General Dermatology PGY-3

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General Dermatology Rotation Goals/Objectives for PGY-3
Patient Care
Goal: To provide care for medical dermatology patients that is caring, sensitive, and effective in
optimizing diagnosis, management, patient education and outcomes.
Objectives:

1. Consistently able to extract difficult-to-elicit but pertinent information and clinical
   findings; occasionally needs guidance with subtle or complex findings. PC1
2. Consistently gives targeted and precise presentation with pertinent negatives. PC1
3. Consistently performs in-office tests (KOH, Tzanck, scabies prep, trichogram)
   proficiently and interprets results correctly. PC6
4. Consistently accurately interprets laboratory and imaging test results. PC6
5. Usually interprets dermatopathology and applies findings to clinical care accurately.
   including for uncommon neoplasms and common inflammatory dermatoses. PC4
6. Usually interprets the results of special stains in dermatopathology. PC4
7. Consistently selects appropriate medication and changes to medical therapy and usually
   selects appropriate systemic medication for management of complex diseases. PC8
8. Consistently monitors for medication side effects, including ordering appropriate tests.
   PC8
9. Consistently develops a comprehensive and weighted differential diagnosis. PC7
10. Usually educates patients with common and complex disorders with guidance. PC1
11. Consistently makes management decisions for patients with common disorders, but
    usually needs guidance for patients with complex disorders; consistently tailors
    counseling and management decisions for individual patient needs and preferences PC&
12. Consistently seeks appropriate specialist consultations. PC1
13. Choose the appropriate biopsy technique and location for different diagnoses. PC3
14. Independently manages patients with common pediatric dermatologic conditions with
    attension to age, weight and psychosocial considerations PC2
    Medical Knowledge
    Goal: To acquire knowledge in medical dermatology and develop expertise in patient
    management.
    Objectives:
15. Usually demonstrates knowledge of the clinical and laboratory manifestations, expected
    course and management options of common, uncommon, and complex medical
    dermatologic disorders; identifies and usually manages urgent dermatological conditions.
    MK1
16. Demonstrates knowledge of the pathophysiology of complex skin disorders MK1
17. Usually applies basic science knowledge to dermatologic disorders, and relates advances
    in basic science to clinical practice. MK1
18. Identifies variable presentations of common disease MK2
19. Integrates visual diagnostic tools (eg. dermoscopy) with assistance MK2
    Practice-Based Learning and Improvement

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Goal: Develop skills in acquiring, analyzing, applying and teaching general dermatology
knowledge. Develop the ability to self-analyze.
Objectives:

1. Actively seeks appropriate resources to find dermatology information to answer clinical
   questions without being requested or assigned this task. PBLI1
2. Applies a set of critical appraisal criteria to different types of research, including
   synopses of original research findings, systematic reviews, meta- analyses, and clinical
   practice guidelines. PBLI1
3. Critically evaluates information from others, including colleagues, experts, industry
   representatives, and patients. PBLI
4. Self-assessment or learning plan demonstrates a balanced and accurate assessment of
   competence and areas for continued improvement. PBLI2
5. Identifies, in journal club or other educational venues, when new evidence, guidelines, or
   information should change how the resident or department functions (ordering tests,
   selecting therapies, etc.) PBLI1
6. Summarizes complex medical topics through effective information synthesis and
   presentation of material. PBLI
7. Seizes the teachable moment with others in the clinical setting. PBLI2
8. Seeks performance data episodically, with adaptability and humility PBLI2
9. Analyzes, reflects on, and institutes behavioral change(s) to narrow the gap(s) between
   expectations and actual performance PBLI2
   Interpersonal communication:
   Goal: To communicate with patients, their families, and other health professionals in a clear,
   concise, caring, and respectful manner.
   Objectives:
10. Consistently communicates effectively and builds rapport with patients and families in
    routine encounters, occasionally requiring guidance in stressful encounters. ICS1
11. Usually recognizes non- verbal cues from patients, and uses non-verbal skills to convey
    empathy. ICS1
12. Usually paces clinical interviews appropriately, spending extra time when indicated.
    ICS1
13. Consistently maintains composure in difficult patient and family encounters. ICS1
14. Considers patient beliefs in shaping the patient- physician relationship and therapeutic
15. Adapts patient/family- related information gathering to social and cultural context. ICS1
16. When prompted, reflects on personal biases while attempting to minimize
    communication barriers ICS1
17. Consistently communicates effectively with health care team members in ways that
    demonstrate appreciation for their skills and contributions in routine situations,
    occasionally requiring guidance in difficult or contentious situations. ICS2
18. Consistently obtains and provides consultation and communicates effectively and
    efficiently with supervisors, consultants, and referring providers in routine patient care
    situations, occasionally needing guidance in complex or nuanced situations. ICS2

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10. Communicates effectively with medical students, peers, and faculty members in a variety
of formal and informal educational settings. ICS2
11. Checks own understanding of consultant recommendation ICS2
12. Provides both positive and negative feedback, as appropriate, when mentoring other
physicians. ICS2
13. Consistently respectful of the opinions of colleagues, and works to resolve conflicts
through proper channels and communication. ICS2
14. Consistently ensures that patient records, including outpatient and inpatient consultations
and transitions of care, are promptly and accurately documented for routine and complex
situations. ICS
15. Appropriately selects and uses direct (eg. telephone, in-person) and indirect (eg.
progress notes, text and inbox messages) forms of communication based on context ICS3
Professionalism
Goal: Develop a commitment to excellence, integrity, and sensitivity in the care for medical
dermatology patients and in the interactions with other health professionals and staff.
Objectives:

1. Educates junior learners and ancillary staff members in, and models adherence to.
   institutional and departmental policies and procedures, proper use of social media.
   equitable and empathic treatment of all patients, and maintaining patient confidentiality.
   PROF1
2. Adheres to state, institutional, and professional guidelines regarding physician
   relationships with industry. PROF1
3. Performs tasks and responsibilities in a timely manner with appropriate attention to detail
   in complex or stressful situations PROF2
4. Proactively ensures that the needs of patients are met PROF2
5. Develops self - improvement plan to address limitations and personal errors. PROF3
6. Lists gaps of knowledge and devises plan for improvement. PROF3
7. Establishes list of priorities and effective time management that enables successful
   pursuit of professional and personal goals. PROF3
8. Consistently demonstrates empathy and compassion to patients of all ages, including
   difficult or challenging patients. PROF1
9. Demonstrates effective strategies to manage conflict when patient values differ from his
   or her own values. PROF1
10. Discusses ideas and strategies to offset disparities in health care for specific dermatologic
    diagnoses. PROF1
    Systems Based Practice
    Goal: Competently navigate the health care system using the resources available to provide
    effective yet cost-conscious patient care.
    Objectives:
11. Reviews local gaps in quality, and identifies systems and human errors that contribute to
    gaps in quality. SBP1

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2. Critically appraises current or proposed quality improvement interventions. SBP1
3. Participates in quality improvement activities. SBP1 [
4. Effectively navigates systems to overcome obstacles to optimal patient care (for example.
facilitating access to care). SBP2
5. Identifies target patient populations, differences in demographics, and can utilize the
appropriate agencies/resources to address specific needs of these populations. SBP2
6. Delegates tasks appropriately to members of the health care team. SBP2
7. Attends and contributes to clinic team/staff meetings at participating sites. SBP2
8. Facilitates checklist- guided briefings (for example pre-procedure timeouts) in health care
activities. SBP1
9. Leads discussion during conferences that highlight systems errors. SBP1
10. Articulates understanding of the intersection of the legal system and health care system in
the context of medical errors. SBP3
11. Consistently identifies the social/governmental services necessary for vulnerable
populations, including determination of eligibility for services and delivery of some
aspects of care. SBP3
12. Consistently advocates for optimal patient care in the setting of interdisciplinary
interactions. SBP2
13. Articulates awareness of common socio-economic barriers that impact patient care.
SBP3
14. Articulates understanding of how cost-benefit analysis is applied to patient care. (that is,
via principles of screening tests and the development of clinical guidelines) SBP3
15. Identifies the role of various health care stakeholders, including providers, commercial
and government payers, and pharmaceutical industry and medical device companies, and
their varied impact on the cost of and access to health care. SBP3
16. Identify and minimize unnecessary care, including tests, procedures, therapies,
ambulatory or hospital encounters. SBP3