Presentation for HMSS on my experience shadowing a Dermatology Cancer Specialist (Powerpoint and Min

HMSS Meeting Presentation:

(Patient-Centered Care-Dr. Skidmore and about how early exposure is essential for us to learn this through shadowing)

My first day shadowing Dr. Skidmore, the Dermatology Specialist, began with a surprise. When I arrived, I explained to him that as Dermatology is one of fields of medicine I am interested in I was hoping to learn about the type of procedures that this field entails. He was very enthusiastic about teaching me about the exciting field of Dermatology and explained to me that the first patient we would be visiting was returning after their previous visit where they had removed cancerous tissue from the face through a surgery technique called Mohs surgery. Mohs surgery is microscopically controlled surgery used to treat common types of skin cancer where the patient waits while the removed tissue is examined through a staining technique and frozen section histology for cancer cells. When we greeted the patient along with the Physician and Medical Assistants, I was surprised and intrigued to see a very large shallow hole on the patient's left cheek. The Doctor and assistants had advised me earlier that the best action to take if you started to feel a little nauseous would be to squat. I had thought that I would not need to use this tip considering I have witnessed bigger surgeries before such as small amputations without issue. However, I find it funny to share that, first thing in the morning, I found it to be a whole new experience to see such a surgery on half of a person's face while they are awake, and while thoroughly intrigued, I found myself squatting towards the end. The Physician Assistants were all extremely kind to me and were eager to share their stories from rotations where they found themselves dizzy or nauseous at the sight of certain procedures they later became accustomed to. This is exactly why I am so thankful for this opportunity to explore a field of medicine I am interested in. I believe it is important to expose oneself to these experiences and learn through observation and immersion. Just as Physician Assistants had told, the rest of the day went by with nothing more than curiosity. I was able to observe many Mohs procedures and how they differ depending on where on the body the surgery is being conducted. I was also able to observe many follow-ups to this procedure and learned about different kinds of stitches depending on the cut that was made. Dr. Skidmore was exceedingly helpful as a teacher and is a very inspiring doctor! I really appreciate his effort in positive communication not only with the patients but also with his co-workers as I believe the human side to medicine is just as important as the science side. In the afternoon, I shadowed one of the Physician Assistants, who was very enthusiastic about how cool dermatology surgery is. I really enjoyed shadowing her, and I must agree that the most exciting procedure I observed all day was the removal of a large cyst on the patient's back with her. The Doctor always draws a plan for the surgery on the area with their "magic marker" as they like to call it, anesthetizes the area, creates the incision, and cuts under to remove the cyst. This was fascinating to observe because with this kind of procedure it is much easier to see the different layers of the skin. Later during this shadowing, I saw another very large cyst on a pregnant woman’s back. After draining the cyst, which is always exciting for the PAs and I because they tend to burst out, the area was still determined to be too inflamed to close yet. The patient was informed to let the cyst drain naturally and return in about a week. It was also interesting to see the changes the doctor had to make in medicine for this patient because she is pregnant. I was again in awe of Dr. Skidmore and inspired by him. This patient was very weak to blood or pain, so Dr. Skidmore held her hand and spoke directly to her the whole procedure as the PA drained the cyst. I was once again reminded of how important the humanistic side to medicine is as much as the scientific side. My experience far exceeded my expectations. I learned so much about the skin, the procedures, the etiquette of a doctor, the caring humanity of a doctor, and how each situation varies needing different approaches each time. Also, I was able to truly see much closer the dynamic between the medical assistants, physician assistants, and the doctor. Dr. Skidmore is a truly inspiring physician. Despite being the “boss”, he maintains his position while still creating an environment where everyone feels at ease with him and appreciated for their hard work. He brings these same feelings to the patients who feel more at ease by the way he easily explains situations and presents a happy attitude to ease their worries.