Each day, the fellows review the current dermatopathology sections as they become available. In addition, the initial writing of microscopic descriptions of the current specimens will rest on the fellows, who then presents the findings and suggested interpretation under simultaneous microscopic viewing to the dermatopathology faculty for critical discussion and formal diagnosis for the patients’ records. A ten-headed microscope is used for dermatopathology teaching. The fellows also have a single-headed scope on their individual desks for further review and interpretation of specimens.
The program is designed to train fellows with backgrounds in either pathology or dermatology. The curriculum is modified in order to best fit each Fellow’s experience and training.
Four board-certified dermatopathologists within the Section of Dermatology actively participate in the dermatopathology fellowship program: Dr. Christopher R. Shea, Dr. Vesna Petronic-Rosic (the Dermatopathology Training Fellowship Program Director), Dr. Arlene Ruiz de Luzuriaga, and Dr. Keyoumars Soltani. Drs. Shea, Petronic-Rosic and Ruiz de Luzuriaga share the diagnostic dermatopathology caseload.
The program is structured so that all fellows attend current diagnostic dermatopathology sessions throughout the year. At the same time, they receive continuous, appropriate training in the complementary specialty area (i.e., general pathology or clinical dermatology, according to the respective background of the trainee) by attending relevant didactic and patient care conferences, clinics, inpatient consultation ward rounds, autopsy sessions, diagnostic sign-out sessions, and review of study sets. In this way, throughout the integrated year 50% of the training time is devoted to dermatopathology, and 50% to the complementary specialty.
Responsibilities for assisting in the teaching of dermatopathology to residents in dermatology and pathology are assumed by the fellows during the major dermatopathology rotation periods. In addition, during the course of clinical activities, fellows have some medical student teaching functions. The fellows’ performance and progression through the program are monitored and assessed continually throughout the year by members of the faculty. A certificate is awarded at the completion of training.
Fellows with Backgrounds in Pathology
During a six-month-equivalent dermatology clinical rotation period, the fellows will attend the Section of Dermatology’s outpatient clinics and participate in the presentations of patients to staff and senior resident dermatologists for discussion of management and disposition. Major emphasis during this period is on the clinical morphology of skin lesions and on clinicopathologic correlations.
Attending dermatology faculty members supervise instruction in all clinic sessions. Fellows are given instruction and experience in performing skin punch and shave biopsies, making KOH and Tzanck preparations, Wood’s light examinations, and clinical testing and culturing for parasites, bacteria, fungi, and yeasts. The fellows also receive instruction and experience in interpreting Mohs surgical specimens. During the dermatology rotation period, the fellows also attend dermatology inpatient service and dermatologic consultation rounds. In addition, the fellows attend other clinical training functions such as the weekly dermatology clinical conferences, the dermatology basic science lectures, and journal clubs. In the various conference sessions, the fellows actively participate on par with the dermatology residents in discussing cases, journal club articles and research seminars.
Fellows with Backgrounds in Dermatology
Throughout the course of the training year, fellows with a background in dermatology spend 50% of the training year being educated in anatomic pathology, including daily attendance at didactic conferences and rotations through surgical pathology, cytopathology, and autopsy pathology. During the course of the year, the fellows are expected to develop a fund of relevant knowledge in general pathology and a sound, systematic approach to pathologic diagnosis. The fellows are expected to become familiar with the workings of a pathology service and the use of relevant cost-containment and quality assurance measures in pathology. The fellows learn the basic laboratory techniques for fixation, embedding, sectioning, and staining of tissue and becomes familiar with the use of the available diagnostic methods. These include conventional histochemical stains, immunoperoxidase techniques, transmission electron microscopy, cytogenetics, flow cytometry, image cytometry, and Southern blotting for immunoglobulin and T-cell receptor gene rearrangements. The fellows are expected to attend and participate in relevant patient care conferences. In addition, fellows have access to study set collections of histologic slides for self-directed study. Through their active participation throughout the year at didactic conferences in which the full range of anatomic pathology is presented, all fellows optimize and maximize the diversity of their experience.