Fellows will provide tertiary care to pediatric dermatology patients during a weekly continuity clinic, and also in regularly scheduled attending clinics throughout the academic year, so as to afford the maximal amount of continuity. During the fellow-run continuity clinic, fellows will formulate diagnostic and therapeutic plans under the supervision of a pediatric dermatology attending. These clinics will provide continuity for inpatient consults requiring outpatient follow-up as well as appointments for new patients requiring urgent evaluation. Participation in a minimum of 5 outpatient half-day clinics in pediatric dermatology per week is required. Fellows will concentrate on patient/caregiver interaction skills (with both patients and parents), diagnostic acumen, and therapeutic management. The pediatric approach, with emphasis on developmental and behavioral issues as pertinent to pediatrics, will be emphasized.
Fellows will be instructed in the evaluation, pre-operative planning and delivery of pediatric dermatologic surgery services, including post-operative wound care and pain management. Decision as to the proper timing and approaches for dermatologic surgery in children will be emphasized, including consideration of patient age, developmental status, activities, etc. Fellows will learn hands-on surgical techniques in skin biopsy, curettage, cryotherapy, and full-thickness excision as well as simple closure techniques. Fellows desiring exposure to more complex surgical issues, including skin grafting or complex closure techniques may elect to spend time with a Pediatric General Surgeon or Pediatric Plastic Surgeon in the OR. Fellows will be instructed in the indications and use of the pulsed dye laser, and receive hands-on training in the use of this laser for therapy of vascular skin lesions in children. Fellows will also be trained on the use of the excimer laser for the treatment of vitiligo and psoriasis in children. All laser procedures will be performed under the direct supervision of an attending pediatric dermatologist with local anesthesia. Fellows desiring experience on other laser modalities, including carbon dioxide and Nd:YAG lasers, may elect to spend time with a Pediatric General Surgeon or Pediatric Plastic Surgeon in the OR. The opportunity exists for the fellow to observe in the Phototherapy Center at the University of Cincinnati, which provides PUVA, broadband UVB and narrowband UVB therapy and currently treats about 100 patients per week.
Fellows will actively participate in inpatient consultative services, including the general and subspecialty pediatric wards, surgical wards, neonatal and pediatric intensive care units and the emergency department. Formulation of diagnostic and therapeutic plans will be expected of the fellow, who will supervise the resident and/or medical student on service under the supervision of an attending pediatric dermatologist. The fellow will be responsible for coordinating communication with the requesting service. Rounds with the pediatric dermatology attending on service will take place daily during weekdays and as needed during the weekends. Weekdays rounds average 5-10 hours per week, depending on patient volume and complexity.
Fellows will be instructed in digital dermatological photography, including use of digital cameras and archival photography software. The Division has a dedicated medical photographer who will provide expert instruction.