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The didactic curriculum includes exposure to dermatology conferences (Grand Rounds at UC Health University Hospital of the University of Cincinnati, Cincinnati Dermatological Society meetings, pediatric dermatology conference/journal club) and pediatric conferences (Pediatric Grand Rounds, pediatric resident noon conferences). Fellows will have the opportunity to review histology slides with dermatopathologists at the Department of Dermatology at UC Health University Hospital of the University of Cincinnati and with pediatric surgical pathologists at CCHMC. Fellowship training will also include monthly journal club, and there is the expectation that the fellow will actively participate in the preparation of manuscripts and presentations for national meetings (1-2 per year). Fellows will also have opportunities within the Division of Pediatric Dermatology for clinical research. Within the broader Department of Dermatology at the University of Cincinnati College of Medicine and at CCHMC, opportunities in basic science research, if desired, are available on a case-by-case basis with the approval of the Program Director.
The Division of Pediatric Dermatology at CCHMC is currently expanding and fully-staffed with appropriate administrative support. This includes clinic-based staff (two dedicated registered nurses and 1 medical assistant) and office-based staff (a business director and senior administrative assistant as well as three patient service representatives). Pediatric dermatology clinical trials will be conducted in coordination with a part-time research coordinator and part-time research nurse under attending physician guidance as principal investigators. Digital photography is utilized within the division, and an archival database is updated and will be maintained regularly by the medical photographer under supervision by attending physicians.
All patient care activities are directly supervised by an attending physician. The fellow is expected to triage all clinical questions from patient/caregivers, referring physicians, and other healthcare providers. This will be done in conjunction with the dermatology resident on service and the pediatric dermatology nurses. Activities will include, but are not limited to, patient appointment triage, prescription refills, pathology report notifications and home management issues. All such duties will be directly supervised or reviewed by an attending pediatric dermatologist.
The fellow will take call from home on evenings and weekends, but will be required to go to the hospital while on call as needed to see emergent and/or complicated inpatient and Emergency Department consults. The fellow will also see consults and round with the on-call pediatric dermatology attending on the weekends. They will be allowed one 24-hour period off each week.
Fellows are expected to engage in a clinical research project during their fellowship. Participation will include study design, protocol preparation and submission to the Investigational Review Board, collection and analysis of data, and manuscript preparation. It is anticipated that initial preparation, including selection of a research topic, should begin prior to the commencement of the fellowship training period, and pediatric dermatology attendings will serve as mentors during this process. The Division of Pediatric Dermatology has access to a Research Coordinator through the Clinical Trials Office who can assist with the coordination and completion of these activities. The Division of Pediatric Dermatology currently participates actively in research within the Hemangioma and Vascular Malformation Center, and it is anticipated that clinical research opportunities will also be available within the Eczema Center, which is co-directed by Dr. Shah.
Fellows will be expected to prepare at least 2 manuscripts for submission for publication during their fellowship. Selection of cases or topics, review of author guidelines, and preparation of the final manuscript will be supervised by one or more of the pediatric dermatology attendings. Fellows will also be expected to submit a case for presentation at the Annual Meeting of the Society for Pediatric Dermatology under the supervision of one of the pediatric dermatology attendings. Additional presentations at local, national, or international conferences are optional at the discretion of the Program Director.
The fellow will be responsible for preparing didactic lectures for the pediatric and dermatology residents, approximately four per year. With experience, the fellow will provide supervision of rotating pediatrics and dermatology residents and medical students in the outpatient clinics and on inpatient consultation.
The program will be evaluated biannually by the staff of the Division of Pediatric Dermatology, including both the administrative and clinical staff. The fellow is expected to participate in these reviews. Areas to be reviewed include whether the program is able to meet the educational goals as outlined above and whether the clinical and research needs of the faculty are being appropriately met.
The fellow will be evaluated biannually through the use of a standardized evaluation form, as appropriate, which addresses the six core competencies. All pediatric dermatology attendings are expected to complete reviews. In addition, other clinical and administrative staff are encouraged to provide feedback as well. Rotating dermatology and pediatric residents will also be encouraged to provide feedback as well but are not required to do so. These reviews will be discussed with the fellow by the Program Director.
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. 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.
