ROTATOR ORIENTATION FOR DERMATOLOGY ELECTIVE
Goals and Objectives
Although rotators are planning different career paths, the basic goals of the elective are similar. By the end of the rotation each rotator should be able to:
1)Describe dermatologic conditions using the appropriate vocabulary
2)Distinguish between inflammatory conditions and neoplastic conditions
3)Construct a simple differential diagnosis for various conditions
4)Construct a basic treatment plan for common dermatologic conditions
5)Construct a clinical case presentation via powerpoint for the faculty, residents, and students (only required for medical students)
Key Players
Rotators will be working with residents, nursing staff, clerical staff, and Attending physicians. Rotators should contact one of the dermatology Chief Residents prior to the rotation in order to know when and where to report on the first day of the rotation. During the rotation rotators will work closely with the dermatology residents in clinic and on in-patient consults. The Chief Resident will assign the daily tasks depending on the clinic, and the number and type of in-patient consults.
Locations
The dermatology clinic is on the 5th floor of Nelson Clinic. The academic office is on the 3rd floor of Grant House.
Schedule
Rotators will typically work in the residents’ ½ day continuity clinics held Monday, Wednesday, and Thursday mornings and Friday afternoons. They will also participate in Dr. Shinn’s pediatric clinic on Thursday afternoons when held at Nelson clinic. At times a medical student will be assigned to work in one of the VA clinics. When not in clinic rotators will have time to read, see in-patient consults and attend the department’s conferences. Most continuity clinics are preceded by a short clinical conference. Dermatology Grand Rounds are at 1 PM on Wednesdays. Didactics are Wednesday afternoons and Friday mornings.
Expectations
Be present and punctual – Ask the Chief Residents to provide you with start times for the various clinics and conferences. Unless specifically excused rotators are expected to attend all department conferences. It is understood that rotators have interviews and other commitments that will require absences from the rotation. The Chief Residents will need to be advised of all of these in order to excuse the absence.
Be presentable – All rotators and residents will wear white coats in the clinic and on consults. An exception is made for the pediatric clinic. All will wear appropriate professional attire; men will wear ties, unless wearing a turtle neck.
Be prepared – We do not expect rotators to be dermatologists. However, we do expect rotators to be prepared and to read about the patients they see. Students- before starting your elective, review the handouts from your M-II course. These handouts have the basics you should know starting your elective. Each medical student will be required to finish the rotation with a powerpoint presentation about a topic or case of his/her choice. The residents and faculty are willing to help regarding the presentations if asked.
Be polite – One of the most challenging aspects of being a professional is maintaining a calm demeanor, especially during stressful encounters. Inappropriate or disrespectful behavior will not to be tolerated. Remember your ‘please and thank yous,’ especially to the staff.
Be proactive – If you have questions regarding patient management or pathophysiology please speak up. We want your experience to be very educational. However, be tactful; sensitive questions should not be asked in front of the patients.
Work Flow
Clinic: Rotators will be assigned clinic patients by the Chief Resident; only patients scheduled with one of the 2nd or 3rd year dermatology residents will be assigned to rotators. Some patients will be new to the clinic and some will be established patients. The rotator will initiate the encounter. After introducing himself/herself as the medical student, or resident, s/he will take an appropriate history and perform as much as of the exam with which s/he with is comfortable. The rotator will then present to the patient’s dermatology resident physician. The dermatology resident will repeat appropriate aspects of the encounter with the rotator in attendance. Then, with the dermatology resident, the rotator will present the case to the Attending. The Attending with the rotator and dermatology resident will repeat the patient encounter and make a treatment plan. The rotator will write the clinic note and send it to the dermatology resident to review and cosign; the dermatology resident forwards the note to the Attending.
In-patient Consults: The dermatology Chief Resident on consults will assign patients for the rotators to see in the hospital. The steps taken for presenting in-patients is similar to that of clinic. The exception is that patients are presented to the Attending on rounds.
Educational Resources
The “resident room” in the dermatology clinic has a wide variety of dermatology texts that rotators may utilize. The AmericanAcademy of Dermatology (AAD) has a splendid Medical Student Core Curriculum available at In addition there are various websites that may be helpful, including articles in the dermatology section of Medscape (AKA eMedicine). Furthermore there is series of clinical cases available through the Department of Dermatology’s website and/or the medical student blackboard.
Feedback and Evaluation
Evaluations for rotating residents are typically via New Innovations; those for students are still hand written. The Consult Attending for the month will complete these evaluations. If there are two or more Attendings during the rotation, the Attending who worked more with the rotator will complete the evaluations. Students and other rotators are welcome to ask for an appointment to discuss his/her evaluation, but it is not required.
Official Interview
Some medicals students rotating on this elective are interested in pursuing a career in dermatology. If it is your goal to pursue a dermatology residency please let the Chief Residents know when you arrive on the rotation. The Chief Resident will see if s/he can arrange time for you at the VAMC. It should be your goal during your rotation to meet and work with as many of the Attendings as you can. As you complete your rotation you should make an appointment to meet with Drs. Nunley and/or Reese (Program Director and Associate Program Director). If you have not had a chance to meet or work with other Attendings they will help facilitate a meeting. Your rotation will serve as your interview as a candidate applicant for the dermatology residency program.