Dermatology Residency Overview
Baylor College of Medicine has 10 residency training positions, with three or four residents accepted each year. The program offers a diverse clinical experience with rotations at the Michael E. DeBakey Veteran Affairs Medical Center, Ben Taub General Hospital, The Methodist Hospital, and Texas Children's Hospital. Additional consultative experience is gained at St. Luke's Episcopal Hospital, The Institute for Rehabilitation and Research, Kindred Hospital, and The Woman's Hospital of Texas. All training facilities are located within the world-renowned Texas Medical Center. Each year offers unique training opportunities and responsibilities.
Dermatologic Surgery
The Dermatologic Surgery Service at Baylor includes two full-time dermatologic surgeons (Dr. Ida Orengo and Dr. Deborah Yang) trained in Moh's micrographic surgery as well as multiple cosmetic and reconstructive procedures. Surgical procedures are scheduled for residents at the VA Medical Center and Ben Taub General Hospital beginning during the first year of training. Moh's surgery is scheduled weekly at the VA Medical Center and the residents play an integral part in assisting during these procedures. Additional surgical experience is gained at the department's private office. Baylor residents obtain excellent and comprehensive surgical experience throughout their three years of training. Recommended standards set forth by the American Board of Dermatology are easily attained. Residents may schedule surgical procedures five days per week at the VA and four days per week at Ben Taub General Hospital.
Pediatric Dermatology
The Pediatric Dermatology Service at Baylor is staffed by three full-time pediatric dermatologists. Clinical activities are based primarily at Texas Children's Hospital, the largest freestanding pediatric hospital in the United States. A private clinic is located at Texas Children's, where approximately 150-200 private patients are seen each week. Inpatient consultations are seen at TCH, Ben Taub General Hospital, and The Woman's Hospital of Texas. The Pediatric Dermatology Service is also active in the Genetics Clinic and the Neurofibromatosis Clinic. A separate Hemangioma Clinic has also been established. A Candela pulsed dye laser is located in the outpatient surgical suite at Texas Children's, where treatment of vascular malformations is frequently performed. Additional lasers for pigmented and other lesions are also available.
Cosmetic and Laser Dermatology
A wide selection of techniques and technology gives Baylor dermatologists the flexibility to offer treatment for a variety of skin problems, providing quality care for patients who want to improve their appearance. Procedures include Botox injections, collagen injections, excessive sweating treatments, laser treatment of acne, scars, hair removal, blood vessels and tattoo removal, as well as mild chemical peels and sclerotherapy. Available lasers are the Candela Smoothbeam, Coherent (Lumenis) Lightshear, Candela V-Beam, Hoya Con-Bio Medite C6, Fraxel laser by Reliant, Laserscope Lyra-i, Weck CO2 laser, and Lumenis One IPL.
Dermatopathology
Experience in dermatopathology is provided by weekly didactic conferences, formal dermatopathology rotations, and interaction with the staff dermatopathologist concerning patients on the resident's service. The staff dermatopathologist and assigned resident review dermatopathology specimens from the outpatient Baylor laboratory material and from the outpatient clinics at the VA Hospital and Ben Taub General Hospital. Material on inpatients is available from The Methodist Hospital and Ben Taub General Hospital.
Psoriasis Treatment Center
Baylor physicians often admit patients to the Methodist Hospital day-care facility. It is located in the Smith Tower of The Methodist Hospital. Treatment protocols are tailored to meet patient needs and include intense topical therapy, medicated baths, and ultraviolet light therapy. The residents play an essential role in the treatment of these patients and thus experience excellent continuity of care.
Consult service
During the hospital consult rotation, residents are responsible for adult inpatient consultations at The Methodist Hospital, St. Luke's Episcopal Hospital, the Texas Institute for Rehabilitation and Research, and Kindred Hospital. Pediatric inpatient consults are seen by a separate dermatology resident assigned to the pediatric dermatology rotation. These consults are seen in conjunction with the pediatric dermatology attendings at Texas Children's Hospital, Ben Taub General Hospital, and the Woman's Hospital of Texas.
Faculty
The Baylor dermatology staff consists of 13 full-time clinical attendings (11 dermatologists + 2 dermatopathologists) with academic responsibilities, and eight research faculty. The faculty has a wide variety of interests, ranging from infectious disease and tropical skin disorders to gene mapping of inheritable skin diseases and cosmetic procedures. All clinical faculty participate in resident and student teaching, as well as ongoing research and publishing. Visit our faculty pages.
Learning curve
Third-year residents at Baylor act as chiefs for the VA Medical Center and Ben Taub General Hospital clinics, where they are responsible for the education of medical students as well as dermatology and rotating residents. Faculty is assigned to every scheduled clinic. However, residents are encouraged to gradually assume increased responsibility for direct patient care. In this environment, residents learn a great deal from each other. Third-year residents also spend time as administrative chief, during which they help organize the lecture series, and may spend extra time doing research or additional training in surgery, pediatrics or in the private offices of the Baylor staff. Research opportunities are individualized according to the particular resident's schedule and research interests.
Call
Residents take call from home for a week at a time, approximately five weeks a year. Holidays are split between the residents, with the major holidays assigned to first-year residents. New first-year residents have senior resident back-up during their initial call rotation.
Vacation, salary, and benefits
Baylor residents enjoy three weeks of vacation time a year during dermatology training. Stipends and benefits can be found in Baylor's Residency Training brochure. Stipend levels are at the national average, but Houston's cost of living ranks among the lowest of metropolitan areas in the U.S. Baylor residents frequently own homes or condominiums, and a large number of apartments in all price ranges are available within minutes of the medical center. Additionally, Houston has a variety of wonderful entertainment, excellent dining and outdoor activities.
Lectures and conferences
Residents at Baylor consider the lecture and conference schedule to be one of the strengths of the program.
Monday morning begins with Journal Club, during which residents and faculty discuss articles mainly from the Journal of the American Academy of Dermatology and the Archives of Dermatology. One Monday morning per month is dedicated to a resident-prepared basic science lecture. Another is devoted to an administrative meeting with the department chairman. Quarterly research seminars are also generally held on Mondays.
The Tuesday morning lecture series is divided monthly between the faculty of Baylor and the UT Houston Medical School. The lecture series is attended by the residents of both schools, who benefit greatly from the wider range of expertise provided by the two shared faculties.
Wednesday morning's Kodachrome conference is also shared by the two schools; residents are asked to provide differential diagnoses for Kodachrome slides brought by the presenter.
The highlight of the week is Baylor's Grand Rounds, which is held Thursday morning at the VA Medical Center. Fascinating patients provided both by the dermatologists in the community and by the Baylor-affiliated hospitals are presented and discussed informally. Grand Rounds is followed by textbook conference, which is led by a faculty member. Chosen texts vary from major references such as Rook, Fitzpatrick, Andrews and Hurwitz, to specialized references such as Fisher's Contact Dermatitis and Bennett's Fundamentals of Cutaneous Surgery. The morning concludes with a resident run conference with subjects and presenters selected by the residents.
Friday morning conference focuses on dermatopathology, with a discussion based on Lever's textbook and correlating glass slides.
In addition to the regular weekly conferences, residents attend monthly meetings of the Houston Dermatologic Society, during which interesting patients are formally presented. In the past, the HDS meeting has also hosted a variety of world-renowned speakers. The Texas Dermatological Society meets semiannually, and Baylor residents frequently attend these meetings. The annual John Knox Conference features outstanding speakers from throughout the country and is held every fall in Houston or Galveston. The American Academy of Dermatology's annual meeting is attended by all third-year residents and by half of the remaining residents, allowing Baylor residents to attend two of their three years. Residents who have had research accepted to additional meetings frequently attend these as well.