Dermatopathology Fellowship

Program Overview

The Dermatopathology Fellowship Program at the University of North Carolina at Chapel Hill is a one-year, ACGME-accredited training program that provides comprehensive education in the diagnosis and management of neoplastic and non-neoplastic cutaneous, mucous membranes, hair, nails, and subcutaneous tissue.

Fellows receive broad exposure to histologic, histochemical, immunohistochemical, immunofluorescent, and molecular diagnostic techniques, with an emphasis on clinicopathologic correlation and diagnostic excellence. Throughout the year, the fellows will be expected to attend and participate in daily sign-out sessions, consensus conferences, grand rounds, tumor boards, and lectures in dermatology and pathology.

Mission and Program Aims

Our mission is to train expert, independent dermatopathologists who deliver accurate, timely, and clinically meaningful diagnoses while advancing patient care, education, scholarship, and health equity.

Patient Care:

Accurate and efficient microscopic diagnosis
Strong clinicopathologic correlation
Clear communication with clinicians and patients
Emphasis on patient safety and quality improvement

Medical Knowledge:

Inflammatory, infectious, and neoplastic skin diseases
Special stains, immunohistochemistry, immunofluorescence, and appropriate use of molecular techniques
Commitment to lifelong learning
Conduct scholarly activities

Professionalism & Systems-Based Practice:

Ethical and professional conduct
Practice with integrity
Understanding laboratory operations and healthcare systems

Training Structure & Daily Workflow

Training is tailored to fellows from either dermatology or pathology backgrounds. The first 8 months fellows will spend 50% of their day in dermatopathology and 50% of their day in surgical pathology (Dermatology background) or dermatology clinics (Pathology background). The last 4 months of the fellowship will be spent entirely in Dermatopathology.

Pathology-trained fellows:

Fellows previously trained in pathology are expected to rotate through various dermatology clinics in their first 8 months (50% clinical dermatology, 50% dermatopathology). The clinics include general dermatology, immunobullous clinic, mucosal disease clinics, CTCL, pediatric dermatology, and cutaneous surgery/Mohs at UNC Chapel Hill Dermatology clinics, to gain experience with clinicopathologic correlation. Fellows are expected to see a minimum of 500 patients by shadowing a dermatology faculty member.

Attend the dermatology clinics daily as an observer over a period of 8 months.
The goal of attending clinics is to learn diagnostic dermatology and generate differential diagnoses from the clinical visit, emphasizing the value of clinical correlation and the role dermatopathologists play in clinical care.
Learn appropriate biopsies and excisions techniques of skin lesions, along with proper site selection and clinical differential diagnosis.
Attend cutaneous surgery clinics and have the opportunity to perform biopsies and/or excisions.
Serve as a liaison between the dermatopathology division and dermatology.

Dermatology-trained fellows:

Fellows with a dermatology background will rotate through various relevant surgical pathology subspecialties in their first 8 months (50% surgical pathology, 50% dermatopathology) in order to get exposure to areas of pathology that overlap with dermatopathology. This occurs at UNC Hospital McClendon Laboratories.

Rotate on various pathology services including Head and Neck pathology, Sarcoma pathology, Gynecologic pathology, Hematopathology, and Molecular pathology,
Review grossing techniques and the grossing manual of dermatopathology specimens.
Learn how to perform gross description and dictation of pathology specimens with particular attention to skin specimens.
Learn specimen processing techniques and different media used for different tests (e.g., electron microscopy, direct immunofluorescence, molecular studies, etc.)
Learn relevant molecular techniques that are applied in Dermatopathology.

Facilities & Resources:

High-volume dermatopathology service (12,000+ cases annually)
Comprehensive immunohistochemistry and direct immunofluorescence
In-house digital slide scanning and exposure to AI applications
Dedicated fellow workspace, microscope, and computer
Access to UNC libraries and dermatopathology textbooks

Eligibility and Requirements:

Applicants must be US citizens, legal permanent residents (green card holders), or J1 visa holders who have completed an ACGME-accredited residency in Dermatology or Pathology (Anatomic Pathology or Anatomic Pathology/Clinical Pathology) and be board-eligible or board-certified prior to fellowship start. Applicants should be eligible for a North Carolina State Medical License.