FELLOWSHIP IN DERMATOLOGICAL SURGERY
GOAL
The fellowship consists of a one or two year program which provides a thorough knowledge of cutaneous surgery including cosmetic procedures, the management and practical experience of all aspects of dermatologic surgery.
GENERAL OBJECTIVES
The fellowship will consist of rotations with experts within the fields of dermatologic surgery, plastic surgery, ophthalmologic surgery, and oncologic surgery.
TECHNICAL SKILLS
1. Mohs micrographic surgery-including closures with grafts, flaps and primary closure.
2. Excision of benign and malignant tumours using simple and complex closure techniques.
3. Electrosurgery.
4. Laser surgery including the various types for resurfacing, tattoos, hair removal, angiomas and
pigmented lesions.
5. Revision of acne scars and scar revision with punch grafts, subincision.
6. Hair transplant.
7. Blepharoplasty.
8. Liposuction.
9. Chemical peeling.
10. Injection techniques with fillers such as collagen, fat transplant, etc.
11. Dermabrasion.
12. Special cosmetic procedures such as Botox for wrinkles and hyperhidrosis.
13. Methods of anaesthesia such as local blocks and conscious sedation.
14. Nail surgery.
15. Vein sclerosing.
16. Viewing of procedures for aging of the face, e.g. facelifts, browlifts-direct and endoscopic.
17. Cryosurgery.
18. Keloid surgery.
19. Surgical drains and haemostasis.
COGNITIVE SKILLS
On completion of the first year, the fellow should have a detailed knowledge of:
1. Basic cutaneous surgery concepts
2. Cutaneous anatomy.
3. Surgical sepsis.
4. Knowledge of anaesthesia and complications.
5. Pre and post-operative care.
6. Pre and post-operative antibiotics.
7. Closures including simple to complicated flaps with understanding of the tissue movement and
placement.
8. Thorough understanding of all types of flaps and their application.
9. Different types of grafts, composite grafts and allografts.
10. Mechanism of action of the different types of lasers.
11. Tumescent anaesthesia.
12. Wound healing.
13.Wound dressing.
14. Dealing with complications.
15. Choosing appropriate patients for cosmetic surgery and dealing with difficult patients.
16. Surgical consent and legal implications.
The fellows in their second year will be given a greater deal of responsibility, being allowed to do more complex surgeries under supervision.
The fellow should also:
-write one article during his/her fellowship or participate in research project.
-participate in the teaching and examination of residents in dermatology.
-maintain a log of surgical procedures as a surgeon or as an assistant.
PROFESSIONAL ATTITUDE
1. Ability to communicate with patients and their families and to deal with the emotional components of
oncological and cosmetic patients.
2. Understanding of ethical issues.
3. Interact with other professionals.
Wayne Carey, MD