July 2014

TUFTS MEDICAL CENTER

Dermatology Residency Training Program

Overview of the Residency Training Program The Tufts Medical Center Department of Dermatology formed its own independent residency training program in April 2008. Our program is ACGME-accredited for 10 resident positions. As of July 2014 we will have 10 residents: 3 first years, 3 second years, 4 third years. We will be participating in the upcoming NRMP Match for July 2016, for 2 positions. Our program has many strengths including:

High patient volume

Patient diversity (Asian, African American, Caucasian, Indian)

Specialty clinics in patch testing, infectious disease, psoriasis and psoriatic arthritis, pediatric dermatology and cosmetics

Two Mohs surgeons who operate on site

ACGME accredited dermatopathology fellowship

Fellowships offered in clinical research

National and international recognition for clinical research in psoriasis and psoriatic arthritis, cutaneous oncology and contact dermatitis

Affiliation with the Boston VA Medical Center (Jamaica Plain, West Roxbury)

Located in Boston’s theater district, near downtown, abundant ethnic cuisine and fine dining is within walking distance

A Brief History of the Tufts Department of Dermatology

Tufts College was founded in 1852 as a non-sectarian institution of higher learning in Medford, Massachusetts, about five miles from Boston. It is now organized into 10 schools on four campuses. The Medical Sciences campus is in Boston’s Chinatown adjacent to Tufts Medical Center (formerly New England Medical Center), the primary teaching hospital of Tufts University School of Medicine. The Medical School and the Dermatology Department were founded in 1893. Initially the Dermatology Department was centered at the Boston City Hospital. It was a Tufts Service and the major site of dermatology teaching for Tufts medical students. Important leaders of the Department in the modern era were Dr. John Downing (1944-1952), Dr. Bernard Appel (1952-1961), and Dr. Walter Lever (1961-1977). Dr. Lever, an eminent German-born dermatologist and dermatopathologist, was a pioneer in understanding and managing blistering diseases of the skin such as pemphigus vulgaris and bullous pemphigoid. Under his leadership dermatology at Tufts grew remarkably, with generous NIH support for research and training. In 1980 Dr. David S. Feingold, boarded in internal medicine, infectious disease and

dermatology, was appointed Professor and Chair of Dermatology at Tufts University School

of Medicine and Tufts Medical Center. Dr. Feingold was given the charge of building a

vibrant academic dermatology presence at Tufts. In the 1980s and 90s dermatology at Tufts

prospered. Dr. Donald Grande set up a strong surgical division with a Mohs surgery

fellowship. The surgical program remains very strong today. Since Tufts Medical Center

includes a pediatric hospital a pediatric dermatology clinic was created. The Department has

remained very busy and financially successful with over 13,000 outpatient visits yearly. Dr.

Feingold stepped down as Chair in 2003 although he served as interim chair until 2006.

In March 2006, Dr. Alice B. Gottlieb, boarded in internal medicine, rheumatology and dermatology, and an internationally recognized expert and leader in the field of psoriasis and psoriatic arthritis, joined Tufts Medical Center as its Chair of Dermatology. Her research using targeted immunobiologics as pathogenic probes, provided new understanding of the pathogenesis of psoriasis and provided the foundation for biologic drug development in psoriasis and psoriatic arthritis. As a direct result of Dr. Gottlieb’s work, many biotechnology-engineered immunomodulators are FDA and /or EMEA-approved for psoriasis and psoriatic arthritis. In 2001 she received the American Skin Association’s Psoriasis Research Award in recognition of her work. In 2006 she received the Honorary Fellowship Award of the American College of Clinical Pharmacology. Currently Dr. Gottlieb’s research centers on developing new treatments for psoriasis and psoriatic arthritis and on understanding the mechanisms of action of these novel agents. Additionally, she is working on initiatives to prevent psoriatic arthritis and the consequences of the metabolic syndrome that is associated with psoriasis. FACULTY LISTING

Faculty Area(s) of interest

Alice Gottlieb, MD, PhD, Chair Clinical trials in psoriasis and psoriatic arthritis

Christine Urman, MD General dermatology, cosmetic dermatology

David S. Feingold, MD Infectious diseases, clinical dermatology

Daniel Loo, MD General and pediatric dermatology, contact dermatitis

David Rosmarin, MD General dermatology

Jeffrey Sobell, MD Psoriasis, clinical trials

Michelle Nguyen,MD, MPH Dermatologic surgery, cosmetic dermatology

Emily Tierney, MD Dermatologic surgery

Elsa Velazquez, MD Dermatopathology

Amy Chang, MD Contact dermatitis

CLINICAL EXPERIENCES (Appendix A: Clinical Rotation Schedule 2013-14) General dermatology: Most of our faculty practice medical dermatology and this will be the focus of your clinical rotations during your first and second years at the Tufts Medical Center and the VA. Pediatric dermatology: Dr. Loo has one half day dedicated pediatric dermatology clinic at Tufts Medical Center. Residents will attend this clinic during all three years. Patch testing: Drs. Daniel Loo and Amy Chang direct patch testing clinics twice per week. They receive referrals from both the community as well as other academic centers. This is a second year rotation. Psoriasis: Drs. Gottlieb and Sobell have clinics at Tufts Medical Center that specialize in the use of the biologic agents in the management of psoriasis and psoriatic arthritis in addition to traditional systemic agents and phototherapy. Residents will attend these clinics during all three years. Surgery: First year residents focus on the fundamentals of performing excisions at Tufts Medical Center under the supervision of Drs. Nguyen and Tierney. Second year residents assist in Mohs surgery during their VA rotation under the supervision of Dr. Christine Liang and at Tufts Medical center under the supervision of Michelle Nguyen Inpatient consults: Second year residents get an introduction to the consult service at the West Roxbury VA. Most of the dermatology consult experience occurs during the third year rotation at Tufts

Medical Center which covers both adult and pediatric inpatient services (Floating Hospital for Children). Cosmetics: Drs. Nguyen and Urman provide the following services at Tufts Medical Center:

Botox injections Fillers/ soft tissue augmentation Hair removal laser Vascular laser Sclerotherapy Chemical peels

Residents will participate in these clinics during their second and third years. Dermatopathology (Appendix B) Elsa Velazquez is Clinical Assistant Professor of Dermatology & Dermatopathology and Director of our dermatopathology fellowship. She is also the director of the dermatopathology curriculum for residents. Dr.Velazquez, as well as other staff dermatopathologists from Miraca Life Sciences, provides a comprehensive dermatopathology curriculum (lectures and slides at multi-headed scope) as well as two unknown sessions at the scope each month... DIDACTIC PROGRAM (Appendix C) Seven hours per week are dedicated to formal didactic sessions systematically covering the following subjects below.

Clinical core curriculum (Andrews/ Bolognia)

Surgical/ cosmetic lectures (1-2x / month)

Dermatopathology curriculum (2x/ month)

Drugs in Dermatology (1x/ month)

Journal club (1x/ month)

Clinical-pathologic correlation (1x/ month)

Kodachromes (6x/ year)

Genodermatoses (Spitz, 1x/ month, resident lead))

Basic science (1x/ month, resident lead)

Grand Rounds lectures (1x/ month)

ELECTIVE TIME: Elective time is optional during the second or third residency year and is provided for the purpose of rounding out your training experience. We advise that your elective be in a subspecialty not offered within our training program.

OTHER CONFERENCES & MEETINGS New England Dermatological Society: Boston, Harvard, Brown, Yale, Dartmouth-Hitchcock, and the University of Massachusetts Departments of Dermatology rotate to provide 3 clinical meetings per year with 20-30 patients with rare diagnoses followed by group discussion. Our department will occasionally host the annual didactic meeting comprised of lectures by the experts on current topics of interest. American Academy of Dermatology: Residents are encouraged to attend the annual spring meeting each year and to participate in poster and/or gross & microscopic presentations. The number of CME days allotted depends upon resident year. FELLOWSHIP OPPORTUNITIES Dermatopathology: Miraca LS has partnered with the Departments of Dermatology and Pathology at Tufts Medical Center to create this fellowship, which is directed by Dr.Velazquez. The fellowship recently received reaccreditation by the ACGME until 2015. They currently train two fellows per year.

CURRENT RESIDENTS

Afnan Hasanain, MD 3rd Year

Bridget Grant, MD 3rd Year

Andrew Wang, MD 3rd Year

Yahya Argobi, MD 2nd Year

Tushar Dabade, MD 2nd t Year

Chad Jessup, MD 2nd Year

Eva Volf, MD 2nd t Year

APPENDIX B

Dermatopathology Conference Schedule

2012/2013 Dates Topics

Jul 9/10

Jul 23/24 Benign and Malignantepidermal neoplasms

Aug 6/7 Psoriasiformdermatitis/Spongiotic dermatitis

Aug 20/21 Pilar and sebaceous tumors

Sep 10/11 Vesiculobullous

Sep 24/25 Infections and arthropod diseases

Oct 9 Cutaneous deposits, cyts, sinuses and metabolic disease

Oct 22/23 Lichenoid Dermatoses

Nov 12/13 Disorders of keratinization, pigment and dermal connective tissue,relapsing polychondritis

Nov 26/27 Mucinosis, cutaneous deposits,cysts, sinuses, metabolic diseases

Dec 10/11 Cutaneous infiltrates lymphoid and non lympho

Jan 7/8 Vascular tumors and metastases

Jan 21/22 Benign melanocytic lesions

Feb 11/12 Atypical nevi and malignant melanocytic lesions

Feb 25/26 Erythrodermas, drug reactions and physical agents

Mar 11/12 Disorders of mucous membranes

Mar 25/26 Vasculopathic reactions

Apr 8/9 Tumors of fibrous tissues and fat

Apr 22/23 Deep fungal and, parasites, arthropods and infestations

May 6/7 Granulomas

May 21/22 Inflammatory conditions of appendages and panniculitis

Jun 10/11 Tumors of bone, muscle, cartilage and nerve

Jun 24/25 Potpourri

APPENDIX C SAMPLE DIDACTIC SCHEDULE

Monday Tuesday Wednesday

1

2

3 7:30AM: Pigs Foot Session - CHUANG (1st yrs & clinical fellow ) 7:30AM: Tumor Board (2nd & 3rd) 9AM: Update/ Review Policy & Procedures-LOO (Mandatory for all residents and fellows) 9:30AM: Housekeeping-WANG 10AM: Systemic and topical retinoids- ROSMARIN 11:00AM: Soarian training (1st yrs & clinical fellow )

8 7:30am: Antibiotics - LARAIA PM MIRACA: Normal Skin, anatomic variations and accessory structures

9 AM MIRACA: Normal Skin, anatomic variations and accessory structures

10 7:30AM: Dermpath unknowns 8:30AM: Housekeeping-WANG 9AM: Andrews Chapter 13: Acne and related disorders - LOO 11AM: OCP and Antiandrogens - URMAN

15 7:30am: Andrews Chapter 11: Papulosquamous d/o - SOBELL

16 17 GRAND ROUNDS 8am: Patient viewing & discussion 10:45am: Gary Chuang

22 7:30am Andrews Chapter 10: Psoriasis & palmoplantar pustulosis SOBELL PM MIRACA: Epidermal neoplasms

23 AM MIRACA: Epidermal neoplasms

24 7:30am: Dermpath Unknowns 8:30AM: Health Information Security 9am: Andrews Chapter 29, part 1: Epidermal neoplasms

(p633-656) - KONNIKOV 10am: Basic science keratinocyte biology, Spitz (Ichythioses)

- DABADE 11am: Journal Club - LOO/WANG

29 7:30am: CPC- SOBELL and WANG

30

31 8am: Techniques in surgical excision- CHUANG 9am: Biology of the hair and nails & Spitz Hair and nail d/o - GRANT 10am: Andrews Chapter 15, PART I: Superficial fungal (Ch15, p297-398, 301-8) - LOO