Dermatology Residency Program

Residents will be under the direct supervision of the preceptors, members of the ACVD. Faculty at the University of Florida in direct support of the program include:

  • Dr. Rosanna Marsella, DVM, Dip ACVD, Professor & Service Chief
  • Dr. Joy Barbet, DVM, Dip ACVD, Visiting Clinical Instructor
  • Dr. Diane Lewis, DVM, Dip ACVD, Clinical Assistant Professor

These preceptors will conduct and supervise the resident's training.
The University of Florida and the University of Florida Veterinary Medical Center have appropriate facilities for this program. The UFVMC has laboratory facilities for clinical pathology and histopathology as well as most necessary hospital services. The J. Hillis Miller Health Center adjacent to the College of Veterinary Medicine has a complete Health Center Library. The College of Medicine offers a dermatology residency training program as well, and there are opportunities for interaction.

Type of Residency Available

The University of Florida College of Veterinary Medicine offers only a formalized residency program in dermatology as approved by the Education Committee of the ACVD. It is subject to current College guidelines.

Scope of Residency Program

The University of Florida College of Veterinary Medicine, offers a two year full-time residency program in Dermatology. On occasion this has been extended to a 3 year training program at the mutual agreement of the preceptors. Residents spend approximately 9 out of 12 months each year in the dermatology clinic. Three weeks are allocated to vacation and the other 2.5 months are "elective" periods. During the two year residency, the resident may rotate through small animal medicine or the resident may feel it advantageous to take rotations through either neurology, cardiology, oncology or large animal medicine. Other open period time is devoted to completion of the residency project. Exchange periods with other institutions are encouraged and limited funding may be available to assist. All residents participate in the after-hours emergency service of the VMC. The schedule is arranged by the residents on a rotational basis with a medical and surgical resident on call.

Dermatology has clinic receiving on Monday - Friday each week. Veterinary students (5-7) have two week rotations in dermatology. Dermatology rounds are held on most clinic days either the day of the cases or the following day. Discharges generally occur on the day of the visit. Dermatology residents share the responsibility for in-house consults.

Group functions in dermatology include journal club weekly, chapter review of a textbook weekly, and a shared dermatopathology seminar.

Within the College, resident seminars are given weekly throughout the academic year. Each dermatology resident is expected to present one of these annually, and these presentations are designed not only to present known material, but to encourage independent thought and discussion on the given subject.

Each resident is encouraged to develop teaching skills through instruction of junior and senior students in clinics and through a few annual hours of lecture. Additional opportunities for participating in continuing education seminars, talks to kennel club groups, etc are encouraged for the resident who wishes to participate.

The University of Florida College of Medicine, has a dermatology residency training program and faculty members who have willingly interacted with our group. There are opportunities to attend seminars, lectures and patient viewing to gain knowledge regarding the comparative aspects of dermatology.

Clinical Training Requirement

During the program, the resident must have a minimum of 250 eight hour days of active clinical training which includes time spent examining patients, conducting diagnostic or therapeutic procedures, reviewing diagnostic material, consulting with appropriate specialists, patient discussions, and following the patients with owners or referring veterinarians. When residents are on in-house active clinic duty (9 mos/yr), they receive patients and see consults 5 days per week. They are directly supervised by one of the preceptors during this time. Faculty members are assigned to clinic duty so that residents always are aware of their supervision. Some time is used for phone calls to clients and veterinarians, referral correspondence, medical record paperwork, and discussion of patients and laboratory data. Every Monday, the dermatology service is dedicated to the assessment and management of otitis externa and media of the dog and cat. Deep ear flushes with video otoscopic examination under general anesthesia are performed as necessary. Residents also meet with students every other Monday (morning) to orient them. This means a minimum of 250 8-hour days in two years not allowing for clinic rotations through other services during the three-month flexible schedule per year. (Attachment 1)

All residents are required to meet the case requirement of the ACVD. This current requirement is that the resident has primary responsibility for a minimum of 500 patients. The ACVD describes these to be new patients or existing patients for which the resident takes primary responsibility for a decision regarding diagnosis or therapy. A case log is maintained for all patients and it is kept in the format necessary for the ACVD. The resident is expected to follow either by re-examination or phone call, at least 50% of his/her primary cases and this data should be included in the log-book.

Residents are encouraged to do outside rotations in dermatology at other Universities or to visit practices managed by ACVD Diplomates. This allows an opportunity to see how others diagnose and treat cases as well as give exposure to alternative teaching and management methods.

The ACVD requires that during the residency, the preceptor(s) and educators must spend a minimum of 384 direct contact hours with the resident in pursuit of studies of basic and applied science related to dermatology. This includes allergy, anatomy, bacteriology, biochemistry, clinical pathology, dermatopathology, embryology, genetics, immunology, internal medicine, mycology, nutrition, oncology, parasitology, pharmacology, physiology, surgery, and virology. Our program at the College of Veterinary Medicine meets this training in a variety of ways.

Journal club is held weekly. All residents and preceptors attend regardless of whether they are on clinic duty or not. Journal club is formatted such that all participants read 3-5 papers selected and circulated before the meeting. The papers are critiqued and discussed by all.

Review of a textbook is done chapter by chapter for one hour per week. For example, in the recent past we have reviewed texts on Immunology, Dermatopathology, Therapeutics, and Advances in Veterinary Dermatology. This is attended by all and is done in a discussion format.

The on-duty residents consult the on-duty faculty throughout the week regarding patients. During this discussion of patients and the literature relative to specific diseases, there is considerable education time. This exceeds one hour per week.

A Suggested Reading List (Attachment 2) is given to the Residents and reading is monitored and discussed regularly and documented on the six month evaluations. Residents also give the preceptors a quarterly report and case log update. A library of appropriate texts is maintained by the section of dermatology as available reference to the residents at all times.

Continuing education in the way of lectures at North American Veterinary Conference, the AAD, AAVD/ACVD meetings also offer excellent educational opportunities. Seminars at the College of Medicine may be attended when clinic time permits.

Histology of the skin is taught to veterinary students as part of the Histology Course. Residents participate in teaching students microscopic identification of parts of the epidermis, dermis and histology of the equine hoof. The University of Florida strongly encourages teaching as a method for residents to learn the material, to retain the material and to be comfortable with it such that they can answer questions.

Dermatopathology sessions are held weekly on Mondays. The residents meet individually with a preceptor, Dr. Diane Lewis, and they discuss slides that had been previously assigned as “unknowns” for practice in the skills of recognition of patterns and differential diagnoses.

1. Dermatohistopathology

The goals of the resident's training in dermatohistopathology are to:

  • Recognize the normal histoanatomy of the domestic animals as well as variations by site and species and the specific histologic features of a species.
    Become adept at pattern diagnosis of inflammatory conditions of the skin.
  • Become fluent, systematic, yet concise with morphologic descriptions of tissue sections.
  • Develop logical differential diagnoses based on the inflammatory pattern present.
  • Be intimately familiar with the textbooks available for ultimately diagnosing the majority of histologic presentations of the skin.
  • Become familiar with the histologic features of non-neoplastic disorders of domestic animals and be able to recognize the common tumors of domestic animals, especially the lymphohistiocytic neoplasms.
  • Review the inflammatory disorders of human dermatohistopathology. The resident is not expected to know the histologic features of disorders not recognized in animals.

These goals will be achieved by weekly dermatopath conferences with the resident's preceptors as well as conferences with pathologists. The resident will prepare their clinic surgical biopsies in a written format for discussion at the weekly dermpath conference. The extent of this format will vary with the resident's stage in the program but will (during the last six months of the program) be compatible to a complete description and morphologic and differential diagnosis with suggestions for special stains if indicated. The resident is expected to accentuate this experience with self-study and investigation. The resident is encouraged to attend dermatopath conferences at the Medical School when clinic time permits.

2. Internal Medicine

All ACVD residents need to have a broad understanding of internal medicine, especially in areas where cutaneous manifestations are common. It is expected that much of this basic clinical training will have been received before beginning the residency in dermatology. Throughout the residency program, residents are encouraged to consult with specialists as appropriate. Residents handle a variety of medicine cases as emergency receiving clinician on weekends and evenings. These cases are monitored by a ACVIM Diplomate or residents.

3. Other

The veterinary college at the University of Florida has a strong Zoological Medicine Program group with three faculty and 2 residents and a large case load. There are opportunities to view exotics with skin disease and any resident with a special interest is encouraged to pursue the application of dermatology to exotic species.

Other Requirements

A. Research Project

All ACVD residents are required to initiate and complete at least one research project during the course of their residency. The resident must be the principal investigator in the project. The project must be completed during the residency and be submitted for presentation at one of the annual ACVD meetings. A manuscript on the project, suitable for publication, must be prepared and submitted with the resident's application to the Credential's Committee. The manuscript must be accepted for publication before the certifying exam can be taken.

Residents at the University of Florida are encouraged to design and conduct a clinical trial during their residency. Intramural funding is available on a competitive basis in the fall of each year. All dermatology residents generally compete for these funds by researching the literature and writing a proposal of their choice. These grants proposals are generally due in October. The ACVD also funds a resident project annually and residents are encouraged to apply. (See Attachment 3)

The specific philosophy of the Department of Small Animal Clinical Sciences regarding the residency project is as follows: The University of Florida College of Veterinary Medicine requires that all Residents receive, in addition to clinical training, some exposure to investigative approaches during their Residency. The Residency Project is a requirement of all Residents in the Department and the awarding of a Resident Certificate is dependant just as much upon the successful completion of the project and manuscript as on the successful completion of other aspects of the program. The Resident should be able to demonstrate that he/she can:

  • Think of an area where a contribution might be made.
  • Design an approach to solve the question.
  • Write up the project in the form of a grant proposal.
  • Present the proposal to supervising faculty for discussion and critique.
  • Make the appropriate deduction.
  • Make an oral presentation on the project to the College Faculty on Resident's Day (first or second Friday in June).
  • Prepare a manuscript suitable for publication and have it accepted.

Projects must obviously be realistic in terms of achievable goals and financial feasibility. Time necessary for completion of the project should be taken into account when planning rotations and schedules. Good planning done well in advance, is clearly critical.

The project is intended to be an entry into the world of scientific investigation. It will better equip the Resident for years ahead, be they specialty practice or academics. It will certainly lead to better trained residents who will be equipped to make significant contributions to veterinary medicine in the future.

B. Case Reports

Three reports of patients managed by the resident are required to be written by the resident and accepted by the ACVD credentials committee. Specific instructions regarding these reports are sent in August to new residents by the Executive Secretary of the ACVD. The first case report can be read, reviewed and critiqued by the preceptors. The other two case reports are written independently.

C. Scientific Presentations

All ACVD residents are required to give at least four scientific lectures during their residency. These lectures are to be at least 30 minutes in length and must be on a topic related to dermatology. Resident Seminars (1 given annually by each resident) will encompass two of these hours. These seminars are discussed at length with the preceptors and they are critiqued in writing by all faculty in attendance. Lectures are also given to clinic students on a regular basis by residents. Residents are encouraged to give lectures to local practitioners as well.

D. Continuing Education

Attendance at dermatology continuing education lectures is valuable for residents. The entire group of dermatologists attend the annual meeting of the American Academy of Veterinary Dermatology/American College of Veterinary Dermatology in the spring. These meetings allow not only an exchange of information but an opportunity for the residents to become acquainted with other veterinary dermatologists across the nation. There are some funds for assistance to attend this meeting. Residents are required to present data from the resident's project in the second year of their program. Some University of Florida residents have presented in their first year as well.

The North American Veterinary Conference and the Florida Veterinary Medical Association Annual Meeting are both held yearly in nearby locations. Residents generally attend dermatology lectures at these meetings at least once during their two year program. The Central Florida Academy also offers extensive 10-12 hour weekend courses and generally has a dermatology lecturer annually. Residents may attend these with a minimal registration charge and are invited to do so.

E. Other

Residents are evaluated by their advisors every six months. This is done by the entire group of mentors and discussed personally with each individual resident. (Attachment 4) A record of the evaluation is signed by the resident and becomes a confidential part of their file. Residents in turn assess the program as well as their individual faculty supervisors annually.

Residents bring their updated goal checklist (Attachment 5) with them as well as a list of objectives for the next 6 months when they come for their evaluation.

Documentation

All residents must complete an ACVD registration form at the start of their program. They must keep a log of all cases where they are primary clinician in a format suitable for the ACVD. Residents must file yearly progress reports with the ACVD Education Committee.

The case log includes patient identification (case number/owner name), signalment, diagnosis, and indication of whether the case was followed. The yearly progress report uses the ACVD form. The preceptor's personal evaluation of the candidate annually goes to the Education Committee. Any Diplomate, other than the preceptor who participates in the training of a resident documents the nature and duration of the training and the resident's performance.

All residents completing the program at the University of Florida including their project and manuscript suitable for publication will receive a certificate of Residency Completion.