Cosmetics PGY-2

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Cosmetic Dermatology Rotation Goals/Objectives for PGY-2
Patient Care
Goal: To provide care for cosmetic dermatology patients that is caring, sensitive, and effective
in optimizing evaluation, management, patient education and outcomes.
Objectives:

1. Consistently obtain accurate, targeted history and examination for routine conditions
   efficiently but may need guidance with subtle or complex findings. PC5
2. Usually give a targeted presentation using appropriate terminology and providing pertinent
   negatives. PC5
3. Usually performs in-office tests proficiently. PC
4. Consistently select clinically-appropriate laboratory and imaging tests. PC6
5. Usually interprets dermpath and applies findings to clinical care accurately for common
   neoplasms. PC1
6. Usually select appropriate medications for common dermatologic disorders. PC8
7. Consistently select correct vehicle and quantity for topical medications. PC8
8. Consistently prescribe and manage medications for common dermatologic diseases. PC8
9. Usually recognize common and serious side effects, but can need direction in ordering
   monitoring tests. PC8
10. Usually perform in-office procedures (shave biopsy, punch biopsy, electrodessication and
    curettage, intralesional injections, and cryotherapy) proficiently. PC3
11. Consistently able to manage post-procedure care and minor complications. PC5
12. Usually able to perform pre-procedure assessment and set up procedure equipment. PC5
13. Consistently able to perform skin preparation and to administer local anesthesia for more
    complex procedures. PC5
14. Consistently able to assess and counsel patients for basic procedures. PC5
15. Consistently develop a differential diagnosis that includes common disorders and some more
    do top ae and road pries for bade ocean co
    complex conditions and only occasionally need guidance for prioritization. PC7
16. Occasionally counsel patients about prevention, disease expectations, treatment, and
    longitudinal care. PC8
17. Usually be able to formulate appropriate management plans for patients with common
    disorders, including longitudinal continuity care. PC8
18. Usually suggest appropriate specialist consultations. PC5
    Medical Knowledge
    Goal: To acquire knowledge in cosmetic dermatology, demonstrate competence in knowledge of
    topics specified by the American Board of Dermatology and develop expertise in patient
    management.
    Objectives:
19. Demonstrate knowledge of the pathophysiology, clinical and laboratory manifestations,
    expected course, and management options of common dermatologic disorders. MK1

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2. Distinguish most urgent from non- urgent surgical dermatological conditions and
complications. MK1
3. Demonstrate rudimentary knowledge about socio-behavioral aspects and the value of
preventive care in dermatology. MK1
4. Demonstrates knowledge of relevant oral sedatives or analgesics, including narcotics. MK1
5. Demonstrates knowledge of complex concepts of suture material and wound healing. MK1
6. Demonstrates knowledge of topical anatomy and relevant underlying structures. MK1
7. Demonstrates knowledge of and is able to differentiate the properties of different materials
and equipment used on the rotation. MK1
8. Identifies uncommon diseases with characteristic findings. MK2
9. Describes morphology of skin lesions, with assistance. MK2
Practice Based Learning and Improvement
Goal: Develop skills in acquiring, analyzing, applying and teaching cosmetic dermatology
knowledge. Develop the ability to self-analyze and the ability to design quality improvement
projects to optimize patient outcomes.
Objectives:

1. Without being directed, access appropriate print or electronic resources to find dermatology
   information requested or assigned. PBLI1
2. Consistently ask for feedback. PBLI2
3. Remain open to constructive criticism of performance, avoid defensiveness or denial of
   constructive criticisms received PBLI2
4. Participate in the collection and analysis of program-specific resident competency data (for
   example, patient logs, procedure logs, and treatment logs) PBLI2
5. Identify deviations from standards of dermatologic care (for example, identifies when
   guidelines of care were not followed, and when over- or under-utilization of diagnostic testing
   and therapy has occurred). PBLI2
6. Articulates clinical questions and elicits patient preferences and values in order to guide
   evidence-based care. PBLI1
7. Demonstrates openness to performance data (feedback and other input) in orderto inform
   goals. PBLI2
8. Analyzes and reflects on the factors which contribute to gap(s) between expectations and
   actual performance. PBLI2
9. Designs and implements a learning plan, with prompting. PBLI2
10. Actively participates by selecting articles, leading article review discussion and by asking
    appropriate questions during cosmetic journal club. PBLI1

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Interpersonal Communication
Goal: To communicate with patients’ their families, and other health professionals in a clear,
concise, caring, and respectful manner.
Objectives:

1. Usually communicate effectively and build rapport with patients and families in routine
   encounters, but may require guidance in stressful encounters. ICS1
2. Occasionally recognize non-verbal cues from patients and use non-verbal skills to convey
   empathy, but may require guidance in time- pressed, complex, and stressful situations. ICS]
3. Avoid technical jargon. ICS1
4. Actively seek the patient’s and family’s perspective ICS1
5. Use patient hand-outs and/or diagrams to explain diseases and treatments when appropriate.
   ICS1|
6. Counsel and provide clear and specific verbal and/or written instructions to patients related to
   diagnostic tests, risk/benefits of treatment, treatment alternatives, and therapeutic plans
   (including prescriptions), and assesses patient comprehension. ICS1
7. Identify special communication needs of vulnerable populations (for example, pediatric and
   elderly patients, persons with disabilities or illiteracy, immigrants, refugees, veterans, prisoners).
   ICS1
8. Appropriately use translators to facilitate communication with patients and families ICS1
9. Demonstrate appropriate face-to-face interaction while using the electronic medical record or
   completing the patient health record. ICS1
10. Recognize the circumstances related to having difficult conversations with patients and
    families ICS1
11. Communicate effectively with health care team members in ways that demonstrate
    appreciation for their skills and contributions in routine situations, but may require guidance in
    difficult or contentious situations. ICS2
12. Obtain and provide consultation and communicate effectively with supervisors, consultants,
    and referring providers in routine patient care situations, but may need guidance in complex or
    nuanced circumstances. ICS2
13. Demonstrate receptiveness to requests for consultations from other specialties and
    communicate promptly with referring providers. ICS2
14. Consistently document office visits, consultations, letters to referring providers, procedures.
    and counseling with clearly written and relevant information for routine situations, but may
    occasionally need assistance with complex situations. ICS2
15. Ensure that patient records and orders are accurate, comprehensive, timely, and legible with
    attention to preventing confusion and error. ICS3
16. Establishes a therapeutic relationship in straightforward encounters using active listening and
    clear language. ICS1
17. Identifies complex barriers (e.g., health literacy) to effective communication. ICS1
18. Identifies elements of shared decision making. ICS
19. Solicits feedback on performance as a member of the health care team. ICS2
20. Demonstrates organized diagnostic and therapeutic reasoning through notes in the EHR.
    ICS3

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22. Uses documentation tools and short cuts (e.g., copy/paste) accurately and appropriately, per
institutional policy. ICS3
Professionalism
Goal: Develop a commitment to excellence, integrity, and sensitivity in the care for cosmetic
dermatology patients and in the interactions with other health professionals and staff.
Objectives:

1. Treat all patients with respect and dignity, regardless of socio- economic, racial, or ethnic
   background or sexual orientation PROF1
2. Understand the actions and relationships that constitute potential boundary crossings and
   violations, and actively avoid these. PROF1
3. Respond promptly and appropriately to clinical responsibilities (for example, timely reporting
   for duty, completion of medical records, returning patient phone calls, answering pages). PROF2
4. Carry out timely interactions with colleagues, patients, and their designated caregivers.
   PROF2
5. Promptly complete clinical tasks. PROF2
6. Explain the concept of leading by example. PROF1
7. May need assistance with time management and setting priorities, but all patient care
   activities are completed in a timely fashion. PROF2
8. Consistently demonstrate empathy and compassion to patients of all ages. PROF1
9. Demonstrates insight into professional behavior in routine situations. PROF1
10. Takes responsibility for own professionalism lapses. PROF1
11. Analyzes straightforward situations using ethical principles. PROF1
12. Performs tasks and responsibilities in a timely manner with appropriate attention to detail in
    routine situations. PROF2
13. Recognizes situations that may impact own ability to complete tasks and responsibilities in a
    timely manner. PROF2
14. Independently recognizes status of personal and professional well-being. PROF3
15. Independently recognizes limits in one’s own knowledge/skills and seeks help when
    appropriate. PROF3
    Systems Based Practice
    Goal: Competently navigate the health care system using the resources available to provide
    effective yet cost-conscious patient care.
    Objectives:
16. Adapt to clinical work in different sites and health care systems (for example, university
    medical center, outreach clinic, inpatient setting, etc.). SBP1
17. Maintain access to all needed systems. SBP1
18. Access support services appropriately at different practice sites. SBP2
19. Describe the use of checklists and briefings to prevent adverse events in health care;
    recognize the roles of team members and participate in briefings. SBP1
20. Articulate understanding of institutional risk- management resources available SBP1

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6. Begin to identify the social/governmental services necessary for vulnerable populations,
including determination of eligibility for services and delivery of some aspects of care. SBP3
13. Demonstrate knowledge of how a patient’s health care is paid for, and how this affects the
patient’s care. SBP3
14. Articulate awareness of costs for common diagnostic or therapeutic tests, including the cost
of performing and interpreting skin biopsies. SBP3
15. Consider cost of medical and surgical therapies, and incorporate this into therapy decisions
and discussions with the patient. SBP3
16. Demonstrate awareness of minimizing unnecessary care, including tests, procedures.
therapies, and ambulatory or hospital encounters. SBP3