4th Year Medical Student Electives in Dermatology
Welcome to your rotation in dermatology! We are glad you have the opportunity to spend some time on our service and trust that the experience will be both enjoyable and educational. Please review this information carefully before starting your rotation.
INFORMATION
Elective Director: Amit Garg, MD
Elective coordinator: Daniella Adrien
609 Albany St., 2nd Floor
617-638-5523
dadrien@bu.edu
Dermatology Clinics: Doctors Office Building, 9th floor
Every day at 8:30 am
Didactic sessions: 609 Albany St, 2nd floor
Wednesdays 8:00 am
Occasional Mondays at 5:15 pm
Occasional Thursday mornings at 7:00 am
Grand Rounds: Doctors Office Building, 9th floor
8:15 am on 1st Wednesday of the month
More information on the Training Program and the Department can be found on our website: http://www.bumc.bu.edu/derm/
On the first day of your rotation, please see Daniella Adrien at 8:30AM.You’ll receive an up-to-date schedule of clinics and didactic sessions when you arrive. In general, the workday starts at 830AM, though there are important teaching conferences that may occur at an earlier time on some days. Clinics and/or Consultations generally end by 5:30PM. Didactic sessions typically take place on Wednesday mornings beginning at 800am. In addition, there may be occasional didactic sessions on a Monday after clinics and on a Thursday morning before clinic. Our monthly Grand Rounds takes place on the first Wednesday morning of the month at the DOB, 9th floor clinic. You are expected to attend all teaching conferences occurring on days when you are here.
Please let Daniella know of in advance any dates that you anticipate being away from the rotation.
WHO WE ARE
See our department website (http://www.bumc.bu.edu/derm/) for a ‘who’s-who’ of individual faculty and residents. Our group is comprised of attending dermatologists, dermatopathologists, procedural dermatologists, doctorate scientists, dermatology residents, international trainees, dermatopathology fellows and a skin oncology fellow. Many of our faculty are nationally and internationally recognized experts in their respective fields. Boston University is a center of excellence in basic cutaneous biology research, skin oncology, wound healing, psoriasis, connective tissue disease, photomedicine, hair disorders, dermatologic surgery/oncology, dermatopathology and dermatology education.
THE ROTATION
Dermatology is an ambulatory rotation integrated with a vibrant inpatient consultation service. Generally, there are two to three 4th year medical students and one internal medicine or family medicine resident on rotation each month. We encourage you to work with as many different attendings and residents as you can. You should spend the majority of your time in general dermatology and medical specialty clinics, but be sure to work with the dermatologic surgeons to get a more in depth feel for the procedural aspects of dermatology.
OUR CLINICS
The clinics take place at the Doctors Office Building on the 9th floor. You’re welcome in all clinics—we don’t have private practices or private patients here. The clinics tend to be busy and offer a robust learning environment. Please be sensitive to the pace of the clinic. There will be days when things are very busy and your questions and teaching may have to wait until after clinic is over. In general, though, we teach as we go. Please refrain from offering diagnostic opinions or advice and counseling to patients on dermatologic matters without first reviewing with the dermatologist.
COMPETENCY BASED GOALS AND OBJECTIVES
The purpose of the dermatology elective is to provide BUSM IV students the content, functional knowledge and practical skills needed to identify, evaluate, manage and prevent common and important disorders of the integumentary system.
By the end of the dermatology elective, the BUSM student will be able to:
1. Obtain a relevant dermatologic history (B,U)
2. Perform physical examination of the integumentary system (B,U)
3. Describe accurately morphology of lesions and eruptions on patients. (B,U,C)
4. Diagnose common and important lesions and eruptions, including the following: melanocytic nevi, malignant melanoma, non-melanoma skin cancer, actinic and seborrheic keratoses, acne, seborrhea, rosacea, atopic dermatitis, psoriasis, contact dermatitis, stasis dermatitis, urticaria, pityriasis rosea, drug eruptions, vasculitis, leg ulcers, vitiligo, verruca, acrochordons, molluscum, cysts, keloid scars, dermatofibroma, hemangioma, dermatophytoses, pityriasis versicolor, candidiasis, herpes simplex, herpes zoster, impetigo, scabies, cellulitis, furunculosis, pediculosis. (U,R,E)
5. Demonstrate familiarity with common diagnostic and therapeutic procedures used in dermatology, including cryotherapy, shave and punch skin biopsy, potassium hydroxide mounts, scabies oil mounts, Tzanck smear, and dermatoscopy. (U,R)
6. Describe 1st and 2nd lines of therapy for common and important lesions and eruptions. (U,R,E)
7. Demonstrate knowledge of basic pharmacology and administration of medications commonly used for treatment of skin disease, particularly topical and anti-inflammatory agents including steroids, topical and oral retinoids, topical and oral antimicrobial agents, and emollients. (U,R,E)
8. Differentiate between formulations of topical steroids based on potency, side effects, and vehicles. (U,R,E)
9. Demonstrate understanding of basic epidemiology of malignant melanoma, melanocytic nevi and nonmelanoma skin cancer. (U,R)
10. Identify risk factors for melanoma and non-melanoma skin cancer. Perform at least five supervised full-body skin exams for high-risk patients. (U,R)
11. Summarize impact on qualify of life for chronic skin diseases, including atopic dermatitis, psoriasis, pruritus, and acne. (U,R)
12. Translate skin care advice to layman’s terms for at least one patient for each of the following topics: sun protection, ABCDEs of melanoma, atopic dermatitis skin care regimens, dry skin care regimens, and wound care. (B,U)
13. Demonstrate understanding of the basic principles of dermatologic lasers and Mohs micrographic surgery. (U,R)
14. Demonstrate familiarity with important new or evolving issues in dermatology and how research and the medical literature are being used to develop evidence-based best practices and guidelines for management of skin disease. (U,R)
15. Identify clinical situations in which a dermatologist should be consulted and other clinical situations which may be managed without referral. (U,C,S)
Furthermore, we expect that rotators will:
1. Interact with patients, their families, our office staff and other health professionals in a manner that is culturally sensitive and appropriate to the resident’s dual role as healthcare provider and student of dermatology. (B,A)
2. Communicate with patients, their families, our office staff and other healthcare providers in an effective fashion in spoken and written English. Handwriting and signatures must be legible. (B)
3. Demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles, sensitivity to a diverse patient population, and dress and deportment appropriate to a physician. (B,A)
4. Wear neat, clean clothing, a white coat and identification badge when seeing patients. (A)
Educational Resources
1. Bedside teaching by dermatologist preceptors
2. Clinical and Basic Science conferences
3. Weekly teaching conference for student rotators
4. Web Based Dermatology Curriculum for Medical Students
5. Journal club and Medical ethics conference
6. Grand Rounds
7. Department of Dermatology Library (textbooks, atlases, journal collection)
8. Additional Recommended Resources:
Marks JG, Miller JJ. Lookingbill and Marks’ Principles of Dermatology. 4th ed. W.B. Saunders Co.; 2006.
Habif TP. Clinical Dermatology: a color guide to diagnosis and therapy. 4th ed. Mosby, Inc.; 2004. (Great reference book for any primary care practitioner)
www.dermatologylexicon.org. This website provides an interactive look at primary morphology of the skin. (strongly recommended)
Assessment Tools
1. Daily faculty observation of clinical care activities
2. Faculty observation of participation in student conferences
3. End-of-rotation presentation
4. End of elective assessment
The acronym BU CARES stands for the BUSM education program’s seven fundamental objectives, which describe the knowledge, skills, and attitudes that every graduate should possess. The principles behind BU CARES guide the management of the curriculum, inform student assessments, and form the basis of all course and clerkship learning objectives. BUCARES can found on http://www.bumc.bu.edu/oaa/.
The BU CARES Institutional Learning Objectives
(The linked ACGME competencies are in parenthesis)
The BUSM Graduate:
Behaves in a caring, compassionate and sensitive manner toward patients and colleagues of all cultures and backgrounds, using effective interpersonal and communication skills (Interpersonal and Communication Skills; Professionalism)
Uses the science of normal and abnormal states of health to prevent disease, to recognize and diagnose illness and to provide an appropriate level of care (Medical Knowledge; Patient Care)
Communicates with colleagues and patients to ensure effective interdisciplinary medical care (Interpersonal and Communication Skills; Patient Care)
Acts in accordance with the highest ethical standards of medical practice (Professionalism)
Researches and critically appraises biomedical information and is able to contribute to the advancement of science and to the practice of medicine (Practice-based Learning and Improvement; Medical Knowledge)
Exhibits commitment and aptitude for life-long learning and continuing improvement as a physician (Practice-based Learning)
Supports optimal patient care through identifying and using resources of the health care system (Systems-based Practice; Patient Care)
