GUIDELINES FOR COMBINED TRAINING
IN DERMATOLOGY AND PEDIATRICS

TRAINING

The training requirements for eligibility for the certification process of each board will be satisfied by the completion of 60 months of approved combined training. A reduction of 12 months over that required for two separate residencies is possible due to the overlap of curriculum and experience inherent in the training of each discipline. The reduction of 6 months of the standard 36 months of pediatric training is met by 30 months of training in the pediatric component of the combined residency, and 6 months of credit granted for training appropriate to pediatrics obtained during the 30 months of dermatology residency. The requirement of 48 months of training in dermatology is met by the 12 months of the first year of residency in pediatrics, 30 months of training in the dermatology component of the combined residency, and 6 months of credit for training appropriate to dermatology obtained during the remaining 18 months of residency in pediatrics. The integration of training after the PGY-1 year will increase the exposure of pediatric categorical residents to dermatology via the combined residency trainees. The working relationships developed among categorical and combined residency trainees will facilitate communication between the two specialties.

Training in the PGY-1 must include at least 10 months of training in pediatrics. During the second year, the resident must have at least 10 months of training in dermatology. In each of the remaining 3 years, the resident shall have 6 months of training in dermatology and 6 months of training in pediatrics. Rotations of shorter duration, but not less than 3 months, are also acceptable. During these last 3 years, it is important that program directors make certain that in the PGY-3, -4, and -5 years, each resident will have 18 months of training in each specialty.

Training in each discipline must incorporate graded responsibility throughout the training period.

FACULTY

The combined residency must be coordinated by a designated full-time director, from either specialty, or co-directors from both specialties who can develop substantial time and effort to the educational program. If a single combined residency training director is appointed, an associate director from the other specialty must be designated to insure both integration of the training and supervision in each discipline. An exception to this requirement would be a single director who is certified in both specialties and has an academic appointment in each department. The directors from both specialties must document meetings with each other at least quarterly to monitor the success of the residency and the progress of each resident.

Well-established communication must occur between the program directors of each discipline, particularly in those areas where the basic concepts in both specialties overlap, to assure that the training of residents is well coordinated.

As a general principle, the training of residents in dermatology is the responsibility of the dermatology faculty and the training of residents in pediatrics is the responsibility of the pediatrics faculty.

There should be an adequate number of faculty members who devote sufficient time to provide leadership to the residency and supervision of the residents. It is recommended that some faculty members have completed combined training in these two specialties. Since each component of the residency must be accredited by its respective discipline, the faculty must meet the requirements for their specialty.

Dermatology faculty must be certified by the American Board of Dermatology or have appropriate educational qualifications in dermatology.

Pediatric faculty must be certified by the American Board of Pediatrics or have appropriate educational qualifications in pediatrics.

EVALUATION

There must be adequate, ongoing evaluation of the knowledge, skills and performance of residents. Entry evaluation assessment, interim testing and periodic reassessment, utilizing appropriate evaluation modalities, including in-training examinations, should be employed. There must be a method of documenting the procedures that are performed by the residents. Such documentation must be maintained by the program director, be available for review by the Residency Review Committees in Dermatology and Pediatrics, the American Board of Dermatology, the American Board of Pediatrics, and site visitors, and may be used to provide documentation for application for hospital privileges by graduates of these training programs.

The faculty must provide a written evaluation of each resident after each rotation and these must be available for review by the site visitors of Residency Review Committees. Written evaluation of each resident's knowledge, skills, professional growth, and performance, using appropriate criteria and procedures, must be accomplished at least semi-annually and must be communicated to and discussed with the resident in a timely manner.

Residents should be advanced to positions of higher responsibility only on the basis of evidence of their satisfactory progressive scholarship and professional growth.

The program director/s is/are responsible for the maintenance of a permanent record of each resident and its accessibility to the resident and other authorized personnel. The training director and faculty are responsible for provision of a written final evaluation for each resident who completes the program. This evaluation must include a review of the resident's performance during the final period of training, should verify that the resident has demonstrated sufficient professional ability to practice competently and independently and is prepared to apply for the certification processes of both dermatology and pediatrics. This final evaluation should be part of the resident's permanent record and should be maintained by the institution.

SIXTH YEAR

Both boards encourage residents to extend their training for an additional sixth year in investigative, administrative or academic pursuits in order to prepare graduates of combined training in dermatology and pediatrics residencies for careers in research, teaching, or departmental administration.