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Curriculum

Curriculum

This unique program offers participants graduated autonomy culminating in a hands-on senior resident associate (SRA) year program. Clinical experience offers exposure to common dermatological diseases through service to the local community. Experience in the management of more complex diseases is also ensured by the many international patients who seek care at Mayo Clinic.

Clinical dermatology

Training in clinical dermatology includes outpatient and inpatient experience.

  • Outpatient PGY-2

Outpatient training includes care for community-based patients with straightforward and common dermatologic disease at Mayo Dermatology Clinic Northwest. Evaluation of more complex and rare dermatologic patients referred to Mayo Clinic for tertiary care occurs at the E5 practice in the Mayo Building.

First-year residents spend approximately one month in the dermatology department at Mayo Family Clinic Northwest, where they work with the consultant and a trained nurse team to care for common dermatologic problems. Residents also have a continuity clinic scheduled at the northwest clinic throughout their first two years. Continuity clinic participants are allowed to schedule patients for follow-up visits.

First-year residents also spend time at Mayo Building E5 working with the consultants in their respective subspecialties.

  • Outpatient PGY-3

Second-year residents spend six weeks in the dermatology department at Mayo Family Clinic Northwest, where they have steadily increasing autonomy in the care of community patients. Participants continue to experience outpatient care for more complex patients at the E5 practice in the Mayo Building, working with all consultants to gain experience in subspecialty work-up clinics.

  • Outpatient PGY-4

Third-year residents, or senior resident associates (SRA), are based at Mayo E5. SRA have their own prescheduled outpatient calendars, with oversight from a supervising consultant.

Hospital and Inpatient Dermatology

First-year residents gain nearly four months of inpatient dermatology and consultation service experience at Mayo Clinic Hospital, Methodist Campus. The consult service provides assistance to many surgical specialties, the hematology inpatient service and obstetrics and gynecology. Consultations may vary and include:

  • Evaluation of incidental skin lesions and minor rashes
  • Conditions seen in pregnant patients and neonates
  • Severe graft-versus-host disease (GVHD), cutaneous T-cell lymphoma (CTCL) and life-threatening dermatoses seen in hematology-oncology and transplant patients

Inpatient training at Mayo Clinic Hospital, Methodist Campus is complimented by training in the phototherapy unit and the opportunity to participate in three of many unique selective opportunities, including:

  • Extra corporeal photophoresis (ECPP)
  • Hyperbaric oxygen
  • Exposure to the wound care center
  • Lymphedema clinic
  • Compounding pharmacy

While on inpatient service, residents care for an average of four patients and take call at home via pager for admissions or consultations. Participants learn to care for patients with serious, acute and chronic skin disorders and associated systemic problems. Upon completion of inpatient rotation, residents are prepared to manage patients with serious dermatological problems.

  • Hospital practice PGY-2

First-year residents also cover the day hospital in addition to the inpatient service, which provides the Mayo-developed Goeckerman protocol to psoriasis patients, as well as limited wet dressing therapy, ulcer care and scalp treatment.

  • Hospital practice PGY-3

Second-year residents spend approximately two months at Mayo Clinic Hospital, Saint Marys Campus, where they provide consultative care to numerous medical, intensive care and surgical units, and the emergency room. The scope of dermatologic cases ranges from lesion evaluation to toxic epidermal necrolysis (TEN) and other rare dermatoses.

Dermatopathology

The laboratory dermatology rotation exposes residents to pathologies ranging from basic to complex and challenging dermatoses. High case volume allows participants to build necessary histopathologic interpretive skills. The lab practice is centrally embedded to allow frequent dialog between the lab and clinical practice, particularly for challenging cases seen in floor conferences.

In this rotation, participants learn to use clinical, pathologic and immunopathologic correlation to solve challenging clinical and surgical cases. A large, searchable pathology database can be queried to answer relevant clinical questions. Fully integrated use of digitally scanned pathology slides for educational conferences and private study are available to the residents.

The enthusiastic laboratory dermatology staff reflects broad interests and a firm commitment to teaching.

Surgery

The surgical training offered through the Department of Dermatology is an incremental step-structured program that encompasses three years of residency.

The first year is an apprentice training experience. First-year residents learn the nuances of excellence in basic procedural dermatology from senior residents participating in the senior resident procedure clinic.

Second-year residents spend time learning more complex procedural dermatology, including Mohs surgery and cosmetic procedures. Participants spend one-on-one surgical training time with one of the five Mayo Clinic Mohs surgeon consultants. Participants are expected to take call during this rotation.

Third-year residents are assigned their own procedure clinic for the entire year. They teach first-year resident apprentices, who work with them throughout the year. As the three years of residency progress, participants are given increasingly more autonomy and responsibility regarding procedural dermatology.

Pediatric Dermatology

The pediatric dermatology experience at Mayo Clinic is continuous and progressive. Three pediatric dermatologists represent a broad range of special expertise, including:

  • Connective tissue disorders
  • Childhood nevi and malignancies
  • Dermatoses of pregnancy
  • Genodermatoses
  • Vascular birthmarks

Attendance at a monthly didactic curriculum of lectures and textbook reading is required.

Residents are assigned to the pediatric dermatology rotation for one month during both the first and second year of training. This comprehensive experience includes evaluation of complex medical patients, a community practice, a subspecialty referral clinic, and procedures such as laser and excision.

Hospital consultations expose residents to the complex medical issues of neonates and children, including intensive care patients. The service is also commonly involved in the care of pregnant women with dermatoses and the subsequent management of the dermatosis in the newborn if present.

Second -year residents serve as an integral part of the inpatient pediatric dermatology service while performing their hospital consultative months.

Third-year residents have their own pediatric patients to care for. Supervision and guidance are available from the pediatric dermatology staff.

Extra training in pediatric dermatology is available as an elective rotation upon request.

Call Frequency

Call schedules vary by individual rotation. Mayo Clinic follows the call recommendations of the Accreditation Council for Graduate Medical Education (ACGME).

Didactic Training

Clinical conferences, seminars, small discussion groups, journal clubs and one-on-one instruction are all an integral part of Mayo Clinic's Dermatology Residency Program.

There is also a strong emphasis on self-directed learning. Residents are expected to study dermatology six days each week, even when clinical practice is limited to five days. Formal didactics cannot cover all material necessary for review and study. Additional reading is expected to occur on the sixth day. Residents are encouraged to study in small groups, and to use other learning resources as appropriate.

Resident Conferences

  • Structured Core Curriculum

The weekly core curriculum is the focus of the didactic portion of dermatology training. It provides a systematic review of the dermatologic texts, led by residents with consultant oversight and input.

  • Pediatric Core Curriculum

Pediatric core curriculum teaching is conducted monthly by staff pediatric dermatologists and follows the reference textbook topics.

  • Dermatologic Surgery Core Curriculum

Evening reviews of dermatologic surgery topics, including practical hands-on experience with pig's feet, lasers and other surgical and cosmetic techniques, are conducted twice monthly.

  • Dermatopathology

Residents receive weekly training around the microscope from dermatopathology staff, reviewing the spectrum of dermatopathology. Topics follow the teaching in core curriculum as appropriate.

  • Kodachromes

Weekly kodachromes sessions taught by consultants provide training in visual pattern recognition and prepare residents for board examinations.

  • Journal Club

The journal club meets twice monthly. It is led by residents. The main dermatologic literature is reviewed, as well as other pertinent medical literature. Broad participation by all residents is expected.

  • Mini-courses

Didactic teaching is complimented by several mini-courses, conducted annually by a consultant with specific expertise such as patch testing or mucous membrane disease (alternating annually between oral & genital disorders). Dermoscopy and fungal courses are offered alternate years.

Department-wide Conferences

Clinical pathological conferences (CPC) are presented weekly and attended by staff and residents. Residents can review and discuss pathology with clinicians to highlight clinicopathologic correlation.

Hospital grand rounds are held on Thursday mornings. Cases from the hospital impatient and consultation services are discussed with all members of the department for management challenges.

Clinical grand rounds are held on Thursdays at noon. Residents and staff present interesting or difficult cases seen in the outpatient setting each week from the week for informal discussion and review.

A typical dermatology residency rotation schedule includes:


First Year (PGY-2)

Length

Inpatient dermatology and consultation services
RMH: includes phototherapy and selectives

4-5 months

Outpatient dermatology
Mayo E5: Work with consultants following their unique interest and referral patients
Continuity clinic
Scheduled weekly at NW clinic except when on hospital

2-3 months

Dermatopathology and immunodermatology
Participate in daily readout of biopsies

1 month

Dermatologic surgery
Basic dermatologic surgery under the guidance of consultants or senior resident associates

2 months

Pediatric outpatient dermatology
NW Clinic and Pediatric center

1 month

Dermatology team at Mayo Family Clinic Northwest
Community-based patients seen with a team including resident, consultant and nurse

1 month

Second Year (PGY-3)

Length

Dermatopathology and immunodermatology
Participate daily in readout, with opportunity to correlate immunofluorescent, monoclonal antibody and histochemical studies

2-3 months

Outpatient dermatology
E-5 assignment with consultant

1 month

RCC-5 – modified senior resident associate (SRA) experience

1 month

Pediatric/Outpatient dermatology
NW Clinic, E-5 and Pediatric Center

1 month

Dermatologic surgery
Intensive one-on-one outpatient dermatologic surgery care, with exposure to Mohs micrographic surgery and advanced cutaneous surgical procedures (e.g., laser, cosmetic and reconstructive procedures)

6 – 7 weeks

Dermatology consultation service
Inpatient dermatologic consultations at Mayo Clinic Hospital, Saint Marys Campus

6 – 7 weeks

Mayo team at Family Clinic Northwest, Rochester, Minn.

6 weeks

Elective(optional)
Clinical or laboratory research experience or outpatient rotation as approved by education committee, or outpatient dermatology rotation at Mayo Clinic in Arizona or Florida

1 months

Third Year (PGY-4)

Length

Senior resident associate (SRA)

11 or 12 months

Outpatient dermatology
Independent outpatient clinic on E-5 with daily supervision by the Mayo Clinic consulting staff
Community and pediatric clinic on Thursdays at NW clinic on a rotational basis

Dermatopathology
One half day per week in dermpath lab. Residents review biopsies from their cases seen in the outpatient practice and stay fresh in preparation for their board examinations

Dermatologic surgery
Weekly dermatologic surgery procedure clinic

Elective- Outpatient dermatology at Mayo Clinic in Arizona or Florida (optional)

1 month

Electives and Other Opportunities

  • Rotations to Mayo Sites (optional)

Residents may also choose to spend one month practicing dermatology at Mayo Clinic in Arizona or Florida during their second or third years. During rotation at the other campuses, participants see patients independently but within a mentored setting.

The elective rotation at the other campuses provides additional outpatient experience in a smaller group practice. Mayo Clinic funds the authorized additional costs of resident travel, housing, car rental and licensure fees for this rotation.

  • Electives (optional)

Residents may apply for a one-month elective in an area of interest or use the elective time for research. Elective time is approved based on educational value. A total of one month at non-Mayo sites is permissible.

Mayo International Health Program

All residents are encouraged to apply for this program. Many dermatology residents have received this scholarship. Participation in local dermatology and medical clinics in countries such as Brazil, Kenya and Tanzania provides participants with the opportunity to see unique skin diseases.

Also see:

Service and Professionalism Project

Service to patients and the community is an intrinsic part of a physician's role. It fosters personal and professional growth through service to the underserved. Dermatology, traditionally strongly tied to patient service, reaffirms this emphasis through a service requirement for all trainees.

Each resident is required to participate in three service activities each year. Significant projects such as Camp Discovery, Mayo International Health Program or chief resident include planning, participation and reported results. Each significant project counts as completion of three activities.

Service opportunities include administrative functions and patient-focused activities. Administrative functions include:

  • Chief resident
  • Participation in interview season
  • Graduate education committee representative
  • American Academy of Dermatology committee membership
  • Zumbro Valley Medical Society committee membership

Patient-focused activities include:

Hawthorne Health Services Dermatology Clinic provides free services at Hawthorne Education Center, which provides adult educational services for Latino, Sudanese, Somali and Cambodian residents of Rochester. Nearly 50% of these learners do not have health insurance or assistance. The clinic provides free skin cancer screening exams and management of common skin diseases for the Hawthorne learners and their families.

Patch Testing

Mayo Clinic physicians with special interest in dermatosis patch test more than 500 patients for suspected allergic contact dermatitis each year. Residents are taught the nuances and interpretation of patch testing.

Wound Care Center

Each year, the multidisciplinary vascular wound care center provides care for hundreds of patients with, primarily, leg wounds. Dermatology participates, so residents may choose to rotate through this clinic.

Mayo residents have the opportunity to see and manage the entire spectrum of ulcerating skin conditions during their residency. Many patients with ulcerating skin conditions are also seen in the hospital and dermatology clinic.

Research Training

Residents are expected to participate in research projects with consulting staff. Participants may choose to be involved in:

  • Clinical/pathological correlative studies
  • Clinical reports
  • Defined laboratory-based projects
  • Clinical pharmacology studies
  • Clinical or laboratory-based research related to dermatologic surgery
  • Dermatopathology or immunopathology projects

Residents are encouraged to submit abstracts for presentation at national meetings.

Mayo Clinic's Department of Dermatology research laboratory collaborates with several other Mayo research laboratories, including immunology, cell and molecular biology and molecular genetics.

The Research Track residency position is one of the eight positions offered. It includes one additional year of training, specifically intended for residents with strong research and academic interest.

Research Track Resident

Residents choose their research projects. The goal is to prepare the resident for an academic pathway, a specific focus, or niche interest. Prior research experience is helpful, but not a prerequisite. The research track position incorporates PGY-2 through PGY-5.

  • The first year of residency is identical to the categorical and advanced program.
  • The second year includes three months of research time.
  • The third year includes 45 percent dedicated research time. Approximately two days per week are given to research. The other 3 days are identical to other third year SRA experience.
  • The fourth year is dedicated to research with the exception of one-half day per week, when the resident is assigned to outpatient practice seeing patients.

Smith-Gibson Fellowship

This fellowship is not part of the residency program but is offered at Mayo Clinic. It may be of interest to future applicants who seek research experience prior to applying to a dermatology program. Some Mayo residents have pursued this fellowship before matching to our program.

The Dr. Smith H. and Lucille Gibson Research Fellowship in the Department of Dermatology at Mayo Clinic in Rochester is a unique training opportunity. The fellowship consists of a one-year program of support for a fellow involved in any aspect of clinical, translational, or basic research within the department, as it relates to dermatologic disease or sciences. One fellowship is supported annually within the department.

Teaching Opportunities

Residents have the opportunity to teach Mayo Medical School students and visiting students from other medical schools through bedside instruction and formal didactic lectures. Other teaching opportunities offered are offered through the Service and Professionalism Project.

Evaluation

To ensure that participants acquire adequate knowledge and develop their technical skills, participants' performance is monitored carefully throughout residency training. Residents are evaluated formally by supervising faculty members. Residents also evaluate the faculty regularly to ensure that educational needs are being met. The evaluation process assesses the ACGME core competencies.

Career Development

Residents meet periodically with various faculty members, administrators and the program director to discuss professional goals. Mayo Clinic recruits many of its staff physicians from its own training programs.

  • Dec 6, 2013
  • ART495909