#

Category 3

Program faculty must provide education relating to the following techniques without necessarily affording direct exposure.

[PR IV.A.5.b).(5)]

Ambulatory phlebectomy/vein surgery

Sclerotherapy

Tumescent liposuction


# # # #

#

#

#

#

#

#

#

#

Row

Total

#

#

#

Resurfacing techniques (including laser dermabrasion, chemical peel, rhinophyma, and non-ablative rejuvenation)

Hair replacement procedures

Soft tissue augmentation/skin fillers

Scar revision (including acne scar revision procedures)

Botulinum toxin chemo-denervation

Other (excluding skin biopsies and skin destruction of benign and malignant lesions)

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

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#

3. What types of surgery do residents perform, under appropriate faculty member supervision? How are residents given the opportunity to assume increasing responsibility as their surgical competence

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grows? [CPR IV.A.4.]


Patient Care

Indicate the settings and activities in which residents will demonstrate competence in the following areas of patient care. Also indicate the method(s) that will be used to assess competence.

Assessment Method(s)


Competence Area

Performing and interpreting the results of diagnostic techniques, including dermatology-relevant serologic testing, patch testing,

KOH examination, and Tzanck smears

[PR IV.A.5.a).(2).(b)]

Settings/Activities

Skin biopsy techniques, including local anesthesia and regional


blocks, destruction of benign and malignant tumors, excision of benign and malignant tumors, and closures of surgical defects using layered repairs, in patients of all ages, with attention to the chronologic and developmental age of the patient

[PR IV.A.5.a).(2).(a)]



The use of and indications/contraindications for photomedicine, phototherapy, and topical/systemic pharmacologic therapies in all age groups, including infants and young children

[PR IV.A.5.a).(2).(c)]



Medical Knowledge

Indicate the activity(ies) (lectures, conferences, journal clubs, clinical teaching rounds, etc.) in which residents will demonstrate competence in their knowledge in each of the following areas. Also indicate the method(s) that will be used to assess competence.

Competency Area Settings/Activities Assessment Method(s)


Pathophysiology and diagnosis and management of complex medical dermatologic conditions in both adults and children

[PR IV.A.5.b).(1)]

Risks and benefits of commonly used dermatologic therapies in infants and children compared to




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Competency Area Settings/Activities Assessment Method(s) the risks and benefits of those therapies when used in adults

[PR IV.A.5.b).(2)]

Diseases specific to pediatric patients, to include neonatal disorders, congenital neoplasms and hamartomas, cutaneous signs of child abuse, and cutaneous manifestations of inherited and sporadic multisystem diseases

[PR IV.A.5.b).(3)]


Proper techniques for botulinum toxin injections, soft tissue augmentation, repairs of cutaneous surgical defects using flaps and grafts, and use of light and laser modalities for skin conditions

[PR IV.A.5.b).(4)]

Interpretation of molecular diagnostic tests and direct immunofluorescence specimens

[PR IV.A.5.b).(6)]


Indications and contraindications for, and complications and basic techniques of, elective cosmetic dermatology procedures, to include liposuction, scar revision, hair transplants, and invasive vein therapies

[PR IV.A.5.b).(5)]







Practice-based Learning and Improvement

1. Briefly describe one learning activity in which residents demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and life-long learning. [PR IV.A.5.c)]


2. Briefly describe one planned learning activity in which residents engage to identify strengths, deficiencies, and limits in their knowledge and expertise (self-reflection and self-assessment); set learning and improvement goals; and identify and perform appropriate learning activities to achieve self-identified goals (life-long learning). [PR IV.A.5.c).(1)-(3)] (Limit response to 400 words)


3. Briefly describe one planned quality improvement activity or project that will allow the resident to demonstrate an ability to analyze, improve, and change practice or patient care. Describe planning, implementation, evaluation, and provisions of faculty member support and supervision that will

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guide this process. [PR IV.A.5.c).(4)] (Limit response to 400 words)


4. Briefly describe how residents will receive and incorporate formative evaluation feedback into daily practice. (If a specific tool is used to evaluate these skills, have it available for review by the site visitor.) [PR IV.A.5.c).(5)] (Limit response to 400 words)


5. Briefly describe one example of a learning activity in which residents engage to develop the skills needed to use information technology to locate, appraise, and assimilate evidence from scientific studies and apply it to their patients' health problems. [PR IV.A.5.c).(6)-(7)] (Limit response to 400 words)

The description should include:



Locating information



Using information technology



Appraising information



Assimilating evidence information (from scientific studies)



Applying information to patient care


6. Briefly describe how residents will develop teaching skills necessary to educate patients, families, students, and other health professionals. [PR IV.A.5.c).(8)] (Limit response to 400 words)


Interpersonal and Communication Skills

1. Briefly describe one learning activity in which residents demonstrate interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families, and health professionals. [PR IV.A.5.d)] (Limit response to 400 words)


2. Briefly describe one learning activity in which residents develop competence in communicating effectively with patients and families across a broad range of socioeconomic and cultural backgrounds, and with physicians, other health professionals, and health-related agencies. [PR

IV.A.5.d).(1)-(2)] (Limit response to 400 words)


3. Briefly describe one learning activity in which residents develop their skills and habits to work effectively as a member or leader of a health care team or other professional group. In the example, identify the members of the team, responsibilities of the team members, and how team members communicate to accomplish responsibilities. [PR IV.A.5.d).(3)] (Limit response to 400 words)


4. Briefly describe how residents will be provided with opportunities to act in a consultative role to

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other physicians and health professionals. [PR IV.A.5.d).(4)] (Limit response to 400 words)


5. Briefly describe how residents will be provided with opportunities to maintain comprehensive, timely, and legible medical records, if applicable. [PR IV.A.5.d).(5)] (Limit response to 400 words)


6. Briefly describe how residents will be provided with opportunities to counsel patients regarding their disease and treatment options, and provide appropriate anticipatory guidance to parents and, as age-appropriate, to children, regarding chronic disorders, genodermatoses, and congenital cutaneous anomalies. [PR IV.A.5.d).(6)] (Limit response to 400 words)


Professionalism

Briefly describe the learning activity(ies), other than lecture, by which residents develop a commitment to carrying out professional responsibilities and an adherence to ethical principles, including: compassion, integrity, and respect for others; responsiveness to patient needs that supersedes selfinterest; respect for patient privacy and autonomy; accountability to patients, society, and the profession; and sensitivity and responsiveness to a diverse patient population, including to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation [PR IV.A.5.e).(1)-(5)] (Limit response to 400 words)


Systems-based Practice

1. Briefly describe the learning activity(ies) through which residents develop an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care. [PR IV.A.2.f)] (Limit response to 400 words)


2. Briefly describe the learning activity(ies) through which residents achieve competence in the elements of systems-based practice: working effectively in various health care delivery settings and systems, coordinating patient care within the health care system; incorporating considerations of cost-containment and risk-benefit analysis in patient care; advocating for quality patient care and optimal patient care systems; and working in interprofessional teams to enhance patient safety and care quality. [PR IV.A.5.f).(1)-(5)] (Limit response to 400 words)


3. Briefly describe an activity that fulfills the requirement for experiential learning in identifying system errors and implementing potential systems solutions. [PR IV.A.5.f).(6)] (Limit response to 400 words)


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Curriculum Organization and Resident Experiences

1. Briefly describe resident education and experience in dermatologic surgery. Is there a separate surgery rotation? [PR IV.A.6.b).(1)]


2. Briefly describe resident education and experience in the use of lasers. [PR IV.A.6.b).(2);

IV.A.6.c).(5)]


3. Briefly describe the manner in which residents maintain records of their surgical experience. [PR

IV.A.6.d)]


Dermatopathology

1. Provide the following data from a recent 12-month period for each site where residents will be assigned for dermatopathology education. [PR IV.A.6.c).(6)]


Statistics



Dermatopathology Specimens

# cutaneous specimens from within the site

# cutaneous specimens from outside the site

Site #1

#

#

Site #2

#

#

Site #3

#

#

Site #4

#

#

Row

Total

#

#

# direct immunofluorescence specimens

# immunoperoxidase studies

#

#

#

#

#

#

#

#

#

#

2. Provide a concise summary of resident education in dermatopathology. Is there a separate dermatopathology rotation? [PR IV.A.6.c).(6)]


Phototherapy


Statistics



Phototherapy Site #1 Site #2 Site #3 Site #4

Row

Total

Number of PUVA

Number of UVB - broadband

Number of UVB - narrowband

Other: (specify)

Other: (specify)

Residents’ Scholarly Activities

#

#

#

#

#

#

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Summarize program research activity, including commenting on each of the following: [PR IV.B.]

1. Describe the required basic science curriculum. [PR IV.B.4.]


2. Will residents be provided with protected time and funding to attend at least one national meeting during the program? [PR IV.B.5.] ................................................................................. ☐ YES ☐ NO

3. List the publications in peer-reviewed journals (during the last three years) by program residents.

Provide titles, co-authors, and dates, with resident name, in bold font. [PR IV.B.6.]


4. List the research presentations (during the last three years) that resulted from resident research activity during the program. [PR IV.B.6.]


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New Application: Dermatology

Review Committee for Dermatology

ACGME

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