DERU-4010 - Clinical Dermatology

DERU-4010 - Clinical Dermatology

Elective Title: Clinical Dermatology
Course Number: DERU-4010
Elective Type: clinical Duration/Weeks: 4 Max Enrollment: 5
Prerequisites: Successful completion of Year 2
Additional Requirements: N/A
Responsible Faculty Director: Dr. Anthony Linfante, MD Periods Offered: 1-13 including holiday period 8 
Coordinator: Reynol Lopez Other Faculty: Michael Wilkerson, MD; Bernard Gibson, MD; Erica Kelly, MD; Brent Kelly, MD; Brandon Goodwin, MD; Janice Wilson, MD; Lindy Ross, MD; Kathleen Kroger, MD; Frank Winsett, MD; Ayezel Munoz, MD
Location to Report on First Day:
Dermatology Department 4.112 McCullough

Goals
1. Students should learn to recognize and manage common dermatological diseases.

2. Students should learn to perform common dermatological procedures.

Objectives
-Learn to describe skin lesions.
-Recognize most common dermatological entities.
-Become proficient at dermatological testing.
-Understand common therapeutic options for skin diseases.
-Observe surgical techniques available for skin.

Description of course activities
Students generally will attend clinic daily as assigned M-F and TDC clinic on Tuesday afternoons where students participate in patient care. Students will report to their designated location for the day, either in UHC (Galveston) or UTMB Primary and Specialty Care (League City), at 8:00 AM for lecture. Travel between these clinic locations will be necessary depending on the assigned location for the day. They will be responsible for seeing patients and performing a history and physical, presenting to residents/faculty, and coming up with an assessment and plan. There is a midday break for lunch and then a PM clinic that concludes between 5:00-5:30 PM. Most of the clinical exposure is general (adult and pediatric) dermatology, though students will also get exposure to cosmetics, surgical procedures/Mohs surgery, and dermatopathology.
In addition to formal lectures, self-directed reading is strongly encouraged. The American Academy of Dermatology’s “Basic Dermatology Curriculum” is online for free. Additionally, “Lookingbill and Marks’ Principles of Dermatology” textbook is available through the online UTMB library for free. These resources are both at the level of a 3rdor 4th year medical student. The student will present a 10-15 minute presentation to the department on a topic of their choosing at the end of the rotation.
Students should read about clinical entities seen during each clinic day and about those discussed in conferences. There will also be teaching conferences for which attendance is required on-line or, if allowed, in person from 9-12 on Fridays. Attendance is required for all additional conferences given by faculty for students.
Students may also be assigned to see hospital consultations with the consult resident. Students interested in Dermatology as a career may elect to do an end of rotation presentation.

Type of students who would benefit from the course
Students interested in dermatology or in primary care, ENT or plastic surgery.

    Weekly Schedule
          Estimated Course Activities (Start-Time/Finish-Time):
Day of Week   AM   PM
Monday 9-12 1:15-5
Tuesday 9-12 1:15-5
Wednesday 9-12 1:15-5
Thursday 9-12 1:15-5
Friday 9-12 Conferences
Saturday
Sunday

 Average number of patients seen per week: 50
 Call Schedule: None

Research / Other Course Activities
(estimated schedule)
Activity Hours per Week
Faculty Contact-Time
Self-Directed Study
Data-Collection/Analysis
Other Didactic conferences


Method of Student Evaluation
1.  Clinical Observation
  A. Where are students observed on this elective?
    Inpatient Service   Ambulatory   Surgery   Standardized patients
Patients simulators   Other
  B. Frequency - How often are students observed clinically?
    Daily. Will receive feedback from residents and faculty as needed between patients.
  C. Format - What method(s) are used to document the student's clinical performance?
    Daily oral feedback   End of period oral feedback   Written feedback
Other

2.  Oral Presentation
  A. Audience - To whom does the student present?
    Students will present patients that they have seen to the faculty and residents.
  B. Frequency / Duration of Presentation(s)?
    Daily
  C. Format - What guidelines are set for the student's presentation?
    Standard SOAP format.
  D. Assessment - Who assesses the student's presentation performance?
    Self-assessment   Peer assessment   Faculty assessment
  E. Method of content selection
    Current cases  Student-selected topic   Assigned topic

3.  Written Assignment (H&P's, notes, papers, abstracts, etc.)
  A. Frequency of written assignment(s)?
    None
  B. Format - What guidelines are set for the student's written work?
   
  C. Length of written assignment(s)?
    Abstract   Annotated bibliography   1 - 2 page paper   3+ page paper
  D. Are recent references required?   No    If yes, how are they selected?
   
  E. Method of content selection - e.g. student-selected, relate to cases, etc.?
   
  F. Audience - Who assesses the student's written performance?
    Peer Assessment     Faculty Assessment     Other

4.  Examination
  Format
    Oral   Written multiple choice   Written essay / short answer   OSCE
Other

5.  Extra Course Activities
  What expectations do you have for the student to demonstrate participation in the elective (e.g. small group activities, seminars, thoughtful questions, providing resources, journal club, resident lecture attendance)?
    Expect student to be present and a part of the health care team for each clinic session assigned and to be present for all teaching conferences. Schedules for students may vary somewhat from month to month depending on numbers of students on rotation and the times faculty are available to do lectures.

6.  Additional Costs
  Please list any additional costs and/or purchases (books, materials, movies to watch, etc.) that are required for this course. Include an estimated total cost. If there are no additional costs, please enter "None".
    None

7.  Other Modes of Evaluation
  Please explain below.
   

8.  If this course is an Acting Internship, please complete the following:
  A. Objectives for the AI should relate directly to the Entrustable Professional Activities (EPAs). Each AI should describe how the four key Year-4 EPAs that our school has identified as being Year-4 skills are assessed. The Year-4 objectives are:
1. Entering and discussing orders/prescriptions.
2. Give or receive patient handover to transition care responsibility.
3. Recognizing a patient requiring urgent or emergent care and initiating management.
4. Obtaining informed consent for tests and procedures.
Specify how the student will be given formative feedback on their clinical skills.
   
 
B.
Year-4 students should demonstrate mastery of EPAs they developed in the clerkship year, including recommending and interpreting common diagnostic and screening tests, and performing general procedures of a physician. They should be able to demonstrate masterfully and independently skills they mastered in Years 2-3, including efficiently performing comprehensive admission-notes and succinct daily progress notes and perform accurate, concise, and hypothesis-driven clinical presentations, form clinical questions and retrieve evidence to advance patient care. They should be able to demonstrate basic understanding of and beginning mastery of collaborate as a member of the interprofessional team and identify system failures and contribute to a culture of safety improvement.

List advanced clinical skills that a student will be assured an opportunity to practice.
   
 
C.
How specifically will this AI build on developing skills from the clerkship year to prepare students for internship?
   
 
D.
What opportunities will typically be available to all students who take this AI (procedures, required presentations, etc.)? What opportunities may be available based on patient load/presentation or student initiative (ie. Writing a case report)?
   
 
E.
An AI should have expectation of a minimum of 32 hours per week of clinical responsibilities. Duty hours should be capped at ACGME limits for an intern, thus up to 24 hours followed by 4 hours of activities related to patient safety, education, and handoff. Students cannot work more than 80 hours per week averaged over 4 weeks. They can only have 1 day off in a 7-day work week with 8 hours off between shifts.

Clinical responsibilities will vary depending on specialty, but how is the student functioning with work commensurate to a PGY1 with an appropriate level of training?
   
 
F.
How is the student demonstrating drawing clinical conclusions and/or developing a management plan and documentation as an intern would do?
   
 
G.
How and by whom will midpoint feedback be provided to the student? How will you remediate deficiencies identified at midpoint?
   
 
H.
Acting Internship students often seek letters of recommendation following their experience. How many different Faculty will work directly with the student and have knowledge of the student's abilities to detail in a written evaluation? Describe the degree of supervision and interaction with faculty vs. residents or other providers and how feedback will be obtained if more direct work is with residents or other providers.