Goals for the Pediatric Dermatology Rotation

Dermatologists have always treated the skin diseases of childhood. Only recently has pediatric dermatology been considered as a separate subspecialty, as our knowledge of the differences between children and adults has grown. The participation of pediatric dermatologists in residency training has become the norm. UCSD is fortunate to have one of the largest pediatric dermatology facilities in the country. This rotation will allow the residents to see many children with skin disorders, as well as serve to introduce and reinforce concepts unique to the care of children. The exposure begins with one half day per week clinic during PGY-2, and continues with month long rotations interspersed throughout the PGY-3 and 4. Specific goals include:

1. Clinical Diagnosis
   • Accurately describe primary and secondary dermatologic lesions.
   • Formulate accurate and focused differential diagnoses, incorporating prevalence of conditions appropriate for the patient’s age.
      
2. Laboratory
   • Efficiently utilize specialized laboratory examinations to include:  fungal culture, potassium hydroxide prep, hair mounts, Tzanck prep, scabies prep, DFA and tissue biopsy.
      
3. Consultation
   • Appropriately consult outside specialists when indicated.
   • Appreciate the wide scope of inpatient and newborn consultations, and to provide timely, insightful diagnostic and/or therapeutic recommendations.
      
4. Clinical Therapy
   • Develop treatment plans that reflect the standard of care in the community (or the best care available in the absence of a standard). Administer appropriate and safe dermatologic therapy.
   • Appropriately document patient care and education in the medical record. Dictate clinic notes if indicated, in medically correct and accurate format.
   • Learn the basic principles of laser safety and therapeutic techniques, as pertains to the treatment of pediatric lesions.
   • Learn the basic principles of cutaneous excisional surgery as pertains to the treatment of pediatric lesions.
      
5. Continuity of Care and Education
   • Educate their patients and their parents in the diagnosis, natural history, treatment and prognosis of their disease. Appreciate and evaluate the significant psychosocial impact to the family when a child has a chronic or debilitating condition, and make appropriate referral and/or intervention.
   • Follow patients over the course of their hospitalization to assess their response to treatment and/or progression of their disease.
   • Discuss the latest literature, resources, and controversies in pediatric dermatology.
   • Effectively educate their peers and colleagues, such as pediatric residents also on the service.  Residents will attend the weekly Grand Rounds and pediatric dermatology academic sessions on Tuesday’s at 11:00am, as well as the monthly Vascular Malformation Clinic, and the Dermatopathology Conference, where they will present a brief case report.
   • Attend and present at the weekly Tuesday (7:30am) Pediatric Dermatology Text Review/ therapeutics session. Contact Fellows regarding topic assignment.
      
6. Medical Community and Business Practices
   Learn management skills and business practices, including coding and billing, as well as other factors of managed care impacting medical practice.