General Dermatology PGY-2

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

1. Consistently obtain accurate, targeted history and examination for routine conditions
   efficiently but may need guidance with subtle or complex findings. PC1
2. Usually give a targeted presentation using appropriate terminology and providing
   pertinent negatives. PC1
3. Usually perform in- office tests (KOH, Tzanck, scabies prep, trichogram) proficiently.
   PC6
4. Consistently select clinically-appropriate laboratory and imaging tests. PC6
5. Usually will interpret dermpath and apply 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. PCS
8. Consistently prescribe and manage systemic medications for common dermatologic
   disease. PC8
9. Usually recognize common and serious side effects, but can need direction in ordering
   monitoring tests. PC8
10. Consistently develop a differential diagnosis that includes common disorders and
    some more complex conditions and only occasionally need guidance for prioritization.
    PC7
11. Occasionally counsel patients about prevention, disease expectations, treatment, and
    longitudinal care. PC1 and PC8
12. Usually be able to formulate appropriate management plans for patients with commo
    isorders. including longitudinal continuity care. PC
13. Usually suggest appropriate specialist consultations. PC1
14. Usually perform in-office procedures (shave biopsy, punch biopsy, electrodessication
    and curettage, intralesional injections, and cryotherapy proficiently. PC3
    Medical Knowledge
    Goal: To acquire knowledge in medical dermatology, demonstrate competence in
    knowledge of topics specified by the American Board of Dermatology and develop
    expertise in patient management.
    Objectives:
15. Demonstrate knowledge of the pathophysiology, clinical and laboratory
    manifestations, expected course, and management options of common medical
    dermatologic dısorders.MK1
16. Distinguish most urgent from non- urgent dermatological conditions.MK1

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3. Demonstrates rudimentary knowledge of the value of preventive care and socio-
behavioral aspects of medical dermatologic disorders (for example, health care
economics and medical ethics). MK1
4. Identifies uncommon diseases with characteristic findings. MK2
5. Describes morphology of skin lesions, with assistance. MK2
Practice-Based Learning and Improvement
Goal: Develop skills in acquiring, analyzing, applying and teaching general 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. PBLI
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
   and retreate to 8am
   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. PBLI
7. Demonstrates openness to performance data (feedback and other input) in order to
   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
   Interpersonal Communication
   Goal: To communicate with patients’ their families, and other health professionals in a
   clear, concise, caring, and respectful manner.
   Objectives:
10. Usually communicate effectively and build rapport with patients and families in
    routine encounters, but may require guidance in stressful encounters. ICS1
11. 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. ICS1
12. Avoid technical jargon. ICS1
13. Actively seek the patient’s and family’s perspective ICS1
14. Use patient hand-outs and/or diagrams to explain diseases and treatments when
    appropriate. ICS1

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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. ICSI
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
13. 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
14. Demonstrate receptiveness to requests for consultations from other specialties and
communicate promptly with referring providers. ICS2
15. 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
16. Ensure that patient records and orders are accurate, comprehensive, timely, and
legible with attention to preventing confusion and error. ICS3
17. Establishes a therapeutic relationship in straightforward encounters using active
listening and clear language. ICS1
18. Identifies complex barriers (e.g., health literacy) to effective communication. ICS1
19. Identifies elements of shared decision making. ICS1
20. Solicits feedback on performance as a member of the health care team. ICS2
21. Demonstrates organized diagnostic and therapeutic reasoning through notes in the
EHR. ICS3
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
medical 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

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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. PROF
9. Demonstrates insight into professional behavior in routine situations. PROF1
10. Takes responsibility for own professionalism lapses. PROF
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:

1. Adapt to clinical work in different sites and health care systems (for example,
   university medical center, outreach clinic, inpatient setting, etc.). SBP1
2. Maintain access to all needed systems. SBP1
3. Access support services appropriately at different practice sites. SBP2
4. 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
5. Articulate understanding of institutional risk- management resources available SBP1
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
7. Demonstrate knowledge of how a patient’s health care is paid for, and how this affects
   the patient’s care. SBP3
8. Articulate awareness of costs for common diagnostic or therapeutic tests, including the
   cost of performing and interpreting skin biopsies. SBP3
9. Consider cost of medical and surgical therapies, and incorporate this into therapy
   decisions and discussions with the patient. SBP3
10. Demonstrate awareness of minimizing unnecessary care, including tests, procedures,
    therapies, and ambulatory or hospital encounters. SBP3

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11. Usually apply principles of coding (ICD-9/10) and reimbursement (E&M
levels/procedures) appropriate to medical record documentation. SBP3
12. Identifies system factors that lead to safety events. SBP1
13. Reports patient safety events through institutional reporting systems. SBP1
14. Describes local quality improvement initiatives (e.g., handwashing, needle stick
prevention, wrong site surgery prevention). SBP1
15. Coordinates care of patients in routine clinical situations effectively using the roles of
the interprofessional teams. SBP2
16. Performs safe and effective transitions of care/hand-offs in routine clinical situations.
SBP2
17. Identifies specific population and community health needs and inequities for their
local population. SBP2
18. Describes how components of a complex health care system are interrelated, and how
this impacts patient care. SBP3
19. Delivers care with consideration of each patient’s payment model. SBP3
20. Describes core administrative knowledge needed for transition to practice. SBP3