Fletcher Allen Health Care serves as the regional referral center for a population base of approximately 800,000 people, allowing trainees to care for patients with a wide spectrum of common medical illnesses, as well as evaluate and manage patients with more unusual illnesses from the referral population. More than 75% of the dermatology resident's time is devoted to direct patient care. A large percentage of patients present with basic cutaneous disease either by self-referral or by referral from their primary care physicians. A substantial minority of patients derives from referral by other dermatologists for complex dermatologic disease. An attending physician who is ultimately responsible for patient care and teaching staffs all clinics in which residents participate.

The Dermatology outpatient service at the UHC Campus consists of thirteen exam rooms, one phototherapy suite, three nurse stations, and four Mohs surgery procedure rooms. This space is set for substantial expansion within a newly constructed ambulatory care center in 2004. The dermatology outpatient service operates from 8:00 am to 5:00 pm, Monday through Friday, with more than 100 patients seen daily and approximately 15,000 patient visits per year. Satellite outpatient services are offered Copley Hospital in Morrisville, Stowe Family Practice, and Moses Luddington Hospital in Ticonderoga, NY. As an added service to the rural and outlying physicians the division of dermatology offers a telemedicine outreach service one day per week. Approximately 3000 skin biopsies are performed each year. Over 500 Mohs surgeries are performed along with a broad range of repair procedures. The patient mix is excellent, and focuses on acne, atopic dermatitis, psoriasis, contact dermatitis, nevi and melanoma, bullous disease, cutaneous lupus, pruritus, nonmelanoma skin cancer, actinic damage, and cosmetic dermatology. This is an academic practice and many patients have complex medical and surgical issues.

To ensure educational priorities are not diminished by service needs of the dermatology clinic, a number of valued resources have been developed. These include work hour restrictions, comprehensive clinic staffing, and excellent ancillary services. The average week will entail 45 to 50 hours of work, excluding call responsibilities. Residents will average call every third day and every third weekend. Call is from home. On average residents will spend 8 half days per week in clinic, surgery, or dermatopathology.

Admissions to the dermatology service are rare. Most patients admitted to FAHC are admitted through their primary physician with a dermatology consultation. Several patients per year are admitted directly to dermatology. These patients will be admitted and followed by the dermatology resident responsible for consultations.

The pathology and laboratory services available at FAHC are outstanding. The microbiology laboratory is located on site at the University Health Center. Pathology specimens are accessioned daily at FAHC and reports are issued within 3 to 7 days. Two dermatopathologists are on staff and provide the highest level of dermatopathology service.