I am back with another post on my shadowing experiences! Recently, I had the pleasure of shadowing a wonderful dermatologist, at the hospital, in the dermatology clinic. I spent my time seeing a variety of patients that were all referred to her by other physicians, as well as viewing a lot of the procedural aspects of the specialty.
My morning began in the dermatology team room, where I was introduced to the physician and resident I would be shadowing for the day. One of the nurses on the team would write on the whiteboard, in the team room, when the patients were placed in the examination rooms and what their skin concerns were. Once this information was written on the whiteboard, we would go see the patient and pick up their chart.
Appointments always began by verifying which one of their physicians made the referral to dermatology in and asking about their skin concerns. The process ensured that the information on the requisition was correct and that no details were missed. Depending on the situation, the physician would either take a detailed dermatologic history next or have the patient change into a gown to be examined. Either way, we would eventually be examining the patient’s skin. The specialty was very visual and required a lot of thorough skin examinations in order to make a diagnosis.
Following the examination, the patients would be educated on their skin condition and typically prescribed a medication as a treatment, depending on the diagnosis of course. For example, a lot of the paediatric patients we saw for eczema required counselling on how to avoid exacerbations, parental education about the condition, and a prescription for topical corticosteroid creams.
However, many of the patients we saw were referred because their previous physician suspected some sort of skin cancer. In those cases, the dermatologist would perform a skin exam followed by a shave biopsy, where the concerning skin was shaved off with a small surgical blade and sent for testing. Additionally, there were also instances where liquid nitrogen cryotherapy was used to freeze small skin cancers, such as superficial basal cell and in situ squamous cell carcinomas. All patients were booked for follow up appointments to review both their lab results and their skin changes following therapy.
My experience in dermatology was very interesting, as we saw many different patients with a variety of skin conditions. The specialty is both very visual and procedural, and involves a lot of quick consultations. The physician I shadowed receives many paediatric and geriatric patient referrals, which was particularly interesting. The main conditions we saw that day included: atopic dermatitis (eczema), psoriasis, basal and squamous cell carcinoma, and impetigo.
I was beyond impressed by the exceptional bedside manner and soft skills of the physician I shadowed. She always took the time to listen and validate the patient’s or parents’ concerns while still being efficient with her time. She explained skin conditions and treatment options to the patients in layman’s terms that were easy to understand. She was delightful, empathetic, and very kind to all of her patients, and that was something I really admired.
Overall, I would definitely say this was a positive experience. However, I don’t know if this is something I could see myself doing in the future. The experience involved a lot of quick consultations and procedures, which is fine, but I would prefer to have a more longitudinal relationship with patients. Just keeping it real! I thought I would enjoy the skin and skin disease a lot more than I actually did. I think I enjoyed my day with the dermatologist, who was an absolutely fantastic, brilliant physician, more than the actual scope of practice.
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The Girly MD (to be)