Residency

Program Goals and Objectives

Dermatology Residency Program
University of Washington
Goals and Learning Objectives
Updated January 2016
Roy Colven, MD, Program Director

Program Goals:

  1. To provide trainees with the practical experience in a variety of clinical settings that will enable them to deliver excellent specialized care to patients with diseases of the skin, hair, nails, and mucous membranes.
  2. To provide an educational environment that fosters: a) acquisition and retention of new knowledge, b) appreciation of the limits of present knowledge, c) spirited discussion of controversies within the specialty, and d) formulation of hypotheses subject to scientific testing.
  3. To provide opportunities for mentored scholarly pursuit, including investigative dermatology.
  4. To provide mentorship and guidance to enable trainees to become future leaders in academic dermatology.

II. Program Learning Objectives (ACGME Competency-based)

A. Patient care (PC)

  1. Provide compassionate, appropriate and effective care for promotion of health and the treatment of cutaneous disease and systemic disease related to the skin.
  2. Gather a complete medical history.
  3. Perform and document a complete exam of the skin and other organ systems relevant to the patient’s general and cutaneous health.
  4. Learn and use appropriately, consistently and accurately the language of dermatology.
  5. Become progressively more efficient in the care of ambulatory and hospitalized patients with cutaneous health problems.
  6. Become facile with synthesizing and interpreting data in the care of progressively more complex cutaneous disease.
  7. Generate progressively more astute differential diagnosis with each year in training.
  8. Select appropriate and cost-efficient ancillary studies in the management of patients.
  9. Demonstrate skill in clinic/office-based diagnostic tests, including KOH prep, scabies prep, Gram’s stain, Wood’s lamp exam.
  10. Select appropriate biopsy lesion, body site and technique.
  11. Assumes progressively more independent management of patients, including
    • Therapy selection
    • Side effect monitoring
    • Deciding when to change or discontinue therapy
    • Counseling patients on risks, benefits and alternatives to selected therapy or procedure
    • Awareness of pertinent drug-drug interactions.
  12. Demonstrates competence in cryotherapy, including:
    • Selection of appropriate conditions.
    • Counseling patients on risks, benefits and alternatives to cryotherapy.
    • Careful application of liquid nitrogen.
    • Management of complications of cryotherapy.
  13. Perform an appropriate pre-operative assessment of candidates for skin surgery.
  14. Demonstrates competence in electrosurgery, including:
    • Selection of appropriate uses for electrosurgery.
    • Counseling patients on risks, benefits and alternatives to electrosurgery.
    • Skilled use of electrosurgery unit.
    • Understands risks to operator of electrosurgery unit.
    • Management of complications of electrosurgery.
  15. Demonstrates competence in excisional skin surgery with simple closure, including
    • Selection of appropriate lesions and closure technique.
    • Understands the appropriate surgical anatomy issues for the above procedure on any body site.
    • Counseling patients on risks, benefits and alternatives to surgery.
    • Skilled performance of the above procedure under qualified supervisory observation.
    • Understands risks to operator and assistant during surgery.
    • Management of complications of the above procedure.
  16. Demonstrates competence in excisional skin surgery with layered closure.
    • Selection of appropriate lesions and closure technique.
    • Understands the appropriate surgical anatomy issues for the above procedure on any body site.
    • Counseling patients on risks, benefits and alternatives to surgery.
    • Skilled performance of the above procedure under qualified supervisory observation.
    • Understands risks to operator and assistant during surgery.
    • Management of complications of the above procedure.
  17. Demonstrates competence in excisional skin surgery with closures involving flaps and/or grafts.
    • Selection of appropriate lesions and closure technique.
    • Understands the appropriate surgical anatomy issues for the above procedure on any body site.
    • Counseling patients on risks, benefits and alternatives to surgery.
    • Skilled performance of the above procedure under qualified supervisory observation.
    • Understands risks to operator and assistant during surgery.
    • Management of complications of the above procedure.
  18. Understands the appropriate surgical anatomy and anesthesia pertinent to perform nail surgery and has at least assisted in nail surgery with a qualified surgeon.
  19. Understands the principles of laser surgery and appropriate selection of laser for cutaneous disease and has observed laser surgery conducted by a qualified operator.
  20. Observes and, when possible, perform cosmetic surgical techniques such as, hair transplantation, tattoo removal, liposuction, and dermabrasion.
  21. Understands the principles of and appropriate selection of cutaneous diseases and patients for ultraviolet light therapy and has observed the administration of UV light conducted by a qualified operator.
  22. Understands the principles of contact patch testing and competently reads a standard patch testing panel.
  23. Understands the principles of moist wound healing and has demonstrated appropriate selection of wound dressings.
  24. Gains a longitudinal perspective on the delivery of health care through individualized continuity dermatology clinic patient panels

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B. Medical knowledge (MK)

  1. Demonstrates a progressively expanding core knowledge base in the basic sciences relevant to dermatology.
    a. Applies principles of microbiology, cutaneous oncology, immunology and genomics, including molecular diagnostic techniques, to the counseling and management of patients with dermatologic disorders.
  2. Demonstrates a progressively expanding core knowledge base in clinical dermatology.
    • Applies principles of epidemiology, infection control, and the social sciences to the counseling and management of patients with dermatologic disorders.
  3. Demonstrates a progressively expanding core knowledge base in medical therapeutics used in dermatology, including
    • Topical therapies
    • Systemic therapies
    • Side effect of therapies
    • Interactions between therapeutic agents
    • Monitoring tests for side effects and frequency of monitoring.
  4. Demonstrates a progressively expanding core knowledge base in surgical diagnostics and therapeutics used in dermatology, including
    • Equipment and materials used in skin surgery
    • Critical surgical anatomy
    • Principles and techniques of effective hemostasis
    • Appropriate tissue margins for cutaneous neoplasms
    • Appropriate biopsy technique
    • Appropriate referral to a Mohs and/or plastic surgeon
    • Appropriate tissue handling, including orientation, requesting special stains, and use of immunofluorescence for optimal dermatopathologic interpretation.
  5. Retains core knowledge over time.
  6. Competently teaches others in the above core knowledge areas.
  7. Thoroughly and critically reads up-to-date textbooks of dermatology to enhance a comprehensive understanding of the specialty.

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C. Practice-based learning and improvement (PBL)

  1. Participates in didactic and patient-centered conferences included in the residency program curriculum.
  2. Demonstrates active, self-directed learning.
  3. Efficiently and effectively accesses and assesses best-evidence for clinical decision making.
  4. Actively participates in and comes prepared to didactic conferences and interactive discussions.
  5. Demonstrates progressive metacognition of errors in patient care, gaps in core knowledge and suboptimal interpersonal communication and takes steps to correct them.
  6. Gains insight for improvement in clinical efficiency.
  7. Applies newly acquired medical knowledge to patient care.
  8. Demonstrates progressive consideration of precision, accuracy, expense, and safety when selecting and interpreting diagnostic tests.
  9. Demonstrates progressive facility and diligence in accessing information assessing safety, efficacy, adverse event profile, and cost of therapy or prevention.
  10. Demonstrates progressive facility and diligence in accessing information assessing outcomes of disease and interventions.
  11. Maintains appropriate records documenting practice activities (such as patient logs) and demonstrates initiative in improving weak areas.
  12. Writes effective test questions for peer and self-study.
  13. Begins a lifelong habit of critical reading to remain current in the medical literature of dermatology and related fields.
  14. Understands the process of peer review of journal submissions.
  15. Synthesizes information from a variety of sources, including print and electronic.

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D. Interpersonal communications (IPC)

  1. Empathically listens.
  2. Consistently uses a compassionate, courteous and respectful demeanor in the work setting.
  3. Effectively communicates with other physicians and staff in a manner that respects patient privacy.
  4. Effectively counsels and educates patients, their families and caregivers in a timely fashion.
  5. Presents gathered patient information concisely, completely, logically and lucidly.
  6. Functions effectively as an integral part of a dermatology team.
  7. Offers sensitive and constructive feedback.
  8. Responds positively to appropriately delivered feedback.
  9. Skillfully communicates with referring physicians in written language.
  10. Documents in the medical record all interactions with patients in a timely thorough, concise and lucid manner.
  11. Demonstrates mastery of the language of dermatologic description.
  12. Effectively summarizes and publicly presents a critical analysis of a patient case.
  13. Effectively presents to a group for understanding the different research methodologies encountered in investigative journal papers.

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E. Professionalism (PRO)

  1. Consistently demonstrates ethical conduct.
  2. Creates and maintains healthy and positive relationships with other residents, faculty and students.
  3. Consistently displays emotional maturity.
  4. Consistently demonstrates dependable behavior in patient care, follow-up and administrative tasks.
  5. Consistently dresses in a neat and professional manner.
  6. Consistently is punctual for clinical work and didactics.
  7. Consistently demonstrates respectful behavior toward faculty, staff, co-residents, students, and patients.
  8. Demonstrates sensitivity to issues of culture, age, gender, and disability.
  9. Demonstrates initiative in patient care.
  10. Demonstrates initiative in resolving conflicts.
  11. Considers and grapples with ethical issues including research fraud, informed consent, cost of medical care, billing and compensation issues, withholding of care, appropriateness of treatment, conflict of interest with pharmaceutical companies, and use of human subjects in research.

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Systems-based practice (SBP)

  1. Progressively demonstrates practicing cost-effective care without compromising quality of care.
  2. Understands how different practice systems function to deliver care.
  3. Progressively utilizes non-dermatologist staff effectively as part of the health care team.
  4. Progressively demonstrates when and who to call for appropriate consultation.
  5. Progressively provides effective consultation.
  6. Positively interacts with non-department healthcare providers.
  7. Attends relevant non-department learning opportunities.
  8. Gains a global perspective on dermatology through the reading of the dermatological literature originating from other countries.

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