Reminder: First DIG Meeting of the Year on Monday, 9/22, at 5pm!

Join us for a Q&A Session with Dr. Richard Wagner, the UTMB Department of Dermatology Residency Program Director. This session is a great way to get information on topics such as residency applications, matching, research and more!

Where: Dermatology conference room, 4.112 McCullough Building

When: Monday, September 22, 2014, 5pm

Have any questions? Email Alex Acosta at kaacosta@utmb.edu

Cutis Looking for Resident Columnist

The peer-reviewed dermatology journal, Cutis, is currently offering a columnist position for a dermatology resident during 2015. Please go to the link provided if you are interested in applying for this position.
Cutis Resident Corner 2015 Applications

Required Reading for All 2015 Dermatology Residency Applicants

The 2014 Charting Outcomes of the Match ( http://www.nrmp.org/wp-content/uploads/2014/09/Charting-Outcomes-2014-Final.pdf ) is must reading for current dermatology applicants because it is the best source to evaluate chances of matching in the upcoming 2015 NRMP into a dermatology residency (pages 44-56). Some of the information is expected for MS4s, such as:

-Applicants with a PhD almost always match (other graduate degrees don't seem to help very much)

-AOA membership is a huge advantage for matching (over 50% of spots go to AOA members)

-A Step 1 score of 241 or better increases the chances for a dermatology match (averaged matched applicant has a 247 Step 1, while average unmatched applicant has a 239)

-About 9 interviews were needed to rank 9 contiguous dermatology programs (greatly increase chance of a match)

UTMB Academy of Master Teachers Recognize Outstanding Teaching Each Month

In an effort to recognize excellent teaching, the UTMB Academy of Master Teachers is encouraging UTMB medical students, graduate students, residents, fellows and faculty to nominate outstanding teachers. Nominations may be submitted via http://www.utmb.edu/amt/Educator_of_the_Month.html. Make it a habit to reward excellent teaching with your nomination, so that excellent teachers receive institutional recognition for their efforts!

Skin Research Funding Available for Medical Student Research in 2015

Medical students are invited by the American Skin Association to submit grant proposals about melanoma and skin cancer for potential funding up to $7000. There is an October 18, 2014 deadline. See link below for the application:
American Skin Association Medical Student Grants (For 2014 Applicants).pdf

Multiple Positions Available on the Subcommittees of the Vitiligo Working Group (VWG)

The VWG is composed of numerous, highly respected academic and private practice Dermatologists that periodically meet throughout the year on conference calls to discuss various aspects of vitiligo, including published consensus/guidelines. These positions are a great opportunity to network and learn from experts in the field.

If you are interested in one of these positions, please send an email to Alex Acosta at kaacosta@utmb.edu for more information.

Recommended Reading for Dermatology Residency Applicants

The September 2014 issue of Texas Medicine (“Match-makers: Coaching students to maximum match potential,”, pages 47-51) details the experience of a senior medical student from Houston who did not match into his first choice competitive residency (ENT) despite academic advisement that he was “…an ideal candidate.” He went through SOAP (Supplemental Offer and Acceptance Program) and matched into a pathology residency. He is enjoying his new specialty, but advises, “But just in case the worst happens, have a plan B ready that you came up with when you were in a normal mental and emotional state. And be realistic.”

First DIG Meeting of the Year with Program Director Dr. Wagner!

Join us for a Q&A Session with Dr. Richard Wagner, the UTMB Department of Dermatology Residency Program Director. This session is a great way to get information on topics such as residency applications, matching, research and more!

Where: Dermatology conference room, 4.112 McCullough Building

When: Monday, September 22, 2014 at 5pm

Have any questions? Email Alex Acosta at kaacosta@utmb.edu

UTMB Recovery Front Page News

Houston Chronicle reporter Harvey Rice has a front page story in the 9/5/14 about UTMB's recovery since Hurricane Ike in 2008 (UTMB makes full recovery, Houston Chronicle, Friday, September 5, 2014, pages A1, A10). He provides a summary of institutional events following Hurricane Ike, including UTMB's expansion onto the mainland and the decrease in charity care that the institution now provides (3128 uninsured patients treated in 2008 dropped to to 233 in 2011 according to the Galveston County Free Care Monitoring Project). 

Galveston County on Mosquito Alert

The Galveston Daily News alerted readers via its front page headline (Alex Macon, Mosquito control warns of bloodsucker invasion: Officials say massive hatching of saltwater mosquitoes expected to swarm across county; crews to begin spraying, Friday, September 5, 2013, pages A1, A4) of impending mosquito hatching. According to the report, it is due to abnormally high tides (about 2 feet higher than normal).

UTMB Penalized $900,000?

According to Galveston County Daily News Reporter Laura Elder (“UTMB to pay penalties under federal program to fight hospital infections,” Sunday, August 31, 2014, pages A1, A11), UTMB may be required to pay $900,000 in penalties due to patient infections and injuries.  Hospitals are graded by the Center for Medicare and Medicaid Services and need a score of 7 or less to avoid financial penalties. UTMB scored 7.4. Parkland (Dallas) rated 8.675 and UT Southwestern University Hospital was 7.375. Data was compiled during 2012 and 2013. According to this news report, since over half of US teaching hospitals may be subject to this penalty, it may not be a fair comparison with other hospitals. This is because US teaching hospitals may be providing care for patients with more severe illnesses and more likely to develop complications such as infections.

All UTMB 2014 Completing Dermatology Residents Pass Dermatology Boards

All three UTMB Dermatology Residents who completed our dermatology residency program passed the American Board of Dermatology Certification Examination given in July 2014 on their first attempt, and are now Diplomats of the American Board of Dermatology. Congratulations to Drs. Jason Jones, Megan Moody-Neill, and Samantha Robare-Stout for their excellent academic accomplishment! All are currently in private dermatology practice. For a complete list of new ABD Diplomats, please see http://www.abderm.org/home/cert_dipls.pdf

What Every Dermatology Applicant Should Know: The Perils of PGY1 Preliminary Year in Internal Medicine, Pediatrics, and Family Medicine (If You Don’t Match Concurrently for a PGY2 Advanced Dermatology Residency Position)

Close reading of AAMC’s 2013 “Medicare Payments for Graduate Medical Education:
What Every Medical Student, Resident, and Advisor Needs to Know,” (available at: http://www.uth.tmc.edu/med/administration/edu_programs/Assets/documents/gme/medicare_payments_gme.pdf ) indicates that great care is potentially needed by dermatology residency applicants in selecting their PGY1 year if they fail to match into categorical dermatology (4 year program that includes internship) or advanced dermatology (3 year program that begins in the PGY2 year). Dermatology applicants who fail to initially match into dermatology residency but match for preliminary PGY1 residency positions in any three year residency (internal medicine, family medicine, pediatrics, etc) are determined to have an initial residency period (IRP) of only three years. This cannot be changed. Even if the future dermatology applicant leaves their program following completion of the PGY1 preliminary year and take a nonaccredited clinical dermatology fellowship in an attempt to improve their application competitiveness, they only have 2 years left of Medicare Graduate Medical Education funding available due to the initial IRP determination. This could be a factor when they reapply for a dermatology residency if Medicare residency funding issues are considered. In this type of scenario, it is much better for the PGY1 year to be transitional (IRP not determined until PGY2 program started) or a preliminary PGY1 position in another specialty such as general surgery that has a longer IRP, because the IRP for general surgery is 5 years. A 5 year IRP designation would allow for complete dermatology residency funding should a position be obtained in the future and general surgical training did not extend beyond the PGY2 year.

If a dermatology applicant matches for both the PGY1 and an advanced dermatology position during the same NRMP, it does not matter if the PGY1 year was transitional or preliminary. All three years of dermatology residency will be covered and funding is not an issue.

“Must Read” Research Article for Current Dermatology Applicants

Thanks to authors Farzam Gorouhi, Ali Alikhan , Arash Rezaei, and Nasim Fazel for their valuable research article about the preferences of program directors for dermatology residency selection (Dermatology Residency Selection Criteria with an Emphasis on Program Characteristics: A National Program Director Survey, Dermatology Research and Practice, Volume 2014, http://www.hindawi.com/journals/drp/2014/692760/ ). In their national survey of dermatology program directors, they found that the usual criteria (interview, recommendation letters, Step 1 score, transcript, and clinical rotations) were the top 5 criteria. The interview was the most important factor. Some programs also placed importance on other applicant aspects, such as advanced degrees, interest in academics, medical school rank, and publications. Previous failure to match into dermatology was identified as a possible barrier to a match in the future.

New Funding Mechanism on Horizon for Dermatology Residency--Will Future Residents Pay Tuition?

The August 28, 2014 issue of The New England Journal of Medicine reminds us that current funding patterns for graduate medical education (residency) by Medicare are not guaranteed. Authors David A. Asch and Debra F. Weinstein ["Innovation in Medical Education," 371(9):794-795] wrote that in the future, innovative graduate medical education funding may make "...larger payments to direct trainees toward undersupplied specialties or geographic areas, or eliminating stipends--or even charging tuition--for subspecialties that are oversubscribed."

Dermatology RRC Suspends Medical Dermatology Case Log Requirement

ACGME's Dermatology Residency Review Committee (RRC) has suspended the newly implemented July 1, 2014 requirement for dermatology residents to record specific medical dermatology cases and medication use until further notice. The Dermatology RRC hopes to simplify reporting before this medical dermatology requirement is restored. However, dermatologic surgical procedures still must be reported.

Dermatology Resident Competes in Reality TV Show

First year dermatology resident at Cleveland's Metro Health Center Dr. Angela Funovits is competing for a $10,000 prize on the reality TV show, "Wizard Wars."For additional information please see: http://www.npr.org/2014/08/17/340633697/on-wizard-wars-contestants-must-make-magic-from-the-mundane  The UTMB DIG wishes you the best of luck in this competition!

International Porphyria Expert Lectures UTMB Dermatology Department

Internationally recognized porphyria researcher and expert, Dr. Karl E. Anderson, provided an outstanding lecture about the porphyrias to UTMB dermatology residents, faculty and medical students on Friday, August 8, 2014. Dr. Anderson is Professor of Preventative Medicine and Community Health, Internal Medicine and Pharmacy and Toxicology at UTMB. Thanks to Dr. Brandon Goodwin, UTMB PGY4 Dermatology Chief Academic Resident, for organizing this lecture series of campus experts from other academic departments who greatly contribute to our understanding about disease pathogenesis, diagnosis and treatment!

UTMB Dermatology Clinics Welcome POM2 Medical Students

The UTMB Department of Dermatology will participate in UTMB’s required POM2 (Practice of Medicine 2) medical student education class during the 2014-2015 academic year. Two medical students will participate in morning dermatology clinics in the UHC, while another will travel to the UTMB Dermatology Clinic at Bay Colony in League City. The clinics will host POM2 students on Monday, Tuesday, and Thursday mornings. Every POM2 student will have an opportunity to rotate through our dermatology clinics. POM2 students will have an opportunity to interact with UTMB dermatology residents and faculty, and see a variety of patients with skin diseases. They will also have the opportunity to view dermatologic procedures such as diagnostic tests and the treatment of skin cancers. They will present their clinical experiences to their faculty facilitator during scheduled POM2 class meetings. This is an excellent opportunity for UTMB medical students to gain exposure to dermatology early during their medical education.

Does Dermatology Residency Program Matter for Dermatologic Surgery or Dermatopathology Fellowship Offers?

Yes, where you take dermatology residency appears to matter if you plan on subspecialization in dermatologic surgery (Mohs) or dermatopathology. Fellowship training positions in these subspecialties are very limited, and excellent performing residents from within home dermatology training programs offering these fellowships will likely have the best professional connections to receive a fellowship offer there. These residents also usually have the opportunity to participate in research with the fellowship director, further cementing their desirability as a future fellow. Medical students who know that they want to take a procedural dermatology or a dermatopathology fellowship following dermatology residency are best advised to rank programs offering those fellowships higher on their rank lists, and hope for the best!

Boston University Intends to Extend Dermatology Training to 6 Years

Boston University plans on changing its dermatology training program from the current standard 3 years to 6 years starting in July 2016. Applicants in the current match cycle should understand that matching into the Boston University Dermatology Program will require a 6 year academic commitment. This will be accomplished by having its new dermatology residents complete the standard 3-year ACGME dermatology residency. Graduates will then remain an additional three years as Assistant Professors of Dermatology at Boston University where they will continue to develop academic niche areas in dermatology subspecialties. This type of academic restructuring has previously been attempted at another institution without success. It will be interesting to see how Boston University fares in its innovative change with dermatology education.

UTMB Dermatology Residents and Faculty Rate Program Highly

The results of the 2014 resident and faculty survey for the UTMB Department of Dermatology have been released by the ACGME. 91% of UTMB’s 10 dermatology residents rated the program “very positive” (the highest rating available), while one resident rated the program as “positive.” 100% of the 8 dermatology faculty surveyed reported that the program rated “very positive.” Congratulations on achieving such outstanding ratings!

Baylor Medical School Now on Probation

In a front page leading story that probably surprised many leaders in medical education, reporter Todd Ackerman of the Houston Chronicle reported that highly ranked Baylor Medical School has been placed on probation by the Liaison Committee on Medical Education (Ackerman T. Baylor medical school put on probation: Accrediting body cites 14 different 'areas of concern" none in instruction. Houston Chronicle, Saturday, June 28, 2014, pages A1 and A15). Citations related to medical student education included "...timely reporting of grades and observation of students in clinical rotations; and a need for new processes providing midcourse feedback to students..." Tenure issues for faculty and criticism that "...a mechanism for faculty to contribute in decision making" were also cited. Only four other medical schools are currently on probation by the Liason Committee on Medical Education. Adverse publicity due to this drastic administrative action against Baylor Medical School could potentially reduce Baylor's competitiveness nationally for top medical school applicants, residency applicants, and new faculty. It could also impact the competitiveness of Baylor Medical School graduates for residency positions in the upcoming 2015 NRMP. According to this news report, the earliest that Baylor can be taken off probation is in 2016.

PGY4 Dr. Megan Moody Neill Awarded 2013-2014 Resident Research Award

UTMB dermatology residents are required to design and complete a dermatology scholarly project during their three years of training. Their work is typically presented to the entire dermatology department during the PGY4 (final) year of residency. Dr. Megan Moody Neill was selected by UTMB dermatology faculty for recognition of her excellent dermatology research during the 2013-2014 academic year. Her research was about the mechanisms of dermatopathology laboratory errors and the steps needed to prevent them. Congratulations Dr. Neill for your excellent academic work in the UTMB department of dermatology. Dr. Neill’s dermatology faculty supervisor on this quality improvement study was Dr. Brent Kelly.

UTMB PGY4 Dermatology Resident Presents Scholarly Project About PowerPoints in Dermatology Curriculum

Dr. Samantha Robare-Stout, a current PGY4 dermatology resident at UTMB, presented her scholarly project that focused on introducing resident created PowerPoints into the traditional dermatology textbook conferences held during the 2013-2014 academic year. Evaluation about the impact of changes in the textbook review format was associated with better scores on the recent ITE dermatology exam for the PGY3 and PGY3 dermatology residents. A survey of the dermatology residents indicated that they thought these changes had a positive impact on learning dermatology.

Resident Scholarly Project Presentation: Teaching Medical Students About Dermoscopy

Dermoscopy is rarely taught to U.S. medical students. PGY4 UTMB dermatology resident Dr. Jason Jones decided to see if he could teach UTMB medical students more about the topic. He developed an instructional lecture and gave it to interested medical students. Following the lecture, they were better able to distinguish between melanocytic tumors that required referral to a dermatologist or a diagnostic biopsy.

UTMB Dermatology Residents Recognize Faculty for Excellent Dermatology Teaching

Current UTMB dermatology residents have selected UTMB Dermatology Faculty Dr. Brent Kelly and community dermatologist Dr. M. Colome in recognition for their excellent dermatology teaching during the 2013-2014 academic year. Congratulations on your selection for this honor!

Dr. Megan Moody Neill Presents Dermatology Scholarly Project

On Friday, June 20, 2014 (the final day of her dermatology residency program at UTMB), PGY4 dermatology resident Dr. Megan Moody Neill presented her required departmental scholarly project about dermatopathology laboratory errors. She took a comprehensive quality improvement approach to characterize the types of laboratory errors identified and to make recommendiations for continuous quality improvement. Her literature review on published in this research area was comprehensive. Her faculty mentor on this project was Dr. Brent Kelly, UTMB Associate Professor of Dermatology and Director of Dermatopathology at UTMB. Dr. Moody Neill plans on private dermatology practice in Seattle, Washington.

Period 1 Availability for Period 1 UTMB Dermatology Electives and Selectives

Period 1 of the new 2014-2015 Academic Year begins on June 30, 2014 at UTMB. There is still availability for most of UTMB's clinical and didactic dermatology electives and Selectives for UTMB and visiting medical students during Period 1 (see http://www.utmb.edu/meded/electives.asp for additional information). All of the dermatology didactic electives and Selectives are also available through teleconferencing, a distance learning option that has been popular with medical students for the past several  years. Please contact the UTMB Registrar right away if you are interested in any of these courses. UTMB electives and Selectives are 4 weeks in duration and given 13 times each year (13 Periods).

UTMB Dermatology Reorganizing Clinical Dermatology Elective and Acting Internship Selective

Starting Period 1 of the 2014-2015 academic year (June 30th) UTMB’s popular Clinical Dermatology elective (DERU-4010) and Acting Internship Selective (DERU-4006) will have different curricula developed by Dr. Audra Clos, the new dermatology chief resident for medical student education. She has selected a popular dermatology textbook for these clinical rotations (Habif, 5th edition) and will supplement assigned readings and scheduled faculty lectures with American Academy of Dermatology web-based educational materials. Students will be given a clinical quiz at the beginning and end of the rotation, to evaluate what has been learned. Students will also be assigned journal articles to present at the Friday journal clubs.

Multiple First Authors in Dermatology Publications: An Oxymoron?

First authorship peer-reviewed publication in medicine and other scholarly fields is prized by authors and highly respected by other academics because of its prestige and community acknowledgement about responsibility for the reported work. First authors may eventually be rewarded for their effort by preferential selection for prestigious and competitive positions (such as medical school admissions and dermatology residencies), and on the faculty level, with promotion and tenure. Traditionally, there was usually one first author. First authorship in multiauthored should ideally identify the person most responsible for the publication. Typically the person who initiated the work, wrote the first draft and coordinated all revisions, submitted the work, responded to reviewers, corrected the proofs, etc is listed as the first author. The UTMB DIG recently became aware that a highly innovative and respected dermatology journal published an article this month with two “first authors” (seehttp://escholarship.org/uc/item/5037g18h ). Will this become a growing trend in the dermatology literature? Would it ever be possible that all the authors of a multiauthored work could be first authors? Will selection committees treat each of the multiple first authors as the first author? Or will they concluded that a multiple first author publication really does not have any first authors? Hopefully academic journals will address this concern and issue future guidelines, if they have not already done so.

UTMB Dermatology Resident Publishes Case Report About Infected Tattoo

Congratulations to Dr. Rebecca Philips, a current PGY2 UTMB dermatology resident who has just published an interesting case report about an infected tattoo in the June 2014 issue of Dermatology Online Journal (Philips R, Hunter-Ellul LA, Martin JE, Wilkerson MG. Mycobacterium fortuitum infection arising in a new tattoo. Dermatology Online Journal 2014;20:6 https://escholarship.org/uc/item/6bs3q0h0 ). Her UTMB coauthors on this study were Dr. Lindsey Hunter, a PGY3 UTMB dermatology resident, Dr. Julie Martin, a UTMB residency graduate now practicing in Austin, Texas and Dr. Michael Wilkerson, UTMB Professor of Dermatology.

What is the Best Way to Teach Internal Medicine Residents about Dermatology?

According to a recent study from Southwestern Medical School, internal medicine residents learn more dermatology when they are given didactic lectures and multiple choice questions while on dermatology rotations (Cayce R, Bergstresser P, Hesterman K, Condie D. Dermatology curriculum for internal medicine residents: a randomized trial. J Grad Med Educ 2014;6:296-300). This study could influence dermatology curriculum for internal medicine residents in the future, since according to the authors, “…dermatology education is a substantial weakness for many internal medicine residencies.”

Dr. Alex Holliday Accepts Dermatology Fellowship Position

Dr. Alex Holliday, a current PGY2 resident in the UTMB internal medicine program and UTMB SOM graduate, has accepted a dermatology fellowship position at the new Virginia Tech dermatology residency program in Roanoke, Virginia for the 2014-2015 academic year. Congratulations Dr. Holliday!

How did Texas Medical Students Fare in the 2014 NRMP?

The Texas Medical Association has published an analysis of the 2014 NRMP for Texas Medical Students (see http://www.texmed.org/template.aspx?id=5183#Failing for additional details). In brief, Texas could do better. 100 Texas MS4s initially failed to match, but of these 68 later found positions. Ultimately 2% of Texas’ MS4s did not match for a PGY1 position. A poll of Texas Deans’ of Student Affairs found that orthopedics, surgery, otolaryngology, dermatology, obstetrics and gynecology, and ophthalmology were the most competitive specialties for Texas medical students this year.

Dermatology Residency Review Committee Expands Resident Logs to Include Medical Management

Beginning July 1, 2014, dermatology residents in ACGME accredited programs will be required to log medical procedures and management that include patch testing and phototherapy, immunobullous and connective tissue diseases, and “high risk systemic medication management.” High risk medications exclude prednisone and isotretinoin, but include “…cyclosporine, methotrexate, acitretin, dapsone, mycophenolate mofetil, TNF antagonists, IL-12/23 antagonists, IL-17 antagonists, rituximab, thalidomide, lenalidomide, cyclophosphamide, daclizumab, ipilimumab, vemurafenib, vismodegib, and other new and emerging molecular-based therapies.” More detailed information about these new requirements may be found here:
http://www.acgme.org/acgmeweb/Portals/0/PFAssets/ProgramResources/080_Case_and_Medical_Logs_2014.pdf

Tenure Controversy Emerges At MD Anderson

The June 7, 2014 Houston Chronicle featured a front page article coauthored by reporters Todd Ackerman and Eric Berger about a faculty dispute at Houston’s premier cancer center, MD Anderson (“Cancer center in tenure dispute,” pages A1 and A13). Academic censure is possible for MD Anderson if the institution is investigated by the American Association of University Professors (AAUP). It has long been known in academic circles that MD Anderson does not offer its faculty traditional tenure. Instead, it offers 7 year appointments that are usually renewed following faculty review. According to Ackerman and Berger, the current controversy arose when three faculty were given unanimous recommendations for renewal by MD Anderson’s institutional committee, but the MD Anderson President rejected the recommendations. UTMB remains on the AAUP censure list following the reduction of tenured faculty in the wake of Hurricane Ike and the resulting financial problems for the institution.

UTMB Dermatology Interest Group 2014 Awards for Excellent Dermatology Teaching

The UTMB Dermatology Interest Group (DIG) President Shelia Jalalat made its annual awards for excellent dermatology teaching to Dr. B. Gibson (UTMB faculty pictured) and
Dr. Samantha Robare-Stout (PGY4 dermatology resident) on Friday, May 30, 2014 during the weekly dermatology journal club. Congratulations on this outstanding recognition by UTMB medical students for your excellent teaching efforts throughout the year!

Dermatology Resident Elected to UTMB House Staff Leadership Committee

Congratulations to Dr. Lindsey Hunter-Ellul, a current PGY3 UTMB dermatology resident, for her recent election to the UTMB Graduate Medical Chief Resident/House Officer Association Officers Subcommittee for the upcoming 2014-2015 academic year. Dr. Hunter-Ellul was elected by the entire UTMB house staff to one of the four “members-at-large” positions.

2014 UTMB Dermatopathology Review Course a Success

2014 UTMB Dermatopathology Review Course a Success

Attendees at the Annual Dermatopathology Review Course held at UTMB on Saturday, May 31, 2014 were very pleased with course content and teachers. Dr. Brent Kelly (UTMB Associate Professor of Dermatology and Chief of UTMB Dermatopathology) co-directed the course this year, and gave lectures along with co-course director Dr. Maribel Colome (former UTMB Chief of Dermatopathology), Cris Berlingeri (UTMB Dermatology Clinical Assistant Professor), Matthew Petitt (former UTMB dermatopathology fellow), Palak Parekh (former UTMB dermatopathology fellow), and Ramone Sanchez (UTMB Dermatopathology Fellowship Director). Representative participant comments were:

“Very helpful while preparing for the boards”

“The handouts are great”

“All the speakers did an excellent job”

“The course was great and all the speakers were wonderful! Thanks for organizing it!”