Houston Methodist. Leading Medicine.
Houston Methodist. Leading Medicine

Rotations

Rotations

PGY5
PROCEDURAL DERMATOLOGY FELLOWSHIP
MOHS AND DERMATOLOGIC SURGERY ROTATION

Supervising Faculty:
Dr. Leonard H. Goldberg, Program Director
Dr. Arash Kimyai-Asadi

Locations:
DermSurgery Associates, PA


Length:
12 months of training (1 year)

Level of training:
PGY5

GOALS

Upon completion of this fellowship, the PGY5 fellow will have achieved a broad base of knowledge and skills concerning the preoperative, operative, and postoperative care of patients requiring Mohs Surgery and other procedural dermatologic procedures. The resident will be competent and knowledgeable in the indications and the technical skills to perform Mohs and other dermatologic procedures. The PGY5 fellow will achieve the minimal standards established by the Mohs College for fellows.

PROGRAM DESCRIPTION:

The fellow will spend three days a week (Tuesdays, Wednesdays, and Thursdays) for 12 consecutive months at DermSurgery Associates performing operative procedures, participating in clinic, participating in research and diadetic sessions. At DermSurgery Associates, the fellow will have the opportunity to observe and perform techniques in clinic as well as in the Ambulatory Surgery Center (ASC.)

OBJECTIVES
Patient Care

Fellows must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of skin cancer and other skin conditions. Fellows will:

  • Demonstrate competence in performing medical and surgical evaluation and treatment planning in all Mohs surgery cases
  • Demonstrate competence in performing identified surgical procedures, including: Mohs micrographic techniques, including reconstructive techniques, flaps, graphs, simple and complex repairs; excisions; nail procedures; lip biopsy; scar revisions; tumescent liposuction and blepharplasty
  • Participate in all aspects of patient care, including pre-op, post-op, surgical procedures, care for complications and clinic

Medical Knowledge

Fellows must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological and social-behavioral sciences, as well as the application of this knowledge to patient care. Fellows must:

  • Demonstrate established and evolving medical knowledge in anatomy, physiology, and pathology
  • Demonstrate principles of both fixed and fresh micrographic surgical techniques
  • Demonstrate knowledge specific to management of complicated cancers of the skin
  • Demonstrate knowledge in cutaneous reconstructive surgery including random pattern axial flap repair, grafting techniques, and staged reconstructive techniques
  • Demonstrate knowledge of wound healing, surgical anatomy, cutaneous pathology, and advanced cardiopulmonary resuscitation.
  • Demonstrate knowledge required to set up and operate a frozen section laboratory capable of processing sections for Mohs surgery and to supervise and train laboratory personnel

Practice-based Learning and Improvement

Fellows must 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. Fellows are expected to develop skills and habits to be able to:

  • Demonstrate practice-based learning of surgical procedures, emergency procedures and perioperative care of the patient
  • Demonstrate commitment to improving patient care
  • Attend and participate in weekly practical and didactic conference with case presentations
  • Systematically analyze practice using quality improvement methods and implement changes with the goal of practice improvement
  • Locate, appraise, and assimilate evidence from scientific studies related to their patients' health problems
  • Pursue original research in the area of cutaneous oncology, Mohs surgery or other related field.

Interpersonal and Communication Skills

Fellows must demonstrate interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families, and health professionals. Fellows are expected to:

  • Communicate effectively in a team environment composed of peers, nurses, students, staff and supervising faculty
  • Listen and communicate effectively with patients and families
  • Communicate effectively with physicians, other health professionals, and health related agencies
  • Counsel and educate patients and families
  • Demonstrate the ability to include the important elements when composing and generating formal preliminary and final reports

Professionalism

Fellows must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles. Fellows are expected to:

  • Demonstrate compassion, integrity, and respect for others
  • Respect patient privacy and autonomy
  • Demonstrate accountability to patients, society, and the profession
  • Maintain patient confidentiality
  • Respond to the needs of patients and to the medical and professional community
  • Demonstrate progressively mature behavior and leadership skills
  • Accept feedback in a spirit of self-improvement

Systems-based Practice

Fellows must demonstrate 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. Fellows are expected to:

  • Apply knowledge to practice cost effective quality patient care
  • Coordinate patient care within the various settings
  • Understand the various health care systems and their relationship to managed care in the clinical setting
  • Advocate for quality patient care and optimal patient care systems
  • Demonstrate a knowledge of risk-benefit analysis
  • Demonstrate an understanding of the role of different specialists and other health care professionals, including technologists, in overall patient management
  • Demonstrate billing and coding knowledge

SUPERVISION

All patient treatment plans will be discussed with the Program Director or other faculty before clinical care decisions are made. The fellow will perform 500 or more Mohs cases under the direct supervision of the Program Director and/or other designated Faculty. The fellow will observe and participate in 3-4 cases of Blepharplasty and Tumescent liposuction. Once competence has been achieved, the fellow may perform as the primary surgeon at the discretion of the faculty.

PGY5
PROCEDURAL DERMATOLOGY FELLOWSHIP
LASER SURGERY AND COSMETIC DERMATOLOGY ROTATION

Supervising Faculty:Dr. Paul M. Friedman

Locations: DermSurgery Associates, PA
Length: 4 weeks during the fellowship year
Level of training: PGY5

GOALS

Upon completion of this rotation, the PGY5 fellow will have achieved a broad base of knowledge and skills concerning the preoperative, operative, and postoperative care of patients receiving procedural dermatologic procedures as described below. The resident will be competent and knowledgeable in the indications and possess the technical skills to perform the following dermatologic procedures:

BOTOX® Injections; FILLER SUBSTANCES (Juvéderm, Restylane, Perlane, Collagen, Cosmoderm, Cosmoplast, Hylaform, Hylaform Plus); FRAXEL® RE:STORE (SR1500) LASER TREATMENT; FRAXEL® RE:PAIR LASER TREATMENT; RESURFACING (CO2 laser, Erbium laser) ;LASER TONING; (SmoothBeamTM, Nd:Yag laser); ACNE LASER/LIGHT TREATMENT (SmoothBeamTM, PDT) ; PIGMENTED LESION REMOVAL (Q-Switched ruby laser and Nd:Yag laser); VASCULAR LESION REMOVAL (V-Beam Perfecta®, Cynergy); PHOTODYNAMIC THERAPY (PDT); LEG VEIN TREATMENT (Lasers, Sclerotherapy); CHEMICAL PEEL; HAIR REMOVAL LASERS (AltusTM and Light Sheer DiodeTM) and THERMAGE TREATMENT.

PROGRAM DESCRIPTION

The fellow will spend four weeks at DermSurgery Associates observing selected procedures and then participating in pre-op, treatment and post-operative care of patients. This rotation will be scheduled during the absence of the Program Director at DermSurgery Associates in order to optimize the fellow's clinical experiences.

OBJECTIVES

Patient Care

Fellows must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of various skin conditions. Fellows will:

  • Demonstrate competence in performing medical evaluation and treatment planning;
  • Demonstrate competence in performing identified procedures, including: chemical peel, dermabrasion, cutaneous soft tissue augmentation with injectable filler material, laser resurfacing, laser surgery, IPL hair removal and rhinophyma correction;
  • Participate in all aspects of patient care, including pre-op, post-op procedures and care for complications

Medical Knowledge

Fellows must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological and social-behavioral sciences, as well as the application of this knowledge to patient care. Fellows must:

  • Demonstrate established and evolving medical knowledge in laser systems and injectable fillers;
  • Demonstrate principles of laser treatment techniques;
  • Demonstrate knowledge specific to laser operation and safety;
  • Demonstrate knowledge in dermabrasion, cutaneous soft tissue augmentation with injectable filler material, laser resurfacing, laser surgery, IPL hair removal, and rhinophyma correction

Practice-based Learning and Improvement

Fellows must 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. Fellows are expected to develop skills and habits to be able to:

  • Demonstrate practice-based learning of laser procedures, emergency procedures and perioperative care of the patient
  • Demonstrate commitment to improving patient care
  • Attend and participate in weekly practical and didactic conference with case presentations
  • Systematically analyze practice using quality improvement methods and implement changes with the goal of practice improvement

Interpersonal and Communication Skills

Fellows must demonstrate interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families, and health professionals. Fellows are expected to:

  • Communicate effectively in a team environment composed of peers, nurses, students, staff and supervising faculty
  • Listen and communicate effectively with patients and families
  • Communicate effectively with physicians, other health professionals, and health related agencies
  • Counsel and educate patients and families
  • Demonstrate the ability to include the important elements when composing and generating formal preliminary and final reports

Professionalism

Fellows must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles. Fellows are expected to:

  • Demonstrate compassion, integrity, and respect for others
  • Respect patient privacy and autonomy
  • Demonstrate accountability to patients, society, and the profession
  • Maintain patient confidentiality
  • Respond to the needs of patients and to the medical and professional community
  • Demonstrate progressively mature behavior and leadership skills
  • Accept feedback in a spirit of self-improvement

Systems-based Practice

Fellows must demonstrate 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. Fellows are expected to:

  • Apply knowledge to practice cost effective quality patient care
  • Coordinate patient care within the various settings
  • Understand the various health care systems and their relationship to managed care in the clinical setting
  • Advocate for quality patient care and optimal patient care systems
  • Demonstrate a knowledge of risk-benefit analysis
  • Demonstrate an understanding of the role of different specialists and other health care professionals, including technologists, in overall patient management

SUPERVISION

All patient treatment will be discussed with the Supervising Faculty before treatment decisions are made. The fellow will perform cases under the direct supervision of the Designated Faculty until the fellow has achieved competence.

PGY5
PROCEDURAL DERMATOLOGY FELLOWSHIP
MOHS ROTATION AT TMH

Supervising Faculty: Dr. Leonard H. Goldberg, Program Director

Locations: Houston Methodist Hospital
6565 Fannin, Smith Tower, # 601
Houston, TX 77030
Length: 12 months of training (1 year)
Level of training: PGY5

GOALS

Upon completion of this fellowship, the PGY5 fellow will have achieved a broad base of knowledge and skills concerning the preoperative, operative, and postoperative care of patients requiring Mohs Surgery and other procedural dermatologic procedures. The resident will be competent and knowledgeable in the indications and the technical skills to perform Mohs Surgery. The PGY5 fellow will achieve the minimal standards established by the Mohs College for fellows.

PROGRAM DESCRIPTION

The fellow will spend one day a week (Mondays) for 12 consecutive months at Houston Methodist Hospital performing operative procedures and didactic sessions. Operative procedures performed at Houston Methodist Hospital normally consist of complex tumors and/or patients at higher risk.

OBJECTIVES
Patient Care

Fellows must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of skin cancer and other skin conditions. Fellows will:

  • Demonstrate competence in performing medical and surgical evaluation and treatment planning in all Mohs surgery cases
  • Demonstrate competence in performing identified surgical procedures, including: Complex Mohs micrographic techniques, complex reconstructive techniques, flaps, graphs, simple repairs; excisions and nail procedures
  • Participate in all aspects of patient care, including pre-op, post-op, surgical procedures, care for complications and clinic

Medical Knowledge

Fellows must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological and social-behavioral sciences, as well as the application of this knowledge to patient care. Fellows must:

  • Demonstrate established and evolving medical knowledge in anatomy, physiology, and pathology
  • Demonstrate principles of both fixed and fresh micrographic surgical techniques
  • Demonstrate knowledge specific to management of complicated cancers of the skin
  • Demonstrate knowledge in cutaneous reconstructive surgery including random pattern axial flap repair, grafting techniques, and staged reconstructive techniques
  • Demonstrate knowledge of wound healing, surgical anatomy, cutaneous pathology, and advanced cardiopulmonary resuscitation.
  • Demonstrate knowledge required to set up and operate a frozen section laboratory capable of processing sections for Mohs surgery and to supervise and train laboratory personnel

Practice-based Learning and Improvement

Fellows must 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. Fellows are expected to develop skills and habits to be able to:

  • Demonstrate practice-based learning of surgical procedures, emergency procedures and perioperative care of the patient
  • Demonstrate commitment to improving patient care
  • Attend and participate in weekly practical and didactic conference with case presentations
  • Systematically analyze practice using quality improvement methods and implement changes with the goal of practice improvement
  • Locate, appraise, and assimilate evidence from scientific studies related to their patients' health problems

Interpersonal and Communication Skills

Fellows must demonstrate interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families, and health professionals. Fellows are expected to:

  • Communicate effectively in a team environment composed of peers, nurses, students, staff and supervising faculty
  • Listen and communicate effectively with patients and families
  • Communicate effectively with physicians, other health professionals, and health related agencies
  • Counsel and educate patients and families
  • Demonstrate the ability to include the important elements when composing and generating formal preliminary and final reports

Professionalism

Fellows must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles. Fellows are expected to:

  • Demonstrate compassion, integrity, and respect for others
  • Respect patient privacy and autonomy
  • Demonstrate accountability to patients, society, and the profession
  • Maintain patient confidentiality
  • Respond to the needs of patients and to the medical and professional community
  • Demonstrate progressively mature behavior and leadership skills
  • Accept feedback in a spirit of self-improvement

Systems-based Practice

Fellows must demonstrate 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. Fellows are expected to:

  • Apply knowledge to practice cost effective quality patient care
  • Coordinate patient care within the various settings
  • Understand the various health care systems and their relationship to managed care in the clinical setting
  • Advocate for quality patient care and optimal patient care systems
  • Demonstrate a knowledge of risk-benefit analysis
  • Demonstrate an understanding of the role of different specialists and other health care professionals, including technologists, in overall patient management

SUPERVISION

All patient treatment plans will be discussed with the Program Director or other faculty before clinical care decisions are made. The fellow will perform 100 or more Mohs cases under the direct supervision of the Program Director at Houston Methodist Hospital. Once competence has been achieved, the fellow may perform as the primary surgeon at the discretion of the faculty.

PGY5
PROCEDURAL DERMATOLOGY FELLOWSHIP
RESEARCH

Supervising Faculty: Dr. Leonard H. Goldberg, Program Director
Location: DermSurgery Associates & Houston Methodist Hospital
Length: 12 Months
Level of training: PGY5

GOALS

This rotation will provide residents with an experience in the principles and practice of dermatologic research. The overall goals of this rotation are: (1) to allow residents to make meaningful contributions to the field of dermatologic surgery, (2) to stimulate independent scientific thinking, (3) to permit residents to recognize the value of performing clinical or basic science research, and (4) to develop residents' skills in research methodologies.

The fellow is expected to oversee a minimum of two projects of interest under the guidance of Dr. Leonard Goldberg. The fellow will present three projects locally, regionally, or nationally and submit at least two scholarly paper(s) for publication.

Interested residents will be encouraged to become as academically involved as possible with special programs and identify further opportunities for dedicated research.

OBJECTIVES - Research Knowledge

Residents must demonstrate a basic understanding of research methods and carry out a clinical or basic science project as defined above. After formal and informal instructions, the residents are expected to:

  • Apply knowledge of general dermatologic research principles to development and execution of a research project, by demonstrating the ability to::
    • Define a clinical problem to be addressed
    • Conceptualize a hypothesis
    • Systematically review previous work
    • Use appropriate research statistics
    • Demonstrate ability to write a proposal, manuscript, and/or grant
    • Make a research presentation
    • Write and submit an IRB Proposal, if needed
  • Apply knowledge of clinical research principles including:
    • Establishing inclusion / exclusion criteria
    • Establishing baseline information and investigations
    • Determining treatment allocations
    • Specifying treatment wings
    • Determining follow-up methodology
    • Identifying procedures for patient withdrawals
    • Determining outcome measures
    • Statistical analysis (including prospective power studies and post-test significance)
  • Apply knowledge of basic research principles including:
    • Determining the model to be used
    • Using appropriate biomechanical or biological techniques to reach a valid conclusion
    • Using appropriate statistical analysis
  • Apply knowledge of ethical research principles including:
    • Disclosure and resolution of conflicts of interest
    • Limits on interactions with industry representatives
    • Conduct of research on human subjects
    • Compliance with regulatory agencies
    • Specific ethical issues related to orthopaedic research

EVALUATION

Evaluation of Resident Performance

The Program Director will discuss expectations with the each resident at the initiation of the fellowship. During the fellowship, the mentoring attending will discuss performance providing verbal feedback regarding strengths, areas for improvement, and suggesting educational goals for subsequent experiences. Mentoring faculty will be encouraged to notify the program director at any time during the rotation with either commendation or concern regarding the resident's performance.

Faculty members directly supervising residents will complete a computer based evaluation form using the residency management software system (New Innovations.) This evaluation will be reviewed personally with each resident by the Program Director at the end of the fellowship. Competency in six core areas will be assessed. Semi-Annual evaluation by the program director will also be performed in which the resident will meet with the residency program director to review a summary report of the resident's assessment and performance in the core competencies. Individual counseling regarding strengths and potential weakness will be provided. Future career development will be discussed and each resident will have an opportunity to discuss their concerns. The summary report will be signed by both the resident and the program director and will become part of the permanent record.

Evaluation of faculty/educational program

Faculty involved in teaching the residents will be evaluated anonymously by the residents using the electronic residency management software system. Evaluations will include specific items about the rotation, clinical experience, and the faculty's teaching activities. The evaluations will be confidential and will be reviewed by the program director and departmental chair. Feedback on faculty performance will be used to improve teaching.

Residents will have the opportunity to evaluate and comment on services formally on Houston Methodist GME-administered Annual Survey of Residents' Educational and Clinical Experiences, which is also administered via New Innovations. The residents will have informal opportunities to provide feedback about the program to faculty and Program Director.

SUGGESTED READINGS AND REFERENCES

DermSurgery Associates and Houston Methodist Hospital provide numerous texts, subspecialty texts, and journals. Residents on this rotation should emphasize the major research texts emphasizing sections describing basic principles, and specifics regarding their particular project. Houston Methodist Hospital Research Institute offers additional information, texts, and instruction on grant writing, IRB proposals, protection for human subjects, etc.

PROCEDURAL DERMATOLOGY FELLOWSHIP
HAIR TRANSPLANTATION

GOALS

Upon completion of this rotation, the PGY5 fellow will have achieved a broad base of knowledge and skills concerning the preoperative, operative, and postoperative care of patients requiring hair transplantation. During the rotation the fellow will participate in hands-on experience with hair transplantation. The fellow will be competent and knowledgeable in the indications and the technical skills to carry out the most common hair transplantation procedures.

OBJECTIVES

Patient Care

Fellows must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of skin cancer and other skin conditions. The fellow will participate in a 2 to 3 day rotation, which has been scheduled by the Program Director in coordination with supervising faculty. During the rotation, the fellow will:

  • Receive instruction in hair transplantation and apply the principles to selection of patients for such procedures
  • Assist with the Development of Treatment Plan, including Patient Expectations, Surgical Feasibility, and Assessments of Risks/Benefits of Treatment Plan
  • Participate in a staged procedure of grafts containing 1 – 15 hairs during a session that includes 50-500 grafts
  • Demonstrate competence in performing medical and surgical evaluation and treatment planning for hair transplantation
  • Demonstrate competence in performing hair transplantation
  • Participate in all aspects of patient care, including pre-op, post-op, surgical procedures, and clinic

Medical Knowledge

Fellows must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological and social-behavioral sciences, as well as the application of this knowledge to patient care. Fellows must:

  • Demonstrate established and evolving medical knowledge in General Surgical Principles, Sterile Technique, Instrumentation, Instrument Preparation, Closure Materials and Wound Care
  • Demonstrate principles of hair transplantation to include the following:
    • Scalp Anatomy and Physiology, Cyclic Activity of Hair, Androgen-Dependent Hair, Pathophysiology of Androgenic Alopecia, Alopecia: Classification and Incidence, Types of Hair, Racial and Individual, Variations, Hair Loss Etiologies, Excess Hair Growth, Dermatological Scalp Conditions, Epidemiology and Demographics, of Hair Loss, Age and Androgenetic Alopecia (AGA) in Men, Female Androgenetic Alopecia (AGA) and Ethnic Variation in the Characteristics of Skin, Scalp, and Hair
  • Be familiar with Factors that Influence Wound Healing (Anatomic and Skin Type Considerations, Microbiology, Biomechanics and Histology Normal Skin and Scars and Wound Healing.)
  • Demonstrate Psychology of Hair Patient Evaluation, Selection, Hairline Design Details, The Donor Site, Graft Preparation techniques, Graft Insertion Techniques, Postoperative Care, Scalp Reductions and Scalp-Lifting, Pedicle Rotation Flaps in the Surgical Treatment of Alopecia
  • Understand Alternative Therapies, Anesthesia, Acetylsalicylic Acid (ASA) Risk Classification ( Topical, Local, Regional) and Nerve Block Anesthesia of the Scalp
  • Understand and demonstrate competence regarding special considerations complications. (Pain Control and Management of the Postoperative Period, Emergency Situations in Hair Transplantation; Reconstruction; Surgical Techniques; Surgical Options; Co1mplications; General Theory, Management, and Prevention of Complications; Complications of Hair Transplantation; Complications of Flaps in the Treatment of Baldness Scar Revision; Strategies in Updating Old Techniques and Correcting Suboptimal Results, Interdisciplinary Care of Patient, Interdisciplinary Care for Complicated Cases, Nonsurgical Hair Replacement Medical Therapy; Current Understanding of Androgenetic Alopecia (AGA) and Testosterone; Minoxidil –Finasteride- Dutasteride - Over-the-Counter (OTC) Treatments and Hoaxes)
  • Familarize themselves with special considerations - Hair Transplantation in Blacks, Asians, Females, Hair Transplantation o f the Eyebrows, Hair Transplantation of the Eyelashes; Reconstruction of the Temporal Points Area, Moustache Transplantation, Hair Transplantation in Skin Grafts, Thin Recipient Skin, and Radiation-Induced Alopecia; Treatment of the Genetically Male Transsexual; Treatment of Female Pattern Alopecia; Synthetic Hair, Automation Techniques in Hair Restoration Surgery, and Scalp Reconstruction and Techniques

Practice-based Learning and Improvement

Fellows must 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. Fellows are expected to develop skills and habits to be able to:

  • Demonstrate practice-based learning of surgical procedures, emergency procedures and peri-operative care of the patient
  • Demonstrate commitment to improving patient care
  • Systematically analyze practice using quality improvement methods and implement changes with the goal of practice improvement
  • Locate, appraise, and assimilate evidence from scientific studies related to their patients' health problems

Interpersonal and Communication Skills

Fellows must demonstrate interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families, and health professionals. Fellows are expected to:

  • Communicate effectively in a team environment composed of peers, nurses, students, staff and supervising faculty
  • Listen and communicate effectively with patients and families
  • Communicate effectively with physicians, other health professionals, and health related agencies
  • Counsel and educate patients and families
  • Demonstrate the ability to include the important elements when composing and generating formal preliminary and final reports

Professionalism

Fellows must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles. Fellows are expected to:

  • Demonstrate compassion, integrity, and respect for others
  • Respect patient privacy and autonomy
  • Demonstrate accountability to patients, society, and the profession
  • Maintain patient confidentiality
  • Respond to the needs of patients and to the medical and professional community
  • Demonstrate progressively mature behavior and leadership skills
  • Accept feedback in a spirit of self-improvement

Systems-based Practice

Fellows must demonstrate 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. Fellows are expected to:

  • Apply knowledge to practice cost effective quality patient care
  • Coordinate patient care within the office setting
  • Advocate for quality patient care and optimal patient care systems
  • Demonstrate a knowledge of risk-benefit analysis
  • Demonstrate an understanding of the role of different specialists and other health care professionals, including technologists, in overall patient management

SUPERVISION

The PGY5 fellow will report directly to supervising faculty during this rotation. The fellow will perform 3 or more cases under the direct supervision of the designated Faculty.

PGY5
PROCEDURAL DERMATOLOGY FELLOWSHIP
SCLEROTHERAPY

GOALS

Upon completion of this rotation, the PGY5 fellow will have achieved a broad base of knowledge and skills concerning the preoperative, operative, and postoperative care of patients requiring Sclerotherapy. Fellow will be able to clinically evaluate a vein patient with a detailed history and physical examination and be able to cater specific treatment recommendations, organize a plan of treatment for patients with venous disease, treat reticular veins and spider veins effectively, consider the use of Cutaneous Laser and develop skills which can be advanced with further training such us ultrasound guided sclerotherapy, ambulatory phlebectomy and endovenous laser procedures. During the rotation the fellow will participate in hands-on experience with Sclerotherapy. The fellow will be competent and knowledgeable in the indications and the technical skills to carry out the procedures.

OBJECTIVES

The fellow will participate in a 2 to -3 day rotation, which has been scheduled by the Program Director in coordination with faculty.

Patient Care

Fellows must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of venous disease. Fellows will:

  • Be able to manage complications, provide appropriate post-op care and compression therapy.
  • Demonstrate ability to complete a Venous Examination – demonstrating competence in treatment planning and surgical evaluation
  • Apply Sclerotherapy Principles and Sclerotherapy Techniques in provision of patient care
  • Participate in the examination of the Vein Patient using Ultrasound
  • Participate in all aspects of patient care, including pre-op, post-op and surgical procedures – demonstrating ability to inject fluids into vessels typically less than 1mm in diameter

Medical Knowledge

Fellows must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological and social-behavioral sciences, as well as the application of this knowledge to patient care. Fellows must:

  • Demonstrate established and evolving medical knowledge in anatomy, physiology, and pathology – specifically, Anatomy & Physiology of the superficial venous system
  • Application of Anatomy to the Principles of Sclerotherapy
  • Demonstrate knowledge regarding Cutaneous Diagnostic Devices
  • Apply knowledge to Sclerotherapy of reticular veins and spider veins
  • Demonstrate knowledge of Foam Sclerotherapy, Ultrasound Guided Sclerotherapy and application of Cutaneous laser techniques
  • Demonstrate knowledge related to supplies used for Sclerotherapy, Sclerotherapy Emergency Protocols and Sclerosing solutions

Practice-based Learning and Improvement

Fellows must 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. Fellows are expected to develop skills and habits to be able to:

  • Demonstrate practice-based learning of surgical procedures, emergency procedures and perioperative care of the patient
  • Demonstrate commitment to improving patient care
  • Attend and participate in weekly practical and didactic conference with case presentations
  • Systematically analyze practice using quality improvement methods and implement changes with the goal of practice improvement

Interpersonal and Communication Skills

Fellows must demonstrate interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families, and health professionals. Fellows are expected to:

  • Communicate effectively in a team environment composed of peers, nurses, students, staff and supervising faculty
  • Listen and communicate effectively with patients and families
  • Communicate effectively with physicians, other health professionals, and health related agencies
  • Counsel and educate patients and families
  • Demonstrate the ability to include the important elements when composing and generating formal preliminary and final reports

Professionalism

Fellows must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles. Fellows are expected to:

  • Demonstrate compassion, integrity, and respect for others
  • Respect patient privacy and autonomy
  • Demonstrate accountability to patients, society, and the profession
  • Maintain patient confidentiality
  • Respond to the needs of patients and to the medical and professional community
  • Demonstrate progressively mature behavior and leadership skills
  • Accept feedback in a spirit of self-improvement

Systems-based Practice

Fellows must demonstrate 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. Fellows are expected to:

  • Apply knowledge to practice cost effective quality patient care
  • Coordinate patient care within the various settings
  • Understand the various health care systems and their relationship to managed care in the clinical setting
  • Advocate for quality patient care and optimal patient care systems
  • Demonstrate a knowledge of risk-benefit analysis
  • Demonstrate an understanding of the role of different specialists and other health care professionals, including technologists, in overall patient management

SUPERVISION

The PGY5 fellow will report directly to assigned faculty during this rotation. The fellow will assist with 3 or more cases under the direct supervision of the designated Faculty.