Residents obtain their clinical training at our Harvard-affiliated hospitals. These departments of dermatology are staffed with outstanding teachers and clinical experts in general dermatology, subspecialty dermatology, dermatopathology and procedural dermatology. A sample 3-year program follows, along with a description of each training block.
These rotations focus on the diagnosis and treatment of "bread and butter" medical and surgical dermatology under the supervision of a wide variety of full-time attending dermatologists. Medical dermatology and advanced dermatology blocks take place at the three core program institutions: Beth Israel Deaconess Medical Center, Brigham and Women's Hospital, and Massachusetts General Hospital.
Advanced dermatology rotations are comprised of dermatology subspecialty clinics, including laser and cosmetic procedures, wound care, phototherapy, cutaneous oncology, oral medicine, rheumatology-dermatology, and complex medical dermatology.
All residents complete inpatient consultation rotations at Beth Israel Deaconess Medical Center, Brigham and Women's Hospital, Massachusetts General Hospital, Children's Hospital Boston, and the Boston VA/West Roxbury. Inpatient consultation rotations provide experience with the evaluation and management of complex medical dermatology diagnoses in seriously ill patients, such as erythroderma, vasculitis, blistering disorders, severe adverse cutaneous drug reactions, disseminated bacterial and fungal infections, and the cutaneous manifestations of systemic disease. While 10 months are dedicated consult blocks, most of these rotations still include outpatient clinics based on the consult load at each clinical site.
During this two-month block supervised by a Mohs surgery-trained mentor, the resident learns how to take Mohs sections, interpret frozen section histology, and perform complex surgical repairs with flaps and grafts. The resident also advances their skills in fusiform excision, laser medicine and cosmetic procedures.
Residents develop their dermatopathology skills through two dedicated one-month rotations. Residents are immersed in dermatopathology training through daily sign-outs with dermatopathology staff members, specialized dermatopathology conferences, participation in dermatopathology journal clubs, and glass slide self assessment. The experience gained during this rotation provides the resident with insight into the practice of dermatopathology from the initial processing of biopsy specimens to the optimal interpretation of histologic slides and writing of pathology reports.
This block offers dedicated time to hone teaching skills through activities centered on teaching dermatology and internal medicine resident peers, in addition to rotating medical students. In addition, the resident coordinates Grand Rounds as well as supervises and gives several didactic lectures to Harvard medical students. The resident also participates in several subspecialty medical dermatology clinics as well as a weekly supervised teledermatology clinic in collaboration with Nantucket Hospital.
The 2-month dedicated pediatric dermatology block takes place at Children's Hospital Boston. While on this rotation residents are supervised by pediatric dermatology attendings in the care of patients in the ambulatory and inpatient consultative settings. The patient population ranges from neonates to teenagers presenting with common and uncommon diagnoses such as atopic dermatitis, psoriasis, epidermolysis bullosa, disorders of cornification, genodermatoses, vascular anomalies, and pigmented lesions. Residents participate in the Vascular Anomalies Clinic, an internationally-renowned multidisciplinary clinic comprised of dermatologists, plastic surgeons, pediatric surgeons and interventional radiologists who collaborate in the care of patients with severe vascular birth defects.
This two-month rotation provides experience with medical and surgical management of patients who are often afflicted by combat-related conditions such as post traumatic stress syndrome, amputations, burn scars, and extensive sun exposure during tours of duty in Africa, Asia and the South Pacific. As a result, there is a very high incidence of skin cancer and melanoma among this patient population. Residents on this rotation provide continuity of care for these patients in the diagnosis and surgical treatment of their cancers as well as participate in the inpatient consultation service. The VA also provides a unique training setting in which senior residents are allowed more autonomy and independence in the management of their patients.
This two-month rotation takes place at Lahey Clinic in Burlington, MA, which is home to the Northeast Regional Leprosy Center. The clinical experience at Lahey offers exposure to a community based setting with the added benefit of working with Dr. Samuel Moschella and his complex patient population. This rotation also offers the opportunity to participate in advanced dermatology and specialty clinics, procedural clinics and dermatopathology sign-out.
The objective of this rotation is to provide the opportunity to explore areas of clinical or research interest through scholarly activities, to promote activities with a clear discernable plan supporting career development, and to promote volunteerism or community service activities in an area of limited exposure or to an underserved group.