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Clinical Education

The fellow will participate in the following activities and will have other appropriate duties and responsibilities as the program evolves. 

Mohs Micrographic Surgery 

The fellow will participate in Mohs surgery and repair at least four days each week. The fellow will participate in the cases, first as an assistant, gradually evolving into the primary surgeon, and will begin to instruct the residents. The fellow must master both the surgical and histologic aspects of the procedure. This involvement includes the intake, evaluation and follow-up of patients. 

The fellow will also master the technical portion of the procedure including the ability to prepare the microscopic slides and establish a laboratory consistent with current medical and legal standards. 

Repair of Surgical Defects

Approximately 80% of the Mohs cases are followed by an immediate repair at the same operative setting. 

In addition, the fellow will participate with ENT, plastic surgery and oculoplastic surgery specialists, as appropriate, in the reconstruction of the defects. 

Cutaneous Oncology 

The fellow will experience difficult tumor cases throughout the fellowship. In consultation with our colleagues in pathology, medical oncology, radiation therapy and the surgical specialties, strategies for dealing with difficult cases will be developed and the fellow will become accustomed to the need for a multidisciplinary approach to many tumors. 

The fellow will participate in the care of solid organ transplant patients. These patients give rapid exposure to the evolution of cutaneous malignancies.

General Dermatologic Surgery/Cosmetic Dermatologic Surgery

The full range of general dermatologic surgery will be performed during the fellowship. Several lasers are readily available. Exposure to cosmetic surgery will be limited, but a wide range of cosmetic procedures are performed by faculty members. The opportunity for additional exposure may be made available according to the fellow's interests and skill levels. 

Currently, the fellow spends one day each week at the Nashville VA Medical Center performing general dermatologic surgery (excisions, reconstructions, etc.), supervising and instructing dermatology residents in such procedures, and running the VA photodynamic therapy (PDT) clinic. Mohs surgery is currently not performed at the Nashville VA. 

Call and Consultation 

The fellow, when available, will always take first call from the residents for problems relating to dermatologic surgery patients. A faculty member will also be available.  

Teaching

The fellow will be involved in resident teaching, including didactic lectures and in the clinical setting. A willingness to fully participate in resident education is essential. When appropriate, the fellow will also participate in the resident conferences and reviews.

The fellow is also responsible for the bimonthly dermatologic surgery journal club. The fellow will select and assign the articles as well as moderate the session. 

Research and Publications 

Adding to the knowledge base of dermatologic surgery and contributing to the propagation of that knowledge are essential parts of the fellowship. The fellow will be expected to publish at least two papers based on materials developed during the fellowship.

Attendance and presentation of work at appropriate specialty meetings will also be required. Support will be provided for the fellow to attend the Annual Meeting of the American College of Mohs Surgery (ACMS).

Learn more about research in the Department of Dermatology  

Additional Training 

The fellow will attend a course on surgical anatomy. This will most likely be the Superficial Anatomy and Cutaneous Surgery Course at University of California San Diego/Scripps in July or August. Alternative arrangements may be possible. Although tuition will be covered, the fellow will be responsible for transportation and living expenses for the course. 

The fellow will be certified in Advanced Cardiac Life Support.