Beyond the BCC - A Multidisciplinary Rotation in Oncodermatology

Sites: MGH, MGH Cancer Center
Director(s): Steven Chen, Alberto Puig
Prerequisites: HMS Principal Clinical Experience (Core Clinical Clerkships) and Introductory Dermatology DE501M.J course or an equivalent at a different institution
Location: MGH - Mass. General Hospital (3)
Open to Exclerks: US/Canadian
Description: This course is designed for students who are interested in learning the necessary tools for the comprehensive evaluation and management of our oncodermatology patients. The course will build on the foundations acquired through the introductory dermatology course (DE501M.J) or an equivalent course at a different institution. Approximately half of the student's time will be spent in clinics at Massachusetts General Hospital and the MGH Cancer Center. The other half will be spent as independent study in support of a scholarly project. Students will rotate in clinics caring for patients with cutaneous lymphoma, melanoma, graft-versus-host disease, and high-risk skin cancer as a result of prior transplantation. Many clinic experiences will be in multi-disciplinary format, so as to show the intricate multi-pronged approach to the management of these patients. Under the supervision of faculty members from the Departments of Dermatology and Medical Oncology, students will be expected to function as clinical clerks in the work up and management of these complex patients. This includes the mastery of common procedures and tests used in diagnosis and management. Separate time will also be spent to review pathology specimens from the types of malignancies and diseases they are seeing, so as to provide clinicopathological correlation. Students will also participate in clinico-pathological conference and tumor board, as well as department conferences. Comprehensive and daily feedback will be given to the student by attending physicians. The scholarly project will be mentored by a faculty member of the student's choosing. Ideally, students will identify a topic to study related to oncodermatology, however, students can also spend this time working on existing projects already started prior to the rotation. During the rotation, the student will be expected to complete a proposal to summarize progress and plans for completion for their scholarly project.
Incorporation of Basic Science Content and Evidence-Based Medicine:
Students are expected to use the medical literature to support decisions and plans they will formulate for patients in these clinics. Students will also have access to reviews and papers that will cover current knowledge pertaining to the complex malignancies they will be seeing. Furthermore, students will be invited to attend the melanoma lecture series, which highlights new and important research in the field.
Grade Criteria:
Honors with Distinction: Displays most or all of the following qualities: - Observation on rotation: Consistently complete, accurate, and efficient history and physical exam, even on the most complicated patients. Consistently excellent morphologic descriptions and excellent visual diagnosis skills. Knowledge base is superior in both breadth and depth. Consistently able to apply sophisticated understanding of pathophysiology to clinical context. Consistently models highest level of skill in procedural techniques. Differential diagnosis reflects highly sophisticated reasoning process. Understands use of tests/procedures with comprehensive treatment plans. Consistently models superior communication skills, and written and verbal presentations are consistently cogent, efficient and sophisticated. Behavior models the highest standards of integrity, reliability, and collegiality. - Final project proposal is turned in on time and demonstrates excellent understanding of good research methodology and clinical relevance.
Honors: Displays some or most of the following: - Observation on rotation: Most often gathers complete and accurate history, and performs a thorough physical exam. Very good morphologic descriptions and visual diagnosis skills. Knowledge base very good. Solid understanding of pathophysiology and disease mechanisms. Shows a high level of mastery in performing procedures. Differential and treatment plan reflects solid clinical reasoning. Consistently demonstrates empathy and collegiality and communicates effectively. Often seeks out and accepts added responsibility. Often engages in independent self-improvement activities. Comfortable with generating a list of morphologic differential diagnoses or, at a minimum, able to correctly recall and associate morphologies. - - Final project proposal is turned in on time and demonstrates good understanding of good research methodology and clinical relevance.
Satisfactory: Displays some or all of the following: - Observation on rotation: Generally accurate and complete enough to identify key problems although may miss less critical information. Exam is generally appropriate. Generally satisfactory morphologic descriptions and visual diagnosis skills. Adequate knowledge base. Adequate knowledge of basic pathophysiology of disease. Procedural skills and differential are generally appropriate. Adequate communication and presentations; able to establish rapport and demonstrate empathy. Shows interest in improvement and takes initiative in activities that enhance knowledge and skills. - Final project proposal is turned in and somewhat demonstrates understanding of research methodology and clinical relevance.
Unsatisfactory: Displays some or all of the following qualities: - Observation on rotation: Consistently misses essential findings on history and physical examination and often does not make appropriate connection between history and physical. Often inaccurate morphologic descriptions and visual diagnoses. In procedures, often uses faulty or inappropriate technique. Knowledge base is inadequate or has significant deficits. Has consistent difficulty relating basic science principles and clinical information to patients' problems. Differential is often incomplete or incorrect. Written and/or verbal presentations frequently lack clarity, organization or thoroughness. Acts in ways that raise significant concerns about ability to establish rapport, communicate effectively, and behave with integrity, reliability and responsibility, and/or ability to work with others. - - Final project proposal is turned in late or not at all, and demonstrates no consideration of research methodology nor clinical relevance.