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MOHS SURGERY TRAINING PROGRAM

CANDIDATE PORTFOLIO

1 Name of candidate:

Postal address:

Tel:

Email:

2 Training facility:

Address of facility:

Supervisor of Training:

Tel:

Email:

Clinical Supervisors:

3 Program Start Date:

Anticipated Program Completion Date:

4 Signature of Supervisor of Training:

Signature of candidate:


COMMENCEMENT OF TRAINING FORM

This form must be completed and signed by the Supervisor of Training and the candidate at the commencement of training. It is the responsibility of the candidate to ensure that form is forwarded to the College office.

Last updated 4 September 2013

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RIGHTS AND ENTITLEMENTS OF CANDIDATES OF COLLEGE 1. Notification in writing by the Honorary Secretary of all training matters relevant to candidates of

College including: scientific meeting dates, examination dates and venue, etc. 2. Attend the Scientific Meetings of College. 3. Receive the Australasian Journal of Dermatology. 4. All those outlined in the Training Program Handbook for their course. ACCEPTANCE

On acceptance of these requirements candidates of College will be entered into the relevant Training Program. Failure to agree to these conditions or to comply will lead to the loss of entitlement to continue in the applicable Training Program. DECLARATION I have read the Candidates’ Agreement of the Australasian College of Dermatologists and agree to abide by it. I agree to the conditions as set out in the Training Program Handbook of the Australasian College of Dermatologists concerning my specific training program, as well as the regulations and requirements concerning the examinations, and all policies of the College. My acceptance of the conditions is deemed by my signature and by payment of the fees where applicable. SIGNED:_______________________________________________________ DATE: _____________________

PRINT NAME:___________________________________________________

WITNESSED_____________________________________________________ DATE: _____________________

PRINT NAME:___________________________________________________

CANDIDATE AGREEMENT

Addendum December 2013

Candidates are required, as a condition of entry into a College program, to read

and sign this addendum to the Candidate Agreement as evidence of having

understood their additional responsibilities.

Practice and Conduct:

not share any materials / resources from the College ePortal, especially photos, with

any third party

DECLARATION

I have read the addendum to the Candidates’ Agreement of the Australasian College of

Dermatologists and agree to abide by it.

My acceptance of the conditions is deemed by my signature.

SIGNED:_______________________________________________________ DATE: _________________

PRINT NAME:___________________________________________________

WITNESSED_____________________________________________________ DATE: __________________

PRINT NAME:___________________________________________________

TRA

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Training Program Handbook Mohs Surgery V11 - This version 21 September 2015 2

College Coat Of Arms Pictures on shields, flags and Coats of Arms were introduced into the United Kingdom from Europe in the 12th century. The precise origin of the heraldic system in Europe however is not known. It became important to identify the otherwise unrecognisable armour-clad knights both in tournaments and battle. Consequently symbols were embroidered on the knight’s surcoat (a garment worn over a knight’s armour), i.e. a Coat of Arms. The responsibility for identifying the knights lay with the heralds and thus the origin of heraldry. From this early start many organisations developed heraldic designs to identify their group or profession. The various aspects of the College Coat of Arms are: On the Dexter side: The Unicorn stands, a mythological horse with the original cutaneous horn, hence its association with dermatology. On the Sinister side: the Red Kangaroo stands, identifying Australia. The Crest: The stars of the Southern Cross are only seen in the Southern Hemisphere and are easily recognisable from both Australia and New Zealand. The Sailing Ship: Signifies the early discovery of Australia and New Zealand by such ships and the association of our two island countries with the sea. The Knight’s Helmet and Mantle are heraldic designs common to many Coats of Arms. The Shield is lilac purple, the College colour. In the centre of the Shield (The Charge) is the sun, an important contributor to the cause and also the treatment of many skin disorders. Overlying the sun is the Rod of Aesculapius – the serpent entwined about the rod which is symbolically accepted as a sign of medicine. This is sometimes confused with the Rod of Hermes (The Caduceus). This was a magic wand with two shoots entwined at the top to form a knot later represented by two serpents. The wings on the top of the rod signify the carrying of knowledge of the Australasian College of Dermatologists to the wider community and the rest of the world. Beside the shield and intertwined with one another is the Australian wattle and the fern of New Zealand, emphasising our close association. The Motto "Refulgent in Tenebris", literally "They glitter/shine/(or are) resplendent in the dark". The translation moves beyond the literal and implies the throwing of light on to the darkness of areas in dermatology and, in this context, the role of College forever seeking more knowledge in our specialty field. The basic interpretation of the motto is "They succeed in difficulties".


Important Information The Mohs Surgery Training Program Handbook is reviewed annually to ensure information regarding Policies, Procedures, Regulations and all aspects of the training program are current. Minor changes to the current version of the handbook may occur from time to time. While candidates will be notified of changes, it is their responsibility to ensure they remain up-to-date with any such changes. Every effort has been made to be explicit about training matters. However, omissions can occur and the National Education Committee, Mohs Surgery Committee and the Board of Directors reserve the right to clarify any matter not explicitly stipulated. The College website has the most current information: www.dermcoll.asn.au © ACD 2015 This work is copyright. Apart from any use as permitted under the Copyright Act 1968, no part may be reproduced by any process without written permission from The Australasian College of Dermatologists. Requests and enquiries concerning reproduction should be directed to the Education Manager, Australasian College of Dermatologists, PO Box 3785 Rhodes NSW 2138, Australia.


Abbreviations College contacts

CHAPTER ONE: INTRODUCTION

1.1 About the Australasian College of Dermatologists 1.2 Application and selection into the ACD Mohs Surgery Training Program

1.2.1 Eligibility 1.2.2 Application process 1.2.3 General information about selection 1.2.4 Selection process

1.3 Mohs Surgery Training Program Overview 1.4 Mohs Surgery Training Program Curriculum 1.5 College/Candidate Communications CHAPTER TWO: REQUIREMENTS OF THE MOHS SURGERY TRAINING PROGRAM 2.1 Accreditation of Training Positions 2.2 Duration of the Mohs Surgery Training Program 2.3 Candidate Status 2.4 Training Requirements 2.5 Recognition of Prior Learning CHAPTER THREE: CANDIDATE PORTFOLIO 3.1. Purpose 3.2 Requirements 3.3 Candidate Portfolio review CHAPTER FOUR: ASSESSMENTS 4.1 On-line assessments 4.2 Work-based Assessment

4.2.1 In-training assessments 4.2.2 Mohs-ProDA 4.2.3 Mohs-CEX 4.2.4 Case-based Discussion

CHAPTER FIVE: TRAINING ADMINISTRATION AND POLICIES 5.1 Training Administration

5.1.1 Commencing Training 5.1.2 During Training 5.1.3 Completion of Training

5.2. Policies 5.2.1 Shared and Part-time training 5.2.2 Interrupted Training 5.2.3 Unsatisfactory Performance 5.2.4 Other Policies

CHAPTER SIX: ROLES IN THE MOHS SURGERY TRAINING PROGRAM 6.1 Supervisor of Training 6.2 Clinical Supervisors 6.3 Candidate CHAPTER SEVEN: PROGRAM EVALUATION


Abbreviations ACD or the College Australasian College of Dermatologists

AHPRA Australian Health Practitioner Regulation Agency

AMC Australian Medical Council

BoD Board of Directors

CbD Case-based Discussion

CSs Clinical Supervisor(s)

CP Candidate Portfolio (or logbook)

Dean Dean of Education

Hon Sec Honorary Secretary

ITA In-training Assessment

Mohs-CEX Mohs Clinical Evaluation Exercise

NAcC National Accreditation Committee

NEdC National Education Committee

PIF Performance Improvement Form

ProDA Procedural Dermatology Assessment

QAP Quality Assurance Program

RPL Recognition of Prior Learning

SoTs Supervisors of Training

SSP Supplementary Supervision Plan

TPH Training Program Handbook

WBA Work-Based Assessment


College Contacts

General enquires Telephone: +61 2 8765 0242 e-mail: [email protected] Facsimile: +61 2 9736 2194 Address Suite 2a, Level 2, 9 Blaxland Road Rhodes NSW 2138 Postal address PO Box 3785 Rhodes NSW 2138

Education Education Manager Ms Lauris Harper Telephone +61 2 8741 4199 E-mail: [email protected] Education Officer Ms Teresa Llewellyn-Evans Telephone: +61 2 8741 4173 E-mail: [email protected]


CHAPTER ONE: INTRODUCTION

1.1 About the Australasian College of Dermatologists The College is a Fellowship of Dermatologists trained to the highest professional standards whose objective is to serve the community by providing the best quality dermatological care. The Australasian College of Dermatologists (ACD) has a membership of approximately 430 Fellows. Fellows work in private practices and/or attend clinics at major teaching hospitals. A small number of Fellows also have full-time appointments in major hospitals and higher education institutions. Within the College there are a number of specialised groups whose members have received extra training in their particular sub-speciality, for example Mohs Micrographic Surgery. Fellows can be regarded as authorities in all matters pertaining to skin care and the diagnosis, treatment and management of all conditions affecting the skin. The College is committed to:

Educating and training Trainees, Fellows and other health professionals

Ongoing professional development of its Fellows and associated members

Defining and maintaining professional and ethical standards for all Fellows

Ensuring quality dermatological service to the community and the delivery of care to all Australians, including those living in regional and remote areas

Promoting public awareness of skin health and the prevention of disease through

media, government and support groups

Encouraging, supporting and promoting research to ensure the best quality care of all patients

Undertaking its objectives competently, efficiently and responsibly.

Fellows of the College practice in all States and territories of Australia. Regional faculties are currently established in Queensland, New South Wales, Victoria, South Australia and Western Australia. Fellows working in each State elect representatives to the College Board of Directors. For more information about the College Board of Directors and working Committees of the College, please refer to the College website.


1.2 Application and selection into the ACD Mohs Surgery Training Program

1.2.1 Eligibility Applicants must hold the FACD or an equivalent international dermatology qualification and be licensed to practise as a dermatologist in Australia.

1.2.2 Application Process

Mohs Surgery Training positions are advertised on the College website. 1.2.3 General information about selection

There are currently only four ACD accredited Mohs training positions in Australia. Applicants are selected who best demonstrate that they have the skills, abilities, competences and personal qualities that will allow them to achieve the learning outcomes of the training program. The chances of being selected are not influenced by previous selection outcomes.

1.2.4 Selection process

The selection process is made up of five sequential stages:

(i) Seeking and receiving applications All Mohs surgery training positions are advertised on the College website. Prospective applicants apply directly to the Supervisor of Training by the nominated closing date.

(ii) Assessment of applications and references To be eligible for consideration, applicants must: hold the FACD or an equivalent international dermatology qualification and be licensed to practise as a dermatologist in Australia,

OR be an advanced trainee of the ACD and hold full registration as a medical

practitioner with AHPRA.

(iii) Shortlisting All eligible applicants are considered for shortlisting. Shortlisting is undertaken using information provided by applicants in their written application together with referee reports.

(iv) Interviewing Applicants will be interviewed by an interview panel. The panel will include the Supervisor of Training from the training facility together with other clinical supervisors and/or College staff members. Interviews may be conducted at the training facility or at a central location such as the College office, if the interview if being conducted in NSW.


Interviewers are looking for applicants who have: demonstrated a strong motivation to undertake Mohs surgery training; advanced surgical skills; and demonstrated ability to work within a multidisciplinary team. Integrity is vital to being a dermatologist and a Mohs surgeon. Any of the work situations discussed is subject to external verification. Falsifying incidents or overstating your own role will lead to instant exclusion from further consideration. At the end of the interview, each candidate will be given the opportunity to ask questions and to express an opinion as to whether he/she is satisfied with the selection and interview process. If a conflict of interest exists between an interview panellist and a candidate, the panellist will declare this and absent himself/herself from the interview. In situations where there is some doubt as to whether a real conflict of interest exists, the interview chairperson will make a decision as to whether the panellist should absent himself/herself from the interview.

(v) Final selection Upon accepting the offer of a training position, the successful applicant will be expected to commence training at the nominated commencement of training date. Note: All training positions are generally of 12 months duration and will have a nominated commencement date. Not all training positions will commence at the beginning of a calendar year.

1.3 Mohs Surgery Training Program Overview

Mohs micrographic surgery is used to remove certain skin cancers with the highest level of certainty while minimising the damage to normal tissue. ACD accredited Mohs Surgery Training offers 12 months of education and experience, which provides an organised, systematic, and progressive education for dermatologists seeking to acquire advanced competence as a Mohs surgery specialist. A rigorous program of training and assessment provides reassurance to patients and referring doctors that the dermatologists listed on the ACD Register of Approved Mohs Surgeons (published on the College website) have completed training at the highest standards of quality and safety for patients. Training is only undertaken in facilities accredited by the ACD National Accreditation Committee, with an appropriately qualified Supervisor of Training and other supervisors. There are currently four accredited Training positions. State Program Location Supervisor of Training

NSW Skin and Cancer Foundation, Westmead Dr Simon Lee

QLD North West Private Hospital, Everton Park Dr Zoran Gaspar

WA Oxford Day Surgery, Mount Hawthorn Dr Carl Vinciullo

WA South Perth Specialist Skin Cancer Centre, South Perth Dr Tim Elliott Table 1. Accredited Mohs Surgery Training Positions


For more information about the accreditation standards and process see the College website. Upon successful completion of training, candidates are eligible for inclusion on the ACD Approved Mohs Surgeons Register. They are also eligible to apply for membership of the American College of Mohs Surgery, if desired.

1.4 Mohs Surgery Training Program Curriculum The Mohs Surgery Training Program Curriculum is designed to ensure that candidates develop an advanced competence in the identification and management of patients whose conditions should be treated by Mohs surgery, including those that need the involvement of other specialists for a multidisciplinary approach to provide patients with an optimal outcome. The curriculum aims to ensure that candidates become competent in all elements of Mohs surgery, including histopathological interpretation and reconstruction of surgical defects.


DOMAIN 1. CLINICAL EXPERTISE

1.1 Clinical Sciences

1.1.1 Anatomy

1.1.2 Physiology and Immunology

1.1.3 Cutaneous Oncology

1.1.4 Principles of Mohs Micrographic Surgery

1.1.5 Histopathology

1.1.6 Wound Healing

1.2 Clinical Practice 1.3 Procedural Dermatology

1.2.1 Indications for Mohs Micrographic Surgery

1.3.1 Basic Surgery

1.3.2 Pre-operative Assessment for Mohs Micrographic Surgery

1.3.3 Surgical Technique: Anaesthesia

1.3.4 Surgical Technique: Mohs Micrographic Surgery

1.3.5 Peri-operative Management for Mohs Micrographic Surgery

1.3.6 Laboratory and Pathology

1.3.7 Specimen Interpretation

1.3.8 Surgical Technique: Reconstruction

1.3.9 Post-operative Care

1.3.10 Surgical Complication Management

DOMAIN 2. PROFESSIONAL QUALITIES

2.1 Professional Qualities

2.2 Quality Assurance in Mohs Micrographic Surgery Practice

2.3 Facility Management Table 2. Mohs Surgery Training Program Curriculum Framework

The detailed Mohs Surgery Training Program curriculum is available on the College elearning portal.


1.5 College/Candidate Communications

College communicates with candidates regarding their training from time-to-time. For this reason, it is vital that all candidates ensure their email addresses, preferred mailing addresses and mobile phone numbers are always kept up-to-date in the College data base. Candidates can email any changes to: [email protected] or simply post the information to us at:

Australasian College of Dermatologists PO Box 3785 Rhodes NSW 2138

The quickest method for candidates to communicate with College is by email. The following addresses may be used for this purpose:

[email protected] Generic College address where you will be re-directed to the relevant College Officer

[email protected] Education Officer, Teresa Llewellyn-Evans Someone will always acknowledge receipt of your email. If you do not receive a response, call the College on (02) 8765 0242 and request further assistance. Alternatively, candidates can send correspondence to College at the postal address shown above.


CHAPTER TWO: REQUIREMENTS OF THE MOHS SURGERY TRAININGPROGRAM

2.1 Accreditation of Training Positions Training must be conducted in a training position accredited by the ACD National Accreditation Committee. For more about the accreditation process see the College website.

2.2 Duration of the Mohs Surgery Training Program The training program is conducted for a minimum of 12 months. Provision is made for 4 weeks annual leave and 2 weeks leave for illness etc. Training must be continuous unless the candidate has applied to the College, and received approval, to interrupt their training (see Chapter 5). Candidates must complete their training within 2 years of commencement.

2.3 Candidate Status In order to retain candidate status, a candidate must:

a) Hold full registration as a specialist dermatologist with APHRA or occupy an accredited training position, or be on approved leave from the training program (see Chapter 5)

b) Have signed and returned to College the Candidate Agreement.

2.4 Training Requirements Requirements of training are outlined below: Clinical Experience 12 months of training in an accredited training facility.

During this time, the candidate is required to: Participate in at least 500 Mohs surgery cases each year, and

must be the primary surgeon (does all of the first cuts, most of the other cuts and the entire repair) in at least 200 of these cases (at least 90% on the head, neck, lower leg (including feet), hands, digits or anogenital

Participate in at least 35 cases each year which are referrals from other medical and surgical specialists, as these tend to be the more challenging and instructive cases.

Publication/Presentation Prior to the completion of training, the candidate must: Submit an abstract for publication, and Present a paper at a national or international peer review

meeting of relevance to Mohs Surgery.

Assessment During training, the candidate must successfully complete all prescribed assessments (see Chapter 4).


Quality Assurance Program

The candidate must: Participate in the diagnostic QAP module. Participate in and record cases reviewed in departmental

peer review sessions at least twice each year.

Portfolio The candidate must: Submit a completed Mohs Surgery Training Program Portfolio

Other Prior to the completion of training, the candidate must: Attend a CPR course.

Table 3. Training Requirements

2.5 Recognition of Prior Learning (RPL) The principal purpose of RPL is to avoid unnecessary duplication of training and education that is equivalent to that provided by the ACD Mohs Surgery Training Program. Candidates, who believe that they have already attained the learning outcomes/performance competencies required, are able to apply to the College for an RPL assessment. The applicant’s request for RPL will be assessed. If the applicant demonstrates that they have achieved the required learning outcomes/ performance competencies they will be granted recognition for the components of the training program that provide education, training and/or assessment in those learning outcomes/performance competencies. For further information, please refer to the College Policy on Recognition of Prior Learning on the College website.


CHAPTER THREE: CANDIDATE PORTFOLIO Candidates are required to document their training in the Candidate Portfolio. This can be downloaded from the College elearning portal.

3.1. Purpose

a) To assist candidates to monitor their progress. b) To provide a record of progress to communicate to SoTs at any time during the

training period. c) To enable candidates to document that they have satisfied each of the

requirements of the training program.

3.2 Requirements

a) A Completion of Training Form, signed by the SoT. b) A log book completed for the full period of training. c) Record of presentation/publication and appended evidence. d) Record of QAP participation and appended evidence. e) Record of CPR course completion and appended evidence. f) Log of peer review cases. g) Completed ITA, CEX, CbD and ProDA forms.

3.3 Candidate Portfolio review All candidates are required to undergo an end-of-training portfolio review with the SoT. The SoT must review the candidate’s progress, and sign the Completion of Training form to confirm that the Candidate Portfolio is complete and all other training requirements have been met.


CHAPTER 4: ASSESSMENT Candidates must complete a series of formative and summative assessments.

4.1 Online assessments All candidates must work through the on-line module “Introduction to Mohs Surgery” and undertake the associated on-line quiz. Candidates who have completed their FACD (or equivalent) more than five years prior to commencing the Mohs Surgery Training Program must also complete a series of online ‘refresher’ modules and assessments. These are detailed in the Mohs Training Program Curriculum.

4.2 Work-based Assessments (WbAs) A Work-based Assessment is a competence-based assessment conducted in the day-to-day clinical setting. It reflects the curriculum and assesses performance of everyday practice through direct observation. As well as assessing performance, work-based assessments provide constructive feedback to inform and develop a candidate’s knowledge and skills. Work-based assessments are candidate-led. The candidate organises for the supervisor to take part in each assessment. Assessments are intended to encourage learning and development. It is expected that candidates may need to complete assessments, and/or parts of assessments, a number of times in order to become competent. There are no adverse consequences for having to attempt a procedure several times as long as the candidate is finally deemed competent. Candidates should participate in assessments regularly. Ongoing constructive feedback helps to keep progress on track. Candidates should plan to undertake assessments across the training period so there is adequate time to repeat assessments when further development is required. SoTs and CSs act as assessors for WbAs. Patient safety and well-being remain paramount throughout WbAs. The assessor should ensure that the patient is informed, has provided consent for the exercise and is not subject to increased risk or discomfort. The supervisor retains responsibility for patient care throughout and must intervene, should it be required. The supervisor undertaking the assessment must provide feedback immediately after the assessment, especially when deficiencies have been identified. Feedback would normally take about five minutes.


Candidates must undertake the following work-based assessments: a) In-training assessments (ITAs) - two over 12 months at prescribed times b) Case-based Discussions (CbDs) - four during the course of training c) Procedural Dermatology Assessment (ProDA) - as listed below d) Mohs Clinical Evaluation Exercise (Mohs-CEX) - one satisfactory CEX during the

course of training. 4.2.1 In-training Assessments (ITAs)

The ITA is a formative assessment of a candidate’s overall progress towards achieving the learning outcomes detailed in the Mohs Surgery Training Program curriculum, which should be referred to when undertaking the assessment. An ITA form must be completed by the SoT and all CSs involved in the candidate’s training at 4 and 8 months of the 12 months Mohs Training Program. The SoT is responsible for collating the forms, completing the Mohs ITA Summary Form and meeting with the candidate to discuss their performance.

The Mohs ITA Summary Form must be signed by the candidate and the SoT and filed in the candidate’s portfolio. Documents for completion of the ITA can be downloaded from the College elearning portal.

4.2.2 Mohs Procedural Dermatology Assessments (ProDAs)

The ProDAs focus on the core skills that candidates require when undertaking a practical Mohs procedure. They are designed to assess a candidate’s technical skills and their ability to perform procedures effectively and safely. During the course of their training candidates must satisfactorily complete the following ProDAs:

a. Surgical Technique: Mohs Micrographic Surgery & Perioperative Management

in Mohs Micrographic Surgery

b. Laboratory and Pathology

c. Surgical Technique: Reconstruction (three individual reconstruction ProDAs to be completed, each ideally covering a different reconstruction technique, as listed in the curriculum)

4.2.2.1 Using the ProDA form

a. The candidate approaches the SoT or CS and advises they will be completing a procedure on a patient and would like their performance to be assessed.

b. The candidate gives the form to the assessor prior to the assessment.

c. The assessor directly observes the candidate completing the procedure, exploring knowledge where appropriate, and completes the form at the end. The emphasis in these exercises is on the candidate’s ability to complete the procedure and demonstrate understanding of underlying principles.

d. The assessor then provides appropriate verbal feedback on the candidate’s performance.


e. Both the candidate and the assessor sign the ProDA form where indicated. The original form is kept in the candidate’s Portfolio.

f. All ProDAs must be logged until each skill is recorded as satisfactory.

Documents for completion of the Mohs-ProDAs can be downloaded from the College elearning portal.

4.2.3 Mohs Clinical Evaluation Exercise (MohsCEX)

The Mohs-CEX focusses on the candidate conducting an initial consultation with a new patient. It is designed to assess the candidate’s ability to undertake an appropriate pre-operative assessment for Mohs micrographic surgery. Candidates are required to complete a minimum of one satisfactory Mohs CEX per year. These may be undertaken at any time during the training program.

4.2.3.1 Mohs CEX process

a. The candidate approaches the assessor, advising that they would like their performance to be assessed and organises a mutually convenient time to undertake the CEX.

b. The candidate gives the form to the assessor prior to the assessment. c. The assessor directly observes the candidate with the patient and

completes the form at the conclusion of the consultation. d. The assessor then provides verbal feedback on the candidate’s

performance. e. Both the candidate and assessor sign the Mohs-CEX form. The original

form is kept in the candidate’s portfolio.

Documents for completion of the Mohs-CEX can be downloaded from the elearning portal.

4.2.4 Case-based Discussion

Case-based discussion is a structured discussion between a candidate and a supervisor, designed to evaluate clinical practice, decision-making and professional judgment exercised in clinical cases.

It is not intended as a test of knowledge, or as an oral or clinical examination. It is intended to guide the candidate’s learning through structured discussion and feedback. The discussion should reflect the candidate’s level of experience and be linked to the Mohs Surgery Training Program curriculum.

A CbD should take approximately 20-30 minutes, including a 10 minute feedback session.

Candidates are required to undertake four CbDs per year, two of which must include discussion of surgical complication management, where possible. The candidate is responsible for ensuring that they undertake the required number of CbDs.

4.2.4.1 Mohs-CbD process a. The candidate is responsible for initiating each CbD.


b. The candidate chooses case(s) in which they have been significantly involved. The candidate confirms with the supervisor that the case is relevant and acceptable.

c. The candidate discusses the case(s) with the supervisor, including their approach, the results and reflection on what went well and what they would change in similar situations in the future. The candidate may refer to photographs of the surgical procedure during the discussion. The supervisor may prompt for further information when required.

d. The supervisor makes notes and rates the candidate’s performance on the CbD form throughout the session. The supervisor rates the candidate’s performance on each of the areas being assessed. If a candidate receives a rating which is below expectations for their stage of training, the supervisor must complete the ‘suggestions for development’ section of the form.

e. Discussion of the cases(s) is immediately followed by feedback from the supervisor. Feedback should focus on the candidate’s clinical decision-making skills and include comments on what the candidate did well and areas for improvement. If any significant areas for development are identified during the session, the supervisor and the candidate should devise a remediation plan.

f. The CbD rating form is signed by the candidate and the supervisor. The candidate ensures that the form is completed (with signatures) and places the forms in their portfolio.

Documents for completion of the CbD can be downloaded from the College elearning portal.


CHAPTER 5: TRAINING ADMINISTRATION AND POLICIES

5.1 Training Administration 5.1.1 Commencing Training

The candidate and SoT should agree on a commencement date. The candidate is responsible for advising the College that training has commenced, and forwarding a completed Commencement of Training Form and Candidate Agreement to College. Both forms can be found on the College elearning portal

5.1.2 During Training

Candidates are responsible for being aware of program requirements and for ensuring that all requirements are completed. Assessments are candidate led, and the candidate is responsible for liaising with the SoT to complete assessments steadily throughout the program. The Mohs Training Program Resource List and other essential training documents are available on the College elearning portal, and it is the candidate’s responsibility to access these materials as necessary.

5.1.3 Completion of Training

The candidate must notify the College when training is completed, by forwarding a completed Candidate Portfolio to the College. The Honorary Secretary will confirm completion of training. The candidate’s name will then be added to the ACD Approved Mohs Surgeons Register. The candidate is responsible for applying for membership of the American College of Mohs Surgery, if desired.

5.2 Policies

5.2.1 Shared and Part-time training

Candidates may request ‘shared’ or part-time training. See the ACD Policy on shared or part-time training. All requests for such training will be carefully considered but cannot always be accommodated. A request for part-time positions considers the following:

There is no compromise to, or disruption of, patient care. There must be no

disruption to the orderly running of the facility where the part-time or shared position is undertaken.

A part-time candidate has to perform at least 50% of the full-time workload.

A part-time candidate is expected to attend at least 50% of training requirements

and other prescribed educational meetings held at their training facility.

A part-time trainee is expected to work continuously during their part-time position (with the usual provisions for leave).

A suitable timetable for the shared or part-time positions is to be developed by

the SOT in consultation with the two candidates. This should occur as soon as practical after selection and position allocation is completed.


Requests for part-time or shared positions must be made in writing to the SOT at the time of application.

5.2.2 Interrupted Training A candidate may be allowed up to one year leave of absence from the training program, at the discretion of the NEdC and SoT. Such a leave of absence is usually only granted in exceptional circumstances. If a leave of absence is approved, then the candidate may return to the training program the year immediately following. Any training time during an approved leave of absence will not be accredited. The candidate will still be required to complete the course within 2 years of their commencement date. Application must be made in advance in writing to the SoT.

5.2.3 Unsatisfactory Performance

Candidates are expected to steadily progress through their training. A Candidate is deemed to have unsatisfactory performance if they have: Failed to complete satisfactorily within the first six months of their studies, the

DermCEX, one CbD, two ProDAs and 30% of the number of surgical procedures Failed to complete satisfactorily within the succeeding three months an

additional one CbD, one ProDA, and another 20% of the required surgical procedures.

In the first instance, the SoT will notify the Mohs Chair of the Candidate’s unsatisfactory performance. In order to address the issue/s and the status of the Candidate’s progress through the Mohs Surgery Training Program, the following will be implemented: A SSP which requires a PIF to be completed. A SSP assists a candidate who

requires additional support and supervision related to knowledge, skills or professional qualities. It is implemented by the SoT in consultation with the Chair of the Mohs Surgery Committee.

The Mohs Surgery Committee is advised when a candidate has been placed on a SSP.

The PIF is in place for three months Regular contact is required between the candidate, mentor and their SOT to

ensure that all possible support/resources are implemented to address areas of concern.

Candidates will receive written notification that any further unsatisfactory performance may result in dismissal from the Training Program.

Continuing unsatisfactory performance will result in candidates receiving written notification that any further unsatisfactory performance may result in dismissal from the Training Program. The Mohs Surgery Committee will be notified and they will place the candidate on probation.

Candidates should refer to the full Unsatisfactory Performance by Candidates policy on the College website.


5.2.4 Other Policies

Other College policies which may apply to candidates in the Mohs Surgery Training Program are:

a. Anti-bullying, Anti-discrimination and Anti-Harassment Policy b. Appeals Policy c. Special Consideration in Examination and Assessments Policy d. Unsatisfactory Performance by Candidates

All polices can be found on the College website.


CHAPTER SIX: ROLES IN THE MOHS SURGERY TRAINING PROGRAM

6.1 Supervisor of Training The Supervisor of Training (SoT) is responsible for overseeing the organisation and implementation of the Mohs Fellowship Training Program in their training facility. This includes:

being involved in selection of Mohs candidates for their institution

selecting and supervising the CSs

being responsible for program accreditation

being familiar with the objectives, curriculum requirements and procedures of the Mohs Surgery Training Program

leading and facilitating effective teaching and learning opportunities for the

candidate within their institution

teaching and supervision of candidates in the clinical situation

ensuring that candidates operate within their scope of their expertise

observing the candidate in the clinical context and giving constructive feedback on performance

completing required work-based assessments

identifying and helping to remediate candidates who are performing below the

required standards

modelling good clinical skills and professionalism.

6.2 Clinical Supervisors CSs provide on-the-job teaching and feedback. Their responsibilities include:

being familiar with the objectives, curriculum and procedures of the Mohs Surgery Training Program

teaching and observing candidates in the clinical context

providing constructive feedback to candidates on their performance in the clinical setting

ensuring that candidates operate within their scope of their expertise

completing work-based assessments as required

discussing the candidate’s performance with the SoT as necessary

in collaboration with the SoT, identifying and helping to remediate candidates who

are performing below the required standard


be responsible for all paperwork that needs completing

modelling good clinical skills and professionalism.

6.3 Candidates

Candidates are required to:

be responsible for their own learning

fulfil the requirements of their job description

understand and adhere to the policies and procedures that their current work environment has in place

put patient needs and safety first

learn in their workplace by being actively involved in patient review and

management

work within the limits of their competence and seek advice and support from a more experienced practitioner when necessary

critically review their own performance and identify and address their learning needs

actively engage in the learning activities provided by their training facility

ensure that they undertake all required assessments, as detailed in the Mohs Surgery

Training Program Handbook, and submit all required documentation to the ACD.


CHAPTER SEVEN: PROGRAM EVALUATION The Mohs Surgery Training Program is regularly evaluated and reviewed. As part of the ongoing evaluation process, Candidates are required to submit a confidential feedback questionnaire to the College on completion of their training. Candidate feedback will be taken into account in both evaluation of the program and accreditation of training positions.

Mohs Log Book

Case Number

Patient Intials Date

Diagnosis/Histology

Primary/ Reccurrent (P or R) Location Pre Op Size Post Op Size

No of Stages

No of Sections Type of repair

Complex* Case (Y or N)

Supervising Faculty Name

Fellow Role Primary**/Assisting (P or A) Complications

190 AB 21/07/2012 BCC P R medial Cheek 9mm x 9mm 13mm x 13mm 2 6 Rotation Flap N Dr Smith A

** A primary role means doing all of the first cut, most of the other cuts and all of the repair.* Cases which have at least one of the following: exposed bare bone or cartilage, perineural tumour, unusual or difficult pathology, >12 sections, > 3 stages, two stage repair, combined repair, or intraoperative medical issues(eg. Hypotensive episodes, difficulty

Details of publication:

1 Journal to which submitted:

Date of submission:

Title of paper:

Has the paper been published?

Please append a copy of your abstract.

Details of presentation:

2 Meeting at which you presented:

Date of meeting:

Title of presentation:

Please append copy of program or other evidence.


RECORD OF PUBLICATION/PRESENTATION

Candidates must submit and abstract for publication and present a paper at a national or international peer review meeting of relevance to Mohs Surgery.

Candidates must participate in the QAP Program.

1. Date of participation:

Please append evidence of participation.


DIAGNOSTIC QUALITY ASSURANCE PROGRAM

Candidates must participate in and record cases reviewed in departmental peer review sessions which must be held at least twice per year.

Date of session

Attendees

Summary of cases discussed

Main clinical issues discussed

Key learning points


LOG OF PEER REVIEW CASES

Date of session

Attendees

Summary of cases discussed

Main clinical issues discussed

Key learning points

Candidates must attend a CPR course.

Details of course attended:

1 Course provider:

Date of attendance:

Please append evidence of participation.


CPR COURSE

Candidates must append copies of the following:

� Mohs-ITA completed at 4 and 8 months of training

� 1 x satisfactory Mohs-CEXs

� 4 x Case-based discussions

� Mohs ProDA 1.3.4/1.3.5

� Mohs ProDA 1.3.6

� Mohs ProDA 1.3.8 (three individual reconstruction ProDAs to be completed, each ideally covering a different reconstruction technique, as listed in the curriculum)


WORK-BASED ASSESSMENT

The ITA is a formative assessment of a candidate’s overall progress towards achieving the

learning outcomes detailed in the Mohs Surgery Training Program curriculum, which should

be referred to when undertaking the assessment.

An ITA form should be completed by the Supervisor of Training and all Clinical Supervisors

involved in the candidate’s training at 4 and 8 months of the 12 months Mohs Training

Program. The Supervisor of Training is responsible for collating the forms, completing the Mohs

ITA Summary Form and meeting with the candidate to discuss their performance.

The Mohs ITA Summary Form must be signed by the candidate and the Supervisor of Training

and filed in the candidate’s portfolio.

Candidate Name

Training Position 4 month ITA/ 8 month ITA (please

circle)

Please rate the candidate’s performance for each

area. The trainee’s performance should be assessed

against the learning outcomes detailed in the Mohs

Surgery Training Program curriculum.

Please rate the following areas:

Below

expectations

for stage of

training

Borderline for

stage of

training

Meets

expectations for

stage of training

Above

expectations for

stage of training

1 2 3 4

Knowledge of the principles of MMS

Knowledge of indications for MMS

Pre-operative assessment for MMS

Surgical technique

Peri-operative management

Laboratory & pathology: preparing and mapping

tissue

Specimen interpretation

Reconstruction: knowledge of reconstructive

options

Post –operative care

Surgical complication management

Mohs Surgery Training Program

In-Training Assessment (ITA) Form

Professional Qualities

Quality assurance in MMS

Knowledge of surgical facility management

In your opinion, what are the main strengths of this candidate’s performance?

In your opinion, what areas of this candidate’s performance are most in need of further development?

Supervisor’s Name

Supervisor’s Signature Date

Please return this form to the Supervisor of Training. The candidate does not see the form.

This form is to be completed by the Supervisor of Training.

Please collate the responses given on the FITA forms for all of the candidate’s supervisors, as

well as your own assessment. The Supervisor of Training should then give a copy of this

summary form to the candidate and organise to meet with the candidate to discuss the

assessment and plan the candidate’s learning for the following months.

Both the Supervisor of Training and the candidate should sign the form, and the form should

be then filed in the candidate’s portfolio.

Candidate Name

Training Position 4 month ITA/ 8 month ITA (please

circle)

Below

expectations

for stage of

training

Borderline for

stage of

training

Meets

expectations for

stage of training

Above

expectations for

stage of training

1 2 3 4

Knowledge of the principles of MMS

Knowledge of indications for MMS


Surgical technique

Peri-operative management

Laboratory & pathology: preparing and mapping

tissue

Specimen interpretation

Reconstruction: knowledge of reconstructive

options

Post –operative care

Surgical complication management

Mohs Surgery Training Program In-Training Assessment (ITA) Summary Form

Follow-up post MMs

Ethical judgment

Quality assurance in MMS

Knowledge of surgical facility management

Summary of the main strengths of this candidate’s performance:

Summary of the areas of this candidate’s performance that are most in need of further development:

Supervisor’s Name


Candidate’s Name

Candidate’s Signature Date

Mohs Surgery Clinical Evaluation Exercise (Mohs-CEX)

Curriculum Element 1.3.2


The Mohs-CEX focusses on the candidate conducting an initial consultation with a new patient. It is

designed to assess the candidate’s ability to undertake an appropriate pre-operative assessment for Mohs

micrographic surgery. Candidates should refer to module 1.3.2 of the curriculum for details of the learning

outcomes being assessed.

Candidates are required to complete a minimum of one satisfactory Mohs CEX per year. This may be

undertaken at any time during the training program.

Mohs CEX process

The candidate approaches the supervisor advising that they would like their performance to be

assessed and organises a mutually convenient time to undertake the CEX.

The candidate gives the form to the assessing supervisor prior to the assessment.

The assessing supervisor directly observes the candidate with the patient and completes the form at

the conclusion of the consultation.

The supervisor then provides verbal feedback on the candidate’s performance.

Both the candidate and supervisor sign the Mohs-CEX form. The original form is kept in the

candidate’s portfolio.

Candidate name

Training Facility

The assessment should be judged against the standard expected at the current point of training. Please record a

rating for each item and a rating for overall clinical competence using the following scale:

1 — Unsatisfactory performs at a level significantly lower than expected for stage of training, requires substantial improvement

2 — Below Expected Standard performs at a level lower than expected for stage of training, requires improvement

3 — Borderline requires some further development

4 — Meets Expected Standard performs at a level expected for stage of training

To be satisfactory the trainee must achieve a 4 in all areas

1 2 3 4 N/A

Selects appropriate patients for Mohs Micrographic surgery (considers tumour type, tumour characteristics and patient factors)

Takes an appropriate medical history for risk assessment.

Identifies absolute and relative contraindications ( where present)

Selects appropriate pre-operative investigations (if appropriate)

Identifies whether patient is at risk of complications (medications that interfere with haemostasis, other medications and supplements, prosthetics and other surgical implants, co-morbidities, allergies, psycho-social issues etc)

Modifies plans to take account of patients with special risks (if appropriate)

Explains procedure to patient

Ensures patient aware of potential risks

Obtains informed consent

Discusses expected follow-up care with patient

Appropriately documents condition and consultation

Overall Assessment Outcome DEVELOPMENT REQUIRED SATISFACTORY(must be all 4’s)

Strengths Suggestions for Development

Candidate comments on their performance

Candidate name:

Signature:

Supervisor name:

Signature:

Date:

Mohs Surgery Training Program Cased-based Discussion (CbD)

What is it? Case-based discussion (CbD) is a structured discussion between a candidate and a

supervisor, designed to evaluate clinical practice, decision-making and professional

judgment exercised in clinical cases.

It is not intended as a test of knowledge, or as an oral or clinical examination. It is intended

to guide the candidate’s learning through structured discussion and feedback. The

discussion should reflect the candidate’s level of experience and be linked to the Mohs

Surgery Training Program curriculum.

A case-based discussion should take approximately 20-30 minutes, including a 10 minute

feedback session.

Candidates are required to undertake four CbDs per year, two of which must include

discussion of surgical complication management, where possible. The candidate is

responsible for ensuring that they undertake the required number of CbDs.

Cases for

discussion

Cases for discussion are chosen by the candidate but must be acceptable to the

supervisor. The candidate should have had a significant role in clinical decision making and

patient management for the cases being discussed.

Areas for

assessment

Preoperative assessment (Curriculum element 1.3.2)

Surgical Technique (Curriculum element 1.3.4)

Laboratory and Histopathology (Curriculum element 1.3.6)

Surgical Technique: Reconstruction (Curriculum element 1.3.8)

Postoperative care (Curriculum element 1.3.9)

Surgical Complication Management (Curriculum element 1.3.10)

Process The candidate is responsible for initiating each CbD.

The candidate chooses case(s) in which they have been significantly involved. The

candidate confirms with the supervisor that the case is relevant and acceptable.

The candidate discusses the case(s) with the supervisor, including their approach,

the results and reflection on what went well and what they would change in similar

situations in the future. The candidate may refer to photographs of the surgical

procedure during the discussion. The supervisor may prompt for further information

when required.

The supervisor makes notes and rates the candidate’s performance on the CbD

form throughout the session. The supervisor rates the candidate’s performance on

each of the areas being assessed. If a candidate receives a rating which is below

expectations for their stage of training, the supervisor must complete the

‘suggestions for development’ section of the form.

Discussion of the cases(s) is immediately followed by feedback from the supervisor.

Feedback should focus on the candidate’s clinical decision making skills and

include comments on what the candidate did well and areas for improvement. If

any significant areas for development are identified during the session, the

supervisor and the candidate should devise a remediation plan.

The CbD rating form is signed by the candidate and the supervisor.

The candidate ensures that the form is completed (with signatures) and places the

form in their portfolio

Mohs Surgery Training Program

Case-based Discussion Form (CbD)

Candidate Name

Training Position

Case Information

Patient Age & Gender: ................... Male Female

Location of Lesion for

surgery:

Please rate the candidate’s performance for

each area. The candidate’s performance should

be assessed against the standard expected at

the current stage of training.

Please rate the following areas:

Below

expectations

for stage of

training

Borderline for

stage of

training

Meets

expectations

for stage of

training

Above

expectations

for stage of

training

1 2 3 4 5 6 7 8

Appropriateness and thoroughness of

preoperative assessment, including:

Identification of contraindications (where

present)

Identification of risk of complications

Accuracy and completeness of record

keeping

Accuracy of histopath interpretation (assessed

via review of slides)

Choice of reconstructive option

Implementation of reconstructive option

Did the case involve surgical complications?

YES/NO

If yes, please rate the candidate’s management

of complications.

Surgical outcome (assessed via review of digital

photo records)

Appropriateness of postoperative care,

including:

Provision of advice regarding aftercare

Wound management

Organisation of follow-up

Documentation and record keeping

Strengths of candidate’s performance

Suggestions for development

Candidate’s reflective comments:

Candidate’s Name

Candidate’s Signature Date

Supervisor’s Name


Mohs Procedural Dermatology Assessment (ProDA) 1.3.1

Basic Surgery

Candidate Name

Training Position

Please record a rating for each component of the procedure observed using the following scale: The assessment should be judged against the standard expected at completion of the current year of training.

1 Candidate required detailed

guidance and instruction from the supervisor prior to performing the

step.

2 Candidate required guidance

and instruction from the supervisor prior to performing

the step.

3 Candidate was able to perform

the step after minimal prompting from the

supervisor.

4

Candidate was able to perform the step

competently.

To be satisfactory the trainee must achieve a 4 in all areas

Perform a Biopsy 1 2 3 4

Selects the appropriate method of biopsy (punch, shave, excisional, incisional).

Identifies any contraindications to anaesthetic agents.

Identifies any contraindications to specific procedure planned.

Documents condition.

Obtains informed consent.

Prepares patient and procedural environment

Selects the appropriate site for biopsy (anatomical and within lesion).

Marks out area to be biopsied, including appropriate margin if excisional biopsy.

Applies appropriate aseptic technique.

Administers appropriate anaesthesia.

Performs the selected biopsy method:

To the most appropriate size and depth for tissue diagnosis

Considers underlying and adjacent important anatomical structures

Handles tissue with care to avoid crush artefact

Places tissue in appropriate transport medium

Ensures accurate documentation and labeling.

Achieves haemostasis by electrosurgical, chemical, suture, haemostatic dressings or wound closure.

Ensures appropriate wound closure, if necessary, for punch, incision or excision biopsy.

Applies wound dressing.

Procedural Skills Assessment - Biopsy

Provides patient with verbal and/or written advice with regard to appropriate after care.

Organises follow up visit/phone call to communicate pathology, to remove sutures if applicable and to arrange any further treatment as indicated.

Overall Clinical Competence DEVELOPMENT REQUIRED SATISFACTORY(must be all 4’s)


Candidate’s comments on their performance

Candidate’s Name

Candidate’s Signature

Supervisor’s Name

Supervisor’s Signature

Date

Date

Mohs Procedural Dermatology Assessment (ProDA) 1.3.3

Surgical Technique: Anaesthesia

Candidate name:

Training position:

Please record a rating for each component of the procedure observed using the following scale: The assessment should be judged against the standard expected at completion of training.



step.



the step.



supervisor.

4


competently.

To be satisfactory the candidate must achieve a 4 in all areas

Anaesethsia 1 2 3 4

Selects the most appropriate method anaesthesia

Selects a suitable anaesthetic agent, concentration and dose.

Selects a suitable adjuvant agent if appropriate.

Selects appropriate delivery method to minimize pain of delivery

Selects the most appropriate site for the anaesthesia

Marks out the anaesthesia site if required

Applies appropriate aseptic technique

Administers the anaesthetic in an appropriate manner

Allows appropriate time for the anaesthetic to take effect

Checks that anaesthetic has taken effect

Ensures accurate documentation is kept



Candidate’s comments on their performance

Cadidate name:

Signature:

Supervisor name:

Signature:

Date:

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Mohs Procedural Dermatology Assessment (ProDA)

Curriculum Element 1.3.4 Surgical Technique: Mohs Micrographic Surgery

Curriculum Element 1.3.5 Peri-operative Management in Mohs Micrographic

Surgery

Candidate Name

Training Facility

Please record a rating for each component of the procedure observed using the following scale:



step.



the step.



supervisor.

4


competently.


1 2 3 4

Identifies patient/lesion

Confirms informed consent

Photographs tumour

Prepares patient and procedural environment

Identifies tumour site

Delineates tumour margins

Administers appropriate anaesthesia

Considers underlying and adjacent important anatomical structures

Applies appropriate aseptic technique.

Incision at 45 degree angle

Scores specimen in situ and surrounding skin for orientation

Detaches specimen appropriately, maintaining proper orientation


Achieves heamostasis

Applies appropriate wound dressing

Implements appropriate pain management

Demonstrates appropriate peri-operative infection control techniques

Demonstrates appropriate peri-operative patient management and supervision




Trainee’s comments on their performance

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Laboratory and Pathology

Candidate Name

Training Facility




step.



the step.



supervisor.

4


competently.


1 2 3 4

Labels specimens appropriately

Draws appropriate and accurate anatomical map of tissue specimen, including:

Numbers the specimens accurately and assigns colour code for stains

Orientates specimen appropriately relating to anatomical placement on patient

Annotates presence of epidermis, cartilage or other important tissue features

Appropriately uses colour coding symbols for tissue dyes used to mark and orient edges of tissue specimen

Orientates specimen correctly as it relates to other specimens

Systematically marks first and subsequent layers excised

Identifies and maps multiple sites as required

Cuts the tissue into sections appropriate for processing

Stains the tissue specimen with coloured dye as per map

Documents staining on anatomical map using colour code

Mounts tissue specimens in appropriate orientation to hand to technician for processing;

Liaises appropriately with technician

Handles specimens appropriately on to lab technician

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Surgical Technique: Reconstruction

Candidate Name

Training Facility Reconstructive

Technique Assessed


1

Candidate required detailed

guidance and instruction from

the

supervisor prior to performing the

step.

2

Candidate required

guidance

and instruction from the

supervisor prior to performing

the step.

3

Candidate was able to

perform

the step after minimal

prompting from the

supervisor.

4

Candidate was able to

perform the step

competently.


1 2 3 4

Identifies patient

Selects appropriate repair option

Correctly designs repair

Considers surrounding anatomical structures

Ensures adequate anaesthesia for planned repair

Selects appropriate suture material

Achieves haemostasis

Ensures appropriate wound closure

Applies wound dressing appropriately

Liaises with nursing staff regarding post-surgical care

Advises patient appropriately regarding wound care and

follow-up

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1 Training facility:

Address of facility:

Supervisor of Training:

Tel:

Email:

2 Name of candidate:

Postal Address:

Tel:

Email:

3 Program start date:

Program completion date:

Number of weeks worked (not including leave)

4 Number of cases as assistant surgeon:

Number of cases as primary surgeon:

Number of cases on head and neck:

Number of cases referred from other specialties:


COMPLETION OF TRAINING FORM

This form should be completed by the candidate and signed by the Supervisor of Training at the completion of training.

5 I certify that:

• I have reviewed the candidate’s portfolio and can confirm that it is complete and accurate.

• The candidate has met all requirements of the Mohs Surgery Training Program

Signature of Supervisor of Training:

1

Completion of Training

Candidate Feedback Questionnaire CONFIDENTIAL

This form should be completed by Mohs Candidates on completion of

training. The survey is confidential and will be reviewed by the Chair of Mohs Surgery Committee in order to improve teaching in Mohs. Return the survey

by email to [email protected]

1. Name of Mohs Candidate:

2. Name of Training Facility:

3. Name of your Supervisor of Training:

4. Names of Clinical Supervisors:

5. Date you started your training:

6. Date you completed your training:

7. Number of cases as primary surgeon:

8. Number of cases as assistant surgeon:

9. Total number of cases:

Please rate your clinical training experience: Poor Below Average

Average Above Average

Excellent

10. Overall assessment of your training

11. Availability of Supervisor of Training

12. Availability of Clinical Supervisor/s

13. Approachability of supervisors

14. Organised approach to training

15. Adherence to curriculum modules

16. Quality of surgical instruction

17. Responsibility appropriate to experience

18. Provision of informal feedback (e.g. during clinics, on the ward – positive encouragement etc.)

19. Provision of formal feedback (e.g. during In- Training Assessments – identification of your strengths and weaknesses)

20. Opportunity to complete work based summative assessments, Mohs-CEXs, Pro-DAs and CbDs

21. Balance between service and training needs

22. Breadth of case mix

Date received by College

2

23. Depth of case mix

24. Opportunities for independent surgery (not directly supervised)

24. Operating facilities and equipment

26. Opportunities for research/ publication

27. Office support

28. Laboratory facilities

29. Research support

30. Orientation to training facility

31. Orientation to Mohs surgery training program

32. Do you have any general comments in relation to your training?