Another FSU College of Medicine Residency Program

http://www.tallahassee.com/story/money/2016/02/21/determined-dermatologists/80616096/

Cases and paperwork litter the top of Dr. David Dolson's desk as he peers into one end of a high powered microscope with three lenses.

He slips a glass slide under one prong of the device that he uses to teach students about scores of diseases. Dolson's expertise is apparent as he explains what he saw on a microscopic level, which to a lay person looks more like a psychedelic snapshot of blue and magenta lines and dark dots.

“We are not just learning how to remove a carburetor," he said. "These are people.”

Dolson diagnoses samples processed within the lab at Dermatology Associates of Tallahassee, the region's largest dermatology practice in the Panhandle.

The private practice is taking a bold step by launching a new residency program. It will one day produce more trained dermatologists for the area, which is desperately needed.

'A big undertaking'

Every day an average of 450 patients turn to Dermatology Associates for care.

Patients represent fishermen, farmers or scores of men and women who may have noticed a curious dark spot on their bodies and were concerned enough to make a call for treatment. But, treatment isn't so easy.

Some drive two to three hours for a diagnosis, surgery and treatment. They come from as far as Lake City, Albany and Tifton, both in Georgia, and Dothan, Alabama, for treatment at the practice's offices in Valdosta, Georgia, Panama City and Tallahassee. The practice, in response to overwhelming need, opened satellite sites in rural areas where patients have a harder time driving themselves to an office hours away.

With Florida being the "Sunshine State," Dermatology Associates is ever busy diagnosing and treating skin cancer and other issues.

John Prince, former chairman of the Tift Regional Medical Hospital Board of Directors, said there are no dermatologists in Tift County, which has a population of 40,000 people. As a result, potentially life-threatening issues go untreated because care is hard to access.

“That’s the reason they won’t go," Prince said. "It develops to a much more serious illness."

He became a patient after he noticed a spot on his leg and was later diagnosed with melanoma in 2014. Several visits to Tallahassee, a surgery at the Mayo Clinic and 68 stitches later, Prince said he is one of the lucky ones because it was caught early.

What makes this residency program so unique is the fact that it's a community-based effort led by Dermatology Associates.

Other residency programs are usually linked to a tertiary care center, such as Shands Hospital. The Tallahassee's dermatology residency program was at least seven years in the making.

 

Dr. Armand Cognetta, the practice's chief of dermatology, was the visionary behind the new program. But four components were needed: a pathologist, core faculty, a program director and the backing of Florida State University.

News of the new program traveled fast once potential students across the country learned of what Dermatology Associates launched. Competition is stiff for the three-year program since only two students per year will be accepted. More than 70 applications poured in.

The ultimate goal is to teach these students with the hope they will stay in the area. Cognetta said, in most cases, residency students will live within 50 miles of where they trained or the "mother ship," as he called it.

"The best way to keep people in the area is to really train people in the area,” Dr. John Fogarty, dean of FSU's College of Medicine, who's supported the program's concept for years.

He views dermatology as a specialty medicine with a shortage of doctors. The new program aligns with the school's mission to serve communities.

"I think it’s great that this kind of strategic planning has taken place," Fogarty said. "They’ve done a great job of long-term planning and not just looking at the long term."

This new program is no small feat, he added.

Cognetta, one of the area's most renowned dermatologists, said the practice is fully funding the launch of the program. He and his team would rather not stall the program by waiting on grants or other funding to surface.

"Hopefully over time, we’ll get some funding from various other sources," he said. "Our highest priority as physicians is to see and care for patients in our community and region. An even higher calling, perhaps, is training the next generation of physicians who will ultimately take our place."

Coveted opportunities with few slots

On Jan. 17, another achievement for the program was when it became accredited by the Accreditation Council for Graduate Medical Education. The group provides accreditation for residency programs nationwide.

The vigorous accreditation process took about two and half years.

Dermatology is a highly specialized field with few opportunities nationwide. Around the country, there are 116 residency programs with 385 slots per year. Florida has four dermatology residency programs, such as University of Miami (six residents per year) and University of Florida (four residents program).

Dr. George Cohen takes a scalpel scrapping from the skin of a patient in his office at the Dermatology Associates of Tallahassee on Thursday, Feb. 11, 2016. Cohen uses the scrapings to perform a quick microscopic diagnosis for living signs of potential skin irritations.
(Photo: Joe Rondone/Democrat)

“To get that accreditation, it’s really a big deal because it shows that you’ve got the ability and they believe you’ll do a good job to produce certified dermatology. That says a lot. That makes us accredited as any university facility,” said Dr. George Cohen, the resident program director.

“Whether it’s the University of Florida or Harvard, they are accredited by the same body.”

Contact TaMaryn Waters at tlwaters@tallahassee.com or follow @TaMarynWaters on Twitter.