In the first year, residents learn basic skills from pigs' foot sessions taught by clinical faculty or visiting professors and from text assignments. In addition, didactic information on technique, complications, lasers and related matters is provided by Dr. Leffell and the residents in a seminar format. When a fellow is being trained, the majority of resident didactic teaching is his or her responsibility as this helps develop teaching skills. Those interested and skilled will progress to excisional surgery in the first year as well. Each first year resident spends one month rotating on Dermatologic and Laser Surgery where they gain extensive exposure to and hands on experience with excisional surgery, cutaneous oncology, reconstruction, pulsed dye laser, ultrapulse laser, and the Q-switched ruby laser.
Residents perform surgery in the faculty practice commensurate with their skill and interest.
By the third year, the resident should understand and be able to perform advanced dermatologic surgery procedures such as flaps and grafts. They should be skilled in Ultrapulse and other laser techniques. During the three years of residency, residents are encouraged to select patients from their own clinic population who require surgery and operate on them as primary surgeons every Friday under supervision by the fellow or Dr. Leffell. About one third to one half of the surgery practice is cosmetic. Chemical peels and laser represent a substantial part of the non-oncologic component of dermatologic surgery and all residents develop hands on experience and didactic knowledge in these areas.