Philosophy and Goals
The Dermatopathology fellow training experience is 12 months in duration. During those 12 months, Pathology-trained fellows will be provided with exposure to a broad range of clinical dermatology and Dermatology-trained fellows with be provided with a broad exposure to general surgical pathology as it relates to dermatopathology.
The ultimate goal of the dermatopathology fellowship is to develope and nurture a skilled and competent dermatopathologist. It is our philosophy that the University of Michigan can foster such development with emphasis not only on clinical service, but also education, scholarly activities and citizenship. To achieve this, the dermatopathology fellow is expected to acquire the following core competencies:
- The fellow is expected to fully understand that how each case is handled has a significant impact on patient care. To this end, the dermatopathology fellow is expected to generate a thoughtful, knowledgeable, and timely interpretation of a skin biopsy specimen to aid the clinician in the care of her/his patient.
- The fellow shall assess the adequacy of clinical information provided with a skin biopsy specimen and obtain additional information from the clinician when appropriate.
- The fellow will understand and accept the responsibility of rendering a tissue diagnosis. The fellow will develop competence in the ability to compose diagnoses and comments to help guide their clinical colleagues in patient management.
- The fellow will understand how to order and interpret ancillary diagnostic tests, such as histochemical stains, immunohistochemical stains, and molecular diagnostic tests, and incorporate these results into a report.
- The fellow will learn how to interpret and understand the utility and limitations of direct immunofluorescence examination of skin and mucosal specimens.
- The fellow will develop the ability to preview and compose consultation reports under the supervision of a dermatopathology faculty member.
- The fellow will convey information to the clinician regarding patient management when appropriate (i.e. whether re-excision of a lesion is warranted, or recommend repeat biopsy if histologic findings do not correlate with the clinical presentation, etc.)
- The fellow will recognize his/her role as a liaison or “patient ambassador”. Many times biopsies are submitted from primary care physicians who may not be familiar with certain terminology used in dermatopathology or may not be clear on how to triage a patient and whether or not the patient should be referred to a specialist. The dermatopathologist is pivotal in facilitating patient care in these circumstances.
- The fellow will acquire knowledge of basic science principles relating to normal skin and disease processes affecting the skin.
- The fellow will have a broad fund of knowledge with regard to dermatopathology and the acumen to diagnose common and rare processes.
- The fellow will learn the clinical correlates of histopathologic diagnoses and be able to use clinicopathologic correlation to arrive at the best diagnosis. Critical to this educational mission, the fellow, who is previously trained in pathology, will observe patients in the dermatology clinic and learn basic concepts in dermatology and how to correlate histologic features of biopsies with their corresponding clinical lesions.
- The fellow, who is previously trained in dermatology, will acquire a basic set of skills in surgical pathology during rotations on several diagnostic services and the Autopsy service in Anatomic Pathology.
- The fellow will learn and recognize the common pitfalls in diagnostic dermatopathology.
- The fellow will be aware and recognize that s/he does have limitations and that outside consultation should be sought in difficult cases.
- The fellow will learn how to critically review current literature and incorporate this knowledge into their current practice of dermatopathology.
- The fellow must demonstrate habits consistent with life-long learning.
Interpersonal and communications skills:
- The fellow will understand that s/he is part of healthcare team and that effective interpersonal and communication skills are important to a productive working relationship.
- The fellow will foster and maintain an ethically sound relationship with clinicians and realize that information must always pass directly from dermatopathologist to clinician.
- The fellow will learn how to communicate diagnostic information succinctly in their consultation reports.
- The fellow will maintain ethical principles with respect to patient confidentiality and informed consent.
- The fellow will understand age, gender, and ethnic differences in the manifestation of cutaneous disease.
- The fellow is expected to demonstrate strong work habits, including previewing cases for daily sign-out, appropriately following through on cases pending additional studies or further consultation, and assisting in the teaching of residents on service or seeking consultation.
- The fellow is expected to consistently demonstrate integrity, honesty, compassion, empathy, and altruism in clinical care, education and research.
- The fellow is expected to understand her/his limitations and acknowledge any errors in a timely manner.
- The fellow will learn from role modeling on a daily basis to see how faculty works in a professional manner, demonstrating respect, compassion and integrity with a commitment to ethical principles and sensitivity to patient diversity.
Practice-based learning and improvement:
- The fellow will learn to locate, appraise and assimilate evidence from scientific studies as they relate to cutaneous disease.
- The fellow will provide clinical teaching to medical students, fellow residents, and residents from other departments.
- The fellow will use information technology to perform his/her duties and access medical information online to support his/her own education.
- The fellow will see and learn from role modeling daily as the faculty engages in all aspects of practice-based learning and improvement.
- The fellow will exhibit evidence of self-evaluation.
- The fellow will demonstrate ongoing self-education and habits of life-long learning.
- The fellow will use feedback to improve his/her practice.
- The fellow will apply these learning tools to improve patient care.
- The fellow will learn the effective use of system resources.
- The fellow will demonstrate an understanding of specimen acquisition and delivery.
- The fellow understands the quality assessment and improvement processes.
- The fellow will learn from role modeling how to participate in cost-effective healthcare and resource allocation, while advocating for quality patient care.