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Curriculum

Photo of Mayo Clinic dermatologist looking through a microscope

The Dermatology Residency is a unique program that offers trainees graduated autonomy culminating in a hands-on senior resident associate (SRA) year.

Clinical experience offers exposure to common dermatologic 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.

Rotation schedule

A typical Dermatology Residency rotation schedule includes:

First year (PGY-2)
Rotation Length
Inpatient dermatology and consultation services
  1. Mayo Clinic Hospital, Methodist Campus: Includes phototherapy and selectives
4-5 months
Outpatient dermatology
  1. Gonda 16: Work with consultants following their unique interests and referral patients
  2. Continuity clinic scheduled weekly at Mayo Family Clinic Northwest except when on hospital service
2-3 months
Dermatopathology and immunodermatology
  1. Participate in daily readout of biopsies
1 month
Dermatologic surgery
  1. Basic dermatologic surgery under the guidance of consultants or senior resident associates
2 months
Pediatric outpatient dermatology
  1. Northwest clinic and Gonda 16
1 month
Dermatology team at Mayo Family Clinic Northwest
  1. Community-based patients seen with a team including resident, consultant and nurse
1 month
Second year (PGY-3)
Rotation Length
Dermatopathology and immunodermatology
  1. Participate daily in readout, with opportunity to correlate immunofluorescent, monoclonal antibody and histochemical studies
2-3 months
Outpatient dermatology
  1. Gonda 16 assignment with consultant
1 month
Sub-SRA
  1. Modified senior resident associate (SRA) experience
1 month
Pediatric and outpatient dermatology
  1. Northwest clinic and Gonda 16
1 month
Dermatologic surgery
  1. Intensive one-on-one outpatient dermatologic surgery care, with exposure to Mohs micrographic surgery and advanced cutaneous surgical procedures, such as laser, cosmetic and reconstructive procedures
6-7 weeks
Dermatology consultation service
  1. Inpatient dermatologic consultations at Mayo Clinic Hospital, Saint Marys Campus
6-7 weeks
Dermatology team at Mayo Family Clinic Northwest
  1. Community-based patients seen with a team including resident, consultant and nurse
6 weeks
Elective (optional)
  1. Clinical or laboratory research experience or outpatient rotation as approved by education committee, or outpatient dermatology rotation at Mayo Clinic's campus in Arizona or Florida
1 month
Third year (PGY-4)
Rotation Length

Senior resident associate (SRA)

Outpatient dermatology

  1. Independent outpatient clinic on Gonda 16 with daily supervision by the Mayo Clinic consulting staff
  2. Community and pediatric clinic on Thursdays at Mayo Family Clinic Northwest on a rotational basis

Dermatopathology

  1. One half-day a week in the Dermatopathology Laboratory, where residents review biopsies from their cases seen in the outpatient practice and stay fresh in preparation for their board examinations

Dermatologic surgery

  1. Weekly dermatologic surgery procedure clinic
11-12 months
Elective (optional)
  1. Outpatient dermatology at Mayo Clinic's campus in Arizona or Florida
1 month

Rotation descriptions

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 Family Clinic Northwest. Evaluation of more-complex and rare dermatologic patients referred to Mayo Clinic for tertiary care occurs in the Gonda Building, 16th Floor.

    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 on Gonda 16 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 on Gonda 16, working with all consultants to gain experience in subspecialty work-up clinics.

  • Outpatient PGY-4. Third-year residents, or senior resident associates (SRAs), are based on Gonda 16. SRAs 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, cutaneous T-cell lymphoma and life-threatening dermatoses seen in hematology/oncology and transplant patients

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

  • Extracorporeal photophoresis
  • 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 rotations, residents are prepared to manage patients with serious dermatologic 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 patients with psoriasis, 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. The high case volume allows trainees to build necessary histopathologic interpretive skills. The lab practice is centrally embedded to allow frequent dialogue between the lab and clinical practice, particularly for challenging cases seen in floor conferences.

In this rotation, residents 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 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 seven 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, residents 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 years 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.

Electives and other opportunities

  • Rotations to other Mayo campuses (optional). Residents may choose to spend one month practicing dermatology at Mayo Clinic's campuses in Phoenix/Scottsdale, Arizona, or Jacksonville, Florida, during their second or third years. While rotating at the other campuses, residents 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 the Mayo International Health 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.
  • 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 reporting 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 offers free services at Hawthorne Education Center, which provides adult educational services for Latino, Sudanese, Somali and Cambodian residents of Rochester. Nearly half 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 interests 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.

Didactic training

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

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 use other learning resources as appropriate.

Conferences

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

Departmentwide 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 inpatient 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 for informal discussion and review.

Research training

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

  • Clinicopathologic 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 and Innovation Track residency position is one of the eight positions offered. It includes one additional year of training, specifically intended for residents with strong interests in research and innovation.

Research and Innovation Track resident

Residents choose their projects. The goal is to prepare the resident for an academic pathway or a career in innovation. Prior research experience is helpful, but not a prerequisite. The Research and Innovation 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 project time.
  • The third year includes 45 percent dedicated project time. Approximately two days a week are given to projects. The other three days are identical to the third-year SRA experience.
  • The fourth year is dedicated to projects with the exception of one half-day a week, when the resident is assigned to see patients in the outpatient practice.

Smith-Gibson Fellowship

This fellowship is not part of the Dermatology Residency 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's campus in Rochester, Minnesota, 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.

Call frequency

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

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 are offered through the Service and Professionalism Project.

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.

Evaluation

To ensure that residents acquire adequate knowledge and develop their technical skills, performance is monitored carefully throughout the Dermatology Residency. 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.

  • Nov 30, 2015
  • ART495909