The Department of Dermatology at The University of Texas Medical School at Houston
Department of Pediatrics
The Department of Pediatrics

Fellowship Program Details

To apply for this fellowship, follow this link: https://www2.mdanderson.org/sapp/discover/


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Program Description

This is a one-year clinical research fellowship with an optional second year. The goals of this program are to train one or two fellows per year in the conduct of clinical and translational research in cancer related dermatology. Clinical and translational studies related to skin cancer, melanoma, chemo-prevention, graft-vs-host disease, and cutaneous lymphomas will be included in this program to give the fellows a wide exposure to cutaneous oncology as practiced in a multi-disciplinary approach in a cancer center. The purpose of the fellowship is to foster scholarly activities in cutaneous oncology and to train future academic faculty members in cutaneous medical oncology.

Clinical Research Fellow

Fellow will take didactic course work and participate in the conduct of clinical research trials in medical cutaneous oncology (skin cancers, lymphoma, GVHD, psoriasis). One fellow per year is accepted with the option of remaining for an additional year to participate in translational research training. Fellow must have at least one or more years of training in internal medicine or pediatrics and hold a Texas medical license. Foreign graduates will not have Texas licenses and therefore are not eligible for this fellowship opportunity. Applicants who have completed a dermatology or internal medicine residency and who wish to get additional training in cutaneous oncology clinical research would be given priority for acceptance in this program.

Program Director

Dr. Madeleine Duvic is responsible for the training. She devotes 50% of her time to research and directly supervises the fellow in clinical training. She has an active clinical research program with a research nurse, data manager, plebotomist, and clinical coordinator.

Liaison with Other Program

The clinical research fellow is based fulltime at MD Anderson Cancer Center. The dermatology residency program is also affiliated with UT Medical School and Dr. Ronald Rapini is the Chairman. The fellow is encouraged to participate in teaching conferences and journal clubs at the UT Dermatology Program, and will be considered as an applicant for the Dermatology residency after the completion of the fellowship. The fellow does not rotate through other institutions. The UT dermatology residents take call at night and weekends so that the fellow is not on call in excess of the hours permitted.

Goals:

  • To learn how to take care of complex oncology patients in a multi-disciplinary cancer center setting.
  • To learn how to design and conduct clinical research studies and follow the protocol and requirements for clinical research.\
  • To learn how to write, submit, and present scientific papers for national meetings and journals.
  • If interested (during second year) to learn the conduct of translational lab-based research.

Definition of Core Competencies

  • Patient care that is compassionate, appropriate, and effective for the treatment of health problems and promotion of health. Fellow will evaluate new and returning patients in the clinic one on one with the faculty members and receive verbal feedback on their interactions with the patients.
  • Medical knowledge about established and evolving biomedical, clinical, epidemiological sciences and application of this knowledge to patient care. Fellow will attend the course on the conduct of clinical research of the OPR. Fellow will also be encouraged to read relevant articles provided in the Dermatology clinic and by the attending and to attend didactic courses. Fellow will also be taught about medical knowledge in evaluating new patients and in conducting clinical research trials. Fellow will be required to read the investigator brochure and the protocols for their research studies which contain basic science information. Fellow will be required to attend the conduct of clinical research course and the core curriculum course for fellows. Fellow is encouraged to attend Dermatology VA and Grand Rounds and MDACC Grand Rounds. Fellow will attend and present at a national meeting.
  • Practice-based learning and improvement that involves investigation and evaluation of their own patient care, appraisal, and assimilation of scientific evidence and improvements in patient care. This is a given and fellow will learn by doing. Fellow will evaluate new and returning patients with skin cancers, learn to do excisions, learn to evaluate and treat cutaneous diseases.
  • Interpersonal communication skills that result in effective information exchange and learning with patients, families and other care professionals. Fellow will have the opportunity to learn by example and to have own efforts critiqued by the attending. Fellow will attend any ethics conference that involves a patient under a fellow’s care. Fellow will work closely with the PA and the dermatology nurses.
  • Professionalism as manifested through commitment to carrying out professional responsibilities, adherence to ethical principles and sensitivity to a diverse patient population. Fellow will learn by doing and by example.
  • Systems-based practice, as manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on systems resources to provide care that is of optimal value. Practicing at MDACC will challenge fellow to learn how and who to call for care of the whole patient. This will include working with social workers, nurses, pharmacists, case workers, etc.

General Expectations of the Fellow’s responsibilities (in addition to competencies)

The fellow will be trained in the conduct of clinical research which shall include drug studies and clinical trials and translational research efforts. If there is an interest, the fellow may also observe or participate in oncologic surgery as time allows although this is a predominantly medical fellowship training program. During the first month the fellow will be supervised one on one by the program director. They will learn how to conduct a clinical evaluation and skin biopsy. They will learn how to collect clinical information including adverse events, assessments of skin lesions, take photographs, and correctly consent patients. They will learn how to fill out case report forms and the regulatory requirements for performing clinical research. After the fellow has been trained, they will be allowed to do the primary assessment of patients (which will then be staffed by the physician) and to mentor the medical students. It is expected that the fellow take care of the patients on research studies, perform evaluations, skin biopsies, write prescriptions, evaluate adverse events with the physician, and answer telephone calls. The fellow will carry a beeper and be available for emergencies when they are on call.

Unless there is a research patient to be taken care of, the research fellow is expected to attend institutional grand rounds, all section laboratory meetings, and the MDACC clinical course on oncology and clinical research. Fellow is encouraged to attend UT Medical School conferences in Dermatology as time allows including journal clubs or grand rounds. Conferences of interest will be suggested based on the institutional schedules.

The fellow will be based fulltime at MD Anderson Cancer Center. The fellow is encouraged to work with other faculty as time allows but no formal rotations will be required.

Teaching Opportunities

The fellow will be given the opportunity to mentor medical students and rotating residents in family practice. They will work one on one with medical students taking the CTCL elective to write papers and to teach them how to evaluate inpatients, new and returning patients. Fellow will have the opportunity to teach the dermatology residents about the currently active research projects.

Continuity of Care

The fellow will have the opportunity to follow all of the patients on research studies through the duration of the trial. Fellow will follow the inpatients and see them back in the clinic after discharge. Since we have a small attending inpatient service and an active clinical practice, there is ample opportunity for continuity of care and this will allow the opportunity to practice many of the core competencies above.

Research/Scholarly Activity

It is expected that the fellow will learn to write clinical research papers. Dr. Duvic will provide written instructions on how to write a research paper at the beginning of the fellowship and discuss topics that would be of interest to the fellow for research development. At least 2 case reports or one substantial paper should be completed and submitted for publication before the completion of the rotation. Dr. Duvic will work one on one with the fellow to teach and improve their analytical and writing skills. The fellow will also be provided the opportunity to present their work in research conferences. Fellow will be expected to submit work to a national research meeting for oral or poster presentation. The most recent fellows presented at the American Society of Hematology, the Society of Investigative Dermatology, the Academy of Dermatology, and the Texas Dermatology Society meetings.

Evaluation of Trainee

Since the fellow works closely with attendings, performance will be evaluated informally on a continuous basis. Suggestions for improvement are given. Manuscripts are reviewed and discussed prior to submission. Dictations on patients are reviewed daily with feedback given at the time. Input on personal relationships and interactions will be sought from the research nurse and the other faculty. The intent of the evaluations will be educational.

Supervision/Work Hours/Work Environment:

  • The fellow is verbally informed regarding the expectations for hours of duty and call. Hours are 8-5 pm during the week days and fellow will take call one of the two days on the weekend if there are inpatients in the house. This is well below the requirement for <80 hours on call. There is a Dermatology resident taking rotational call each night and weekend covering for MDACC patients. The call schedule is written down.
  • The fellow will be supervised in the clinic and on the wards by the attending who is expected to see the patients, participate in the decisions, and sign all notes.
  • Foreign graduates will not have Texas licenses and therefore are not eligible for this fellowship opportunity.
  • The fellow would use the Dermatology Department grievance policy if issues arise and would be given this information at orientation.
  • The fellow is made aware of the GME committee and policies governing fellowship programs. The fellow is encouraged to participate in the GME committee and fellowship activities.

Educational Effectiveness

The clinical research fellowship allows pre-dermatology candidates an opportunity to learn the proper and ethical conduct of clinical research and to specialize in the field of cutaneous oncology. There are no “moonlighting” program(s) in place for this rotation. If you wish to moonlight, it must be done on your own time after hours and must not interfere with your clinical responsibilities. The fellow is not allowed to work more than the allotted 80 hours per week.
Accreditation Status and Duration of Program: This is a non-accredited one or two-year program to train one or two clinical research fellows to conduct clinical research studies and collect clinical data. There will be an opportunity for the fellow to participate in oncologic surgery, translational research, and office dermatology procedures.

 


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