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The three-year dermatology residency program at the University of Mississippi Medical Center is preceded by a minimum of one year of broad-based training at an ACGME-approved program. This may be categorical training in Internal Medicine or Pediatrics, or preliminary/transitional training that may include a broader base of rotations involving primary care specialties. The PGY-1 year may be performed at UMMC or at other accredited programs.
The first several months of residency familiarize the new residents with the program. Under close supervision by the faculty, new residents practice their history-taking and physical examination skills and begin the process of acquiring the cognitive expertise required in the field of dermatology. Plans for diagnosis and treatment are discussed with faculty who make the decisions that affect patient care. Residents learn specialized techniques (KOH and scabies preparations) and procedures (shave biopsy, punch biopsy, elliptical excisions, electrodessication and curettage, snipping of acrochordons) as well as the administrative routines, protocols, instructional and departmental policies and the language of the specialty. Time is spent in general dermatology clinics that include a broad range of ages, races and cultural backgrounds, and care is rendered for patients with medical, surgical and cosmetic problems.
Of particular importance is the Friday afternoon continuity clinic, in which the residents care for their own panel of patients throughout the three years of training. This clinic is staffed by an excellent cadre of volunteer physicians who have private practices in the Jackson area, including several nationally-known individuals.
Didactic and interactive educational sessions are particularly important to dermatology residents in their PGY-2 year. They include a Bolognia textbook reading club, a series of didactic lectures, a “Kodachrome”-style slide show conference, a dermatopathology conference and journal club.
While hospital inpatient/consultation service rotations are not included in the first year schedule, patients with interesting or difficult problems may be transported to Suite K for Grand Rounds when appropriate. First year dermatology residents take home call after the first six months. They are expected to follow up in a timely fashion when a home call is received and contact the faculty dermatologist on call as deemed necessary.
There are no specialty rotations during this year; instead, there are one-month blocks rotating through each clinic location sequentially in General and Medical Dermatology with exposure to Pediatric Dermatology, Procedural Dermatology and Cosmetic Dermatology during those blocks.
During the second year, residents spend a significant amount of time in the outpatient clinic and carry on with their Friday afternoon continuity clinic. In addition, rotations are performed on the hospital in-patient/consultation service, pediatric dermatology, surgery/cosmetic dermatology and dermatopathology modules. On the inpatient and consultation service, residents have an opportunity to evaluate and treat inpatient dermatological problems, develop diagnostic strategies, interpret laboratory findings, order medications and collaborate with a multi-specialty group of doctors and counsel patients. Residents make rounds daily with a staff member who discusses the problems and reviews residents’ decisions.
Second-year dermatology residents also take home call and retain responsibility for their Friday pm continuity clinic. Residents are frequently involved in Mohs surgery closures, excisions, sclerotherapy laser cases and cosmetic procedures including Botox and dermal filler injection.
As in other years of training, clinics are held on campus at UP-Pavilion Suite K, UP-Grants Ferry and at the Face and Skin Center. During the PGY-3 year, residents begin to assume primary responsibility for patient evaluation and care both in their continuity clinic and in other clinic settings under faculty supervision.
Senior residents are assigned an independent patient calendar at the Face and Skin Center, UP-Grants Ferry and UP-Pavilion Suite K and assume responsibility for these patients. The third-year resident is responsible for the EHR and all patient correspondence, but for the first three months, the supervising faculty reviews all resident to patient and physician to physician correspondence. Thereafter, the faculty will review correspondence as required by the attending in complex cases or requested by the resident.
Senior residents run the procedure clinic, with oversight from the supervising surgeon that sees, approves and supervises each case. Many procedures are performed in clinic in the flow of patients.
During the third year, new patients are assigned to residents in all clinic settings with staff physicians acting as consultants. Surgical skills are polished. The administrative and teaching responsibilities of serving as chief resident are granted to a deserving senior resident(s). Research projects and Quality Assurance projects are completed and presentations at major medical meetings are expected. The Friday afternoon continuity clinic continues throughout the third year of dermatology residency training. Teaching includes a focus on preparation for board examinations.
A four-week elective is incorporated into the PGY-4 residents’ schedule. Senior residents may train within the UMMC or at an approved institution outside of the medical center potentially working with future colleagues, honing research skills, or pursuing fellowship interests.
All residents will have the opportunity to make contributions to the science of medicine. These include, but are not limited to, writing case-reports, planning studies utilizing retrospective and prospective gathering of data requiring IRB approval and scholarly reviews of the literature. Residents will be required to identify a project during their first six months of residency and have at least one and not more than two projects to which they are contributing during their second and third years of residency. The UMMC Office of Research provides an instructor for didactic instruction in research design and a primer on statistics each year of the residency program.
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