SPECIFIC OBJECTIVES:

1. Cognitive Skills

On completion of training, a resident must have a detailed knowledge and understanding of:

1. sciences basic to dermatology (embryology, gross and microscopic anatomy, microbiology, biochemistry, physiology and immunology)
2. clinical skills in diagnosing cutaneous disease (skin, mucous membranes and appendages) by the use of history, physical examination and pertinent investigative procedures
3. the cutaneous manifestations of systemic diseases in patients of all ages
4. dermatologic therapy (percutaneous absorption, the pharmacology and side effects of topical and systemic medications, and the use and complications of electrosurgery, cryotherapy, ultraviolet light, ionizing radiation, laser, and dermatologic surgery)
5. dermatopathology and immunodermatopathology, and relevant electron microscopy
6. the dermatological literature and an analytical and critical interpretation of it.
1. Technical Skills
   1. an approach to dermatologic surgical procedures and the technical skills to biopsy and remove common cutaneous lesions and to give post-surgical care
   2. knowledge and experience involved in the use of local anesthesia, sterilization techniques, suture materials and laser therapy.
   3. all technical skills required for the practice of dermatology, including for example phototherapy, patch and photopatch testing, and diagnostic techniques.
2. Professional Attitude

After residency training, a dermatology consultant should have:

1. the ability to communicate effectively with patients and their families
2. an understanding of the patients' psychological, occupational and social needs, taking into account diversities of race, culture and gender.
3. the knowledge and ability to deal with the ethical and medicolegal aspects of the practice of dermatology
4. the ability to interact effectively with other health care professionals and the public.

CONTENT AND ORGANIZATION OF THE RESIDENCY PROGRAM:

There must be an organized program of rotations and other educational experiences, both mandatory and elective, designed to provide each resident with the opportunity to fulfill the educational requirements and achieve competence in the specialty.

Residents must be provided with increasing individual professional responsibility, under appropriate supervision, according to their level of training, ability, and experience for the diagnosis and management of patients with dermatologic disease and in all aspects of the contemporary practice of dermatology. In addition, the resident must gain experience in performing minor surgery and other procedures required for the optimum care of patients. The equivalent of at least two years must be spent in clinical work.

In addition to offering the components noted in the specialty training requirements all accredited programs in dermatology must offer community-based learning experiences.

RESOURCES:

There must be sufficient resources including teaching faculty, the number and variety of patients, physical and technical resources, as well as the supporting facilities and services necessary to provide the opportunity for all residents in the program to achieve the educational objectives and receive full training as defined by the specialty training requirements in dermatology. 

1. Teaching Faculty

There must be a sufficient number of qualified teaching staff to supervise residents and provide teaching in the basic and clinical sciences related to dermatologic diseases.

2. Number and Variety of Patients

The number and variety of patients in each of the following categories must be satisfactory to meet the educational requirements of the residents.

1. General Dermatology

General dermatology, including all primary diseases of the skin, and, in addition, cutaneous manifestations of diseases of internal medicine, pediatrics and other specialties including ophthalmology, obstetrics and gynecology, psychiatry, neurology, rheumatology, infectious diseases and dentistry. There must be adequate exposure to special problems involving allergy and immunology in relation to skin disease, collagen diseases, and radiotherapy.

2. Pediatric Dermatology

It is desirable that there be an adequate number of patients, including ambulatory patients, to provide training in the dermatologic manifestations of acute contagious diseases, and other skin diseases as they occur in children.

3. Clinical Services Specific to Dermatology

The clinical services making up the program must provide full training in the diagnosis and management of dermatological conditions in each of the areas listed below.

1. In-Patient and Consultation

The dermatological service must have access to an adequate number of beds organized for teaching the investigation and treatment of diseases of the skin. The investigation and treatment of these patients will be the delegated responsibility of residents working under the guidance of qualified dermatologists who are members of the organized teaching staff.

It is desirable that teaching sites approved for training have a sufficient number of admissions to ensure an active consultation service.

An active consultation service to internal medicine and its subspecialties, family medicine, and other medical and surgical services must be associated with the program and assume appropriate and progressive responsibility for the care of patients. Residents must take an active part in this service.

2. Ambulatory

There must be an organized out-patient department or ambulatory care facility providing an adequate number of dermatological out-patients both adult and pediatric.

In-patient and out-patient teaching should be integrated as much as possible, in order to provide continuity of observation of patients both in and out of hospital. Organized clinics or other facilities must be available with adequate numbers of patients to provide opportunities for instruction in the broad range of dermatology that can be managed on an ambulatory basis. In addition to general clinics, special clinics under supervision of experienced teachers will provide additional learning opportunities for residents. It is essential that clinics provide a teaching milieu and that schedules of residents be so arranged as to ensure their attendance.

3. Sexually Transmitted Diseases

There should be a service organized for the instruction of residents in the care of patients with HIV infection, syphilis and other sexually transmitted diseases seen by dermatologists, with all necessary supporting personnel and facilities.

4. Dermatologic Therapy

There must be arrangements for special instruction and supervised experience in the use of both topical and systemic pharmacologic agents and in the role of phototherapy and photochemotherapy, cryotherapy and ionizing radiation.

5. Skin Malignancies

The program must include the diagnostic and therapeutic aspects of malignant skin disease, preferably in an interdisciplinary setting providing ample opportunities for consultation with plastic surgeons, pathologists, and medical and radiation oncologists.

6. Surgical Procedures

Facilities must be available for supervised experience in biopsy and other minor surgical procedures, including acne surgery, cryosurgery, laser surgery, and more extensive cutaneous surgery.

7. Diagnostic Procedures

Facilities and supervision must be available for such diagnostic procedures as patch testing, photo testing, Wood's light examination, and microscopic examination of wet mounts for fungal products.

8. Pediatric Dermatology

Pediatric clinics or facilities must be available to provide opportunities for instruction in pediatric dermatology.

9. Dermatopathology

The program must include all aspects of dermatopathology, including microscopic diagnosis of skin disorders by means of light and fluorescent microscopy, electron microscopy, and immuno-histochemistry. Laboratory facilities must be adequate and organized for teaching under the direction of a dermatopathologist or a physician with a special interest in dermatopathology.

10. Community Learning Experiences

Community experiences must provide a learning environment with appropriate supervision, patient encounters, and evaluation based on rotation specific objectives. This assumes administrative support and linkages with the program.

4. Supporting Services — Clinical, Diagnostic, Technical

The following facilities and services must be available, either within the program or by arrangement with other programs or institutions, and closely coordinated with the overall program.

1. Active teaching services in internal medicine, pediatrics, family medicine, emergency, and surgery. Liaison arrangements within the faculty should ensure that clinical training during the basic clinical year and the year of internal medicine or pediatrics, in fulfilment of the specialty training requirements, meets the needs of residents in dermatology.
2. An active teaching service in radiation oncology with adequate arrangements to ensure an understanding of the methods and concepts of radiation therapy on the part of residents in dermatology.
3. An allergy and immunology service with adequate liaison to ensure a close association between residents in dermatology and the teaching staff in immunology.
4. An active service in medical microbiology, with expertise available in mycology, parasitology, bacteriology and virology.
5. A plastic surgery service.
6. An audiovisual and a photography service available to enhance and facilitate learning, and the development and maintenance of appropriate teaching files.
7. Intensive care units and emergency departments to provide experience with the dermatologic complications of severely ill and injured patients.
8. Adequate clinical and laboratory facilities for the performance of minor surgical procedures and diagnostic procedures.
9. Access to library facilities and other learning resources including access to electronic media.

ACADEMIC AND SCHOLARLY ASPECTS OF THE PROGRAM:

The academic and scholarly aspects of the program must be commensurate with the concept of a university postgraduate education. The quality of scholarship in the program will in part, be demonstrated by a spirit of enquiry during clinical discussions, rounds, and conferences. Scholarship implies an in-depth understanding of basic mechanisms of normal and abnormal states and the application of current knowledge to practice.

1. Organized Scholarly Activities

Organized scholarly activities such as journal clubs, clinical and research conferences and seminars must be a regular part of the program.

2. Basic and Clinical Sciences Relevant to Dermatology

There must be an adequate, well-structured, balanced, formal teaching program in basic and clinical sciences relevant to dermatology. In addition to a formal basic science teaching program, there should be regular teaching rounds, combined conferences with internal medicine, pathology rounds, and specific reading assignments.

3. Biomedical Ethics

The academic program must ensure that residents gain an understanding of the basic principles and practice of biomedical ethics as it relates to dermatology.

4. Communication Skills

The program must ensure that residents learn effective communication skills for interacting with patients and their families, colleagues, co-workers from other disciplines, students, and the lay public. Clearly defined educational objectives for teaching these skills and mechanisms of formal assessment should be in place.

5. Patient Care Team

Residents must be given opportunities to develop effective skills in collaborating with all members of the patient care team.

6. Teaching Skills

Residents must be given opportunities to develop effective teaching skills by teaching junior colleagues and students, as well as through conference presentations, clinical and scientific reports, and patient education.

7. Management Skills

Residents must be given opportunities to develop skills in management as applied to dermatology such as efficient practice and records management and the ethical use of health care resources. Residents should also be prepared for their role as a health care advocate.

8. Quality Assurance/Improvement

The program must provide residents with opportunities to gain an understanding of the principles and practice of quality assurance/improvement. Opportunities should be provided for residents to participate actively in such programs in their hospital departments.

9. Research Opportunities for Residents

There must be a faculty member with the responsibility to facilitate the involvement of residents in research and other scholarly work. The academic program must provide the opportunity for residents to learn biostatistics and the critical appraisal of research methodology and medical literature. Such teaching must include issues related to age, gender, culture, and ethnicity in research protocols and data presentation and discussion. Residents should be encouraged to participate in clinical research during the course of the residency program. There should be a designated member of faculty to facilitate resident involvement in research.

The milieu of scholarship should be enhanced wherever possible by close association between residents and active investigators on the staff.

10. Faculty Research

A satisfactory level of research and scholarly activity must be maintained among the faculty identified with the program.

11. Life-Long Learning

All programs must promote development of skills in self-assessment and self-directed life-long learning. To promote this end, the program should provide opportunities for residents to attend conferences outside their own university.

SPECIALTY REQUIREMENTS:

Approved residency training including:

1. Basic clinical training including rotations in surgery, family medicine, and emergency.
2. Approved residency training in dermatology.

PROGRAMS (WITH TRAINING REQUIREMENTS):

Diplomas(Dip):

Six months of approved residency training.

Doctor of Medicine(M.D):

Eighteen months of approved residency training.

Doctor of Philosophy(Ph.D):

Forty eight months(four years)of approved residency training.