Training in clinical dermatology includes outpatient and inpatient experience.

• Outpatient PGY-2. Outpatient training includes care for community-based patients with straightforward and common dermatologic disease at Mayo Family Clinic Northwest. Evaluation of more-complex and rare dermatologic patients referred to Mayo Clinic for tertiary care occurs in the Gonda Building, 16th Floor.

  First-year residents spend approximately one month in the dermatology department at Mayo Family Clinic Northwest, where they work with the consultant and a trained nurse team to care for common dermatologic problems. Residents also have a continuity clinic scheduled at the northwest clinic throughout their first two years. Continuity clinic participants are allowed to schedule patients for follow-up visits.

  First-year residents also spend time on Gonda 16 working with the consultants in their respective subspecialties.

• Outpatient PGY-3. Second-year residents spend six weeks in the dermatology department at Mayo Family Clinic Northwest, where they have steadily increasing autonomy in the care of community patients. Participants continue to experience outpatient care for more-complex patients on Gonda 16, working with all consultants to gain experience in subspecialty work-up clinics.

• Outpatient PGY-4. Third-year residents, or senior resident associates (SRAs), are based on Gonda 16. SRAs have their own prescheduled outpatient calendars, with oversight from a supervising consultant.

First-year residents gain nearly four months of inpatient dermatology and consultation service experience at Mayo Clinic Hospital — Rochester, Methodist Campus. The consult service provides assistance to many surgical specialties, the hematology inpatient service, and obstetrics and gynecology.

Consultations may vary and include:

• Evaluation of incidental skin lesions and minor rashes
• Conditions seen in pregnant patients and neonates
• Severe graft-versus-host disease, cutaneous T-cell lymphoma and life-threatening dermatoses seen in hematology/oncology and transplant patients

Inpatient training at Mayo Clinic Hospital — Rochester, Methodist Campus, is complemented by training in the phototherapy unit and the opportunity to participate in three of many unique selective opportunities, including:

• Extracorporeal photophoresis
• Hyperbaric oxygen
• Exposure to the wound care center
• Lymphedema clinic
• Compounding pharmacy

While on inpatient service, residents care for an average of four patients and take call at home via pager for admissions or consultations. Participants learn to care for patients with serious, acute, and chronic skin disorders and associated systemic problems. Upon completion of inpatient rotations, residents are prepared to manage patients with serious dermatologic problems.

• Hospital practice PGY-2. First-year residents also cover the day hospital in addition to the inpatient service, which provides limited wet dressing therapy, ulcer care, and scalp treatment.
• Hospital practice PGY-3. Second-year residents spend approximately two months at Mayo Clinic Hospital — Rochester, Saint Marys Campus, where they provide consultative care to numerous medical, intensive care and surgical units, and the emergency room. The scope of dermatologic cases ranges from lesion evaluation to toxic epidermal necrolysis (TEN) and other rare dermatoses.

The laboratory dermatology rotation exposes residents to pathologies ranging from basic to complex and challenging dermatoses. The high case volume allows trainees to build necessary histopathologic interpretive skills. The lab practice is centrally embedded to allow frequent dialogue between the lab and clinical practice, particularly for challenging cases seen in floor conferences.

In this rotation, residents learn to use clinical, pathologic, and immunopathologic correlation to solve challenging clinical and surgical cases. A large, searchable pathology database can be queried to answer relevant clinical questions. Fully integrated use of digitally scanned pathology slides for educational conferences and private study are available to residents.

The enthusiastic laboratory dermatology staff reflects broad interests and a firm commitment to teaching.

The surgical training offered through the Department of Dermatology is an incremental step-structured program that encompasses three years of residency.

The first year is an apprentice training experience. First-year residents learn the nuances of excellence in basic procedural dermatology from senior residents participating in the senior resident procedure clinic.

Second-year residents spend time learning more-complex procedural dermatology, including Mohs surgery and cosmetic procedures. Participants spend one-on-one surgical training time with one of the seven Mayo Clinic Mohs surgeon consultants. Participants are expected to take call during this rotation.

Third-year residents are assigned their own procedure clinic for the entire year. They teach first-year resident apprentices, who work with them throughout the year. As the three years of residency progress, residents are given increasingly more autonomy and responsibility regarding procedural dermatology.

The pediatric dermatology experience at Mayo Clinic is continuous and progressive. Three pediatric dermatologists represent a broad range of special expertise, including:

• Connective tissue disorders
• Childhood nevi and malignancies
• Dermatoses of pregnancy
• Genodermatoses
• Vascular birthmarks

Attendance at a monthly didactic curriculum of lectures and textbook reading is required.

Residents are assigned to the pediatric dermatology rotation for one month during both the first and second years of training. This comprehensive experience includes evaluation of complex medical patients, a community practice, a subspecialty referral clinic, and procedures such as laser and excision.

Hospital consultations expose residents to the complex medical issues of neonates and children, including intensive care patients. The service is also commonly involved in the care of pregnant women with dermatoses and the subsequent management of the dermatosis in the newborn if present.

Second-year residents serve as an integral part of the inpatient pediatric dermatology service while performing their hospital consultative months. Third-year residents have their own pediatric patients to care for. Supervision and guidance are available from the pediatric dermatology staff.

Extra training in pediatric dermatology is available as an elective rotation upon request.

Clinical or laboratory research experience or outpatient rotation as approved by the education committee, or outpatient dermatology rotation at Mayo Clinic's campuses in Arizona or Florida.

Residents may also apply for the Mayo International Health Program. Many Dermatology residents have received this scholarship. Participation in local dermatology and medical clinics in countries such as Brazil, Kenya, and Tanzania provides participants with the opportunity to see unique skin diseases.

A one-month rotation at a non-Mayo site may be approved for a unique educational experience that would not otherwise be available at Mayo Clinic.