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.
Elective Director: Amy Y-Y Chen, MD
Short Summary of Elective
The Dermatology elective provides a student with an opportunity to develop fundamental dermatology skills in a 4 week period. It is an ambulatory rotation integrated with a vibrant inpatient consultation service. Generally, there are three 4th year medical students and one internal medicine or family medicine resident on the rotation. You will be exposed to general dermatology, pediatric dermatology, dermatology specialty clinics as well as certain procedures. Although you will be spending the majority of your time in general dermatology, we encourage you to work with as many different attendings and residents to broaden your experience.
The student is expected to attend ambulatory clinics, inpatient consultations, grand round and didactics. There will be an end of rotation quiz assessment. Final grade will be determined based on clinical attendances and performance, didactic participation as well as the quiz.
Description of Elective
The dermatology elective is an ambulatory rotation integrated with a vibrant inpatient consultation service. The main dermatology outpatient clinics are located at Shapiro Ambulatory Care Center. During this rotation, you will directly interact with dermatology residents, international trainees, our clinical support staff as well as various dermatology attendings.
Our clinics very busy and offer a robust learning experience. In general, you are encouraged to see patients and be part of the integral dermatology team. Some attending physicians may let you see patients on your own while others may not. Please check with the specific attending dermatologist you are with that day. In addition, some attending physicians see a wide range of general dermatology patients while others have “specialty clinics,” focusing on a particular dermatologic disorder. Clinical teaching will be done at the bedside and outside of the room. There will also be opportunities for you to see inpatient dermatology consults. Please be sensitive to the pace of the clinic. There will be days when the clinics are very busy and your questions and teaching may have to wait until after the clinic is over. Please also refrain from offering diagnostic opinions or advice and counseling to patients on dermatologic matters without first reviewing with the dermatology attendings.
You are encouraged to ask questions and take initiative in self-learning through reading and literature searches. Reading assignments and additional educational resources are listed under CURRICULUM.
Students will be required to attend assigned dermatology outpatient clinics as well as inpatient consultation. In addition, participation in weekly medical student didactics will also be required. Although you are welcome to attend, students will not be required to attend certain resident didactic sessions (the required sessions will be reviewed during your orientation). A brief quiz designed to assess your fundamental understanding of dermatology will be given at the end of the rotation.
The week prior to your rotation, Daniella Adrien (firstname.lastname@example.org), will send you a clinic and didactic schedule. She will also let you know which resident will meet and orient you on the first day. The orientating resident will reach out to you few days before the start of your rotation to arrange for time and place to meet on your first day. If needed, you will receive an up-to-date schedule of clinics and didactic sessions when you arrive. You will have a mid rotation (wk 2) and an end of rotation (wk 4) meeting with the course director. Daniella will assist you in setting these meeting up. It is, however, your responsibility to ensure that these meetings are scheduled.
In general, the workday starts at 8:45AM, 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 8:00AM. In addition, there may be occasional didactic sessions on Mondays after clinics and on Thursday mornings before clinic. Our monthly Grand Rounds takes place on a Wednesday morning of each month at the Shapiro Ambulatory Care Center, 8th floor clinic. Unless otherwise specified, you are expected to attend all teaching conferences occurring on days when you are here.
Please let Daniella know in advance any dates that you anticipate being away from the rotation for any reason. Students are allowed maximum of 3 days of absence during the 4 week block period.
You may want to visit our department website (http://www.bumc.bu.edu/derm/) for a ‘who’s-who’ of individual faculty and residents before the start of your rotation. Our group is comprised of attending dermatologists, dermatopathologists, procedural dermatologists, doctorate scientists, dermatology residents, international trainees, dermatopathology fellows and sometimes 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.
Teaching Elective Goal
The purpose of the dermatology elective is to provide a learning environment for the student to develop basic dermatology skills.
By the end of the dermatology elective, the BUSM student will be able to:
- Obtain a relevant dermatologic history (B,U)
- Perform physical examination of the integumentary system (B,U)
- Describe accurately morphology of lesions and eruptions on patients. (B,U,C)
- 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)
- 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)
- Describe 1st and 2nd lines of therapy for common and important lesions and eruptions. (U,R,E)
- 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)
- Differentiate between formulations of topical steroids based on potency, side effects, and vehicles. (U,R,E)
- Demonstrate understanding of basic epidemiology of malignant melanoma, melanocytic nevi and nonmelanoma skin cancer. (U,R)
- 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)
- Summarize impact on quality of life for chronic skin diseases, including atopic dermatitis, psoriasis, pruritus, and acne. (U,R)
- 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)
- Demonstrate understanding of the basic principles of dermatologic lasers and Mohs micrographic surgery. (U,R)
- 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)
- 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 rotating students and residents will:
- 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)
- 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)
- 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)
- Wear neat, clean clothing, a white coat and identification badge when seeing patients. (A)
|Elecive Director:||Amy Y-Y Chen, MD|
|Elective Coordinator:||Daniella Adrien
609 Albany Street, J-200
617-638-5523 (direct); 617-638-5500
|Dermatology Clinics:||Shapiro Ambulatory Care Center
725 Albany Street, 8th Floor
Every day at 8:45 AM
|Didactic Sessions:||609 Albany Street, 2nd Floor Conference Room
Wednesdays 8:00 AM -12:00 PM (occasional 7:30 AM)
Occasional Mondays at 5:15 PM
Occasional Thursdays at 7:00 AM
|Grand Rounds:||Shapiro Amubulatory Care Center
725 Albany Street, 8th Floor
8:15 AM on a designated Wednesday each month
|Dermatology Inpatient Consults:||Boston Medical Center|
The curriculum includes reading assignment (see below), patient encounters in the outpatient and inpatient setting, bedside teaching by dermatology attendings, resident teaching, lectures/conferences and grand rounds.
Reading assignment: It is required that you go through the American Academy of Dermatology Medical student core curriculum modules. These can be found on http://www.aad.org/education-and-quality-care/medical-student-core-curriculum.
Each module is composed of a power point presentation and a self-assessment at the end. Typically, each module takes < 30 minutes to complete. This can be done during “down time” in clinic or at home. Below is a template that you should follow. There are also videos on the website for the various dermatologic procedures. You will get much more out of the rotation if you go through these modules.
Other modules that you may want to explore (not in particular order):
- Contact dermatitis
- Petechia, purpura and vasculitis
- Pediatric fungal infection.
- Dermatoses in pregnancy
- HIV dermatology
- Erythema Nodosum
Other educational resources:
- Department of Dermatology Library (textbooks, atlases, journal collection)
- 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.
Students will be evaluated based on clinical performance and didactic participation directly observed by faculty and residents (85%) as well as end of rotation assessment/quiz (15%). A grade of Honor, High Pass, Pass and Fail will be used. Mid-course formative evaluation as well as final summative evaluation will be given by the course director. You will also be able to provide an anonymous evaluation of the elective experience.
Number of Students
Maximum of 4 BU and non-BU 4th year medical students
Length of Elective
Throughout the entire academic year
**Students are responsible for coordinating their own living and communting arrangements**