Specific Standards of Accreditation for Residency Programs in Dermatology

Transcription

1 Specific Standards of Accreditation for Residency Programs in Dermatology INTRODUCTION 2009 A university wishing to have an accredited program in Dermatology must also sponsor accredited programs in Internal Medicine or Pediatrics and Anatomical Pathology or General Pathology. The purpose of this document is to provide program directors and surveyors with an interpretation of the general standards of accreditation as they relate to the accreditation of programs in Dermatology. This document should be read in conjunction with the General Standards of Accreditation, the Objectives of Training and the Specialty Training Requirements in Dermatology. STANDARD B1: ADMINISTRATIVE STRUCTURE There must be an appropriate administrative structure for each residency program. Please refer to Standard B1 in the General Standards of Accreditation for the interpretation of this standard. STANDARD B2: GOALS AND OBJECTIVES There must be a clearly worded statement outlining the goals of the residency program and the educational objectives of the residents. The general goals and objectives for Dermatology are outlined in the Objectives of Training and the Specialty Training Requirements in Dermatology. Based upon these general objectives each program is expected to develop rotation specific objectives suitable for that particular program, as noted in Standard B2 of the General Standards of Accreditation. STANDARD B3: STRUCTURE AND ORGANIZATION OF THE PROGRAM There must be an organized program of rotations and other educational experiences, both mandatory and elective, designed to provide each resident with the opportunity to fulfill the educational requirements and achieve competence in the specialty or subspecialty. The structure and organization of each accredited program in Dermatology must be consistent with the specialty training requirements as outlined in the Objectives of Training and the Specialty Training Requirements in Dermatology. The program must be organized to provide increasing individual professional responsibility, under appropriate supervision, according to the resident s level of training, ability, and This document may be reproduced for educational purposes only provided that the following phrase is included in all related materials: Copyright 2009 The Royal College of Physicians and Surgeons of Canada. Referenced and produced with permission. Please forward a copy of the final product to the Office of Education, attn: Associate Director. Written permission from the Royal College is required for all other uses. For further information regarding intellectual property, please contact: documents@royalcollege.ca. For questions regarding the use of this document, please contact: accred@royalcollege.ca. Page 1 of 6

2 experience for the diagnosis and management of patients with dermatologic disease and in all aspects of the contemporary practice of Dermatology. In addition, the resident must gain experience in performing appropriate surgical and other procedures required for the optimum care of patients. STANDARD B4: RESOURCES There must be sufficient resources including teaching faculty, the number and variety of patients, physical and technical resources, as well as the supporting facilities and services necessary to provide the opportunity for all residents in the program to achieve the educational objectives and receive full training as defined by the Royal College specialty training requirements. In those cases where a university has sufficient resources to provide most of the training in Dermatology but lacks one or more essential elements, the program may still be accredited provided that formal arrangements have been made to send residents to another accredited residency program for periods of appropriate prescribed training. Experiences must include learning environments that facilitate the acquisition of knowledge, skills, and attitudes relating to aspects of age, gender, culture, and ethnicity appropriate to Dermatology. 1. Teaching Faculty There must be a sufficient number of qualified teaching staff to supervise residents and provide teaching in the basic and clinical sciences related to dermatologic diseases. 2. Number and Variety of Patients The number and variety of patients in each of the following categories must be satisfactory to meet the educational requirements of the residents. a. General Dermatology There must be comprehensive exposure to all primary diseases of skin, hair, nails and visible mucosa, cutaneous manifestations of systemic diseases, collagen vascular diseases and skin problems related to allergy and immunology. b. Pediatric Dermatology There must be an adequate number of patients to provide training in the dermatologic manifestations of acute contagious illnesses, and other skin diseases in children. 3. Clinical Services Specific to Dermatology The clinical services making up the program must provide full training in the diagnosis and management of dermatological conditions in each of the areas listed below. Page 2 of 6

3 a. In-Patient and Consultation The dermatology service must have appropriate facilities to teach residents the skills needed to manage patients with skin diseases who require admission to hospital. The program must provide active consultation to all disciplines and to the Emergency Department. It is important that teaching sites approved for training have a sufficient number of admissions to ensure this consultative service; residents must take an active part in this service. b. Ambulatory There must be an organized out-patient department or ambulatory care facility providing an adequate number of adult and pediatric dermatological out-patients. In-patient and out-patient teaching should be integrated as much as possible, in order to provide continuity of observation of patients both in and out of hospital. Organized clinics or other appropriate facilities must be available with adequate numbers of patients to provide opportunities for instruction in the broad range of Dermatology that can be managed on an ambulatory basis. In addition to general clinics, special clinics under the supervision of experienced teachers will provide additional learning opportunities for residents. It is essential that clinics provide a teaching milieu and that schedules of residents be so arranged as to ensure their attendance. c. Infectious Diseases There must be adequate exposure to patients with infectious diseases, including HIV and sexually transmitted diseases. d. Dermatologic Therapy There must be arrangements for special instruction and supervised experience in the use of both topical and systemic pharmacologic agents and in the role of phototherapy, photochemotherapy and cryotherapy. e. Skin Malignancies The program must include the diagnostic and therapeutic aspects of malignant skin disease, preferably in an interdisciplinary setting providing ample opportunities for consultation with Plastic Surgeons, Pathologists, and Medical and Radiation Oncologists. f. Surgical Procedures Facilities must be available for supervised experience in biopsy and other minor surgical procedures, including laser surgery and more extensive cutaneous surgery. g. Diagnostic Procedures Facilities and supervision must be available for such diagnostic procedures as patch testing, Wood's light examination, and microscopic examination for fungi and scabies and of hair mounts. There must be arrangements for special instructions in photo testing and photo patch testing. Page 3 of 6

4 h. Dermatopathology The program must include all aspects of dermatopathology, including microscopic diagnosis of skin disorders by means of light and fluorescent microscopy, electron microscopy, and immuno-histochemistry. Laboratory facilities must be adequate and organized for teaching under the direction of a dermatopathologist or a dermatologist or pathologist with a special interest in dermatopathology. 4. Supporting Services - Clinical, Diagnostic, Technical The following facilities and services must be available, either within the program or by arrangement with other programs or institutions, and closely coordinated with the overall program. a. Active teaching services in Internal Medicine, Pediatrics, family medicine, and Emergency Medicine. Liaison arrangements within the faculty should ensure that clinical training during the basic clinical year and the year of Internal Medicine or Pediatrics, in fulfilment of the specialty training requirements, meets the needs of residents in Dermatology. b. An active service in radiation therapy with adequate arrangements to ensure an understanding of the methods and concepts of radiation therapy applicable to residents in Dermatology. c. An allergy and immunology service with adequate liaison to ensure exposure of residents in Dermatology to teaching staff with expertise in immunology. d. An active service in Medical Microbiology, with expertise available in mycology, parasitology, bacteriology and virology. e. A Plastic Surgery service. f. An audiovisual and a photography service available to enhance and facilitate learning, and the development and maintenance of appropriate teaching files. g. Intensive care units and Emergency Departments that provide experience with the dermatologic complications of severely ill and injured patients. h. Adequate clinical and laboratory facilities for the performance of dermatological surgical and diagnostic procedures. The facilities and the volume and variety of work must be considered adequate by the Specialty Committee of the Royal College. i. Access to library facilities and other learning resources including access to electronic media. STANDARD B5: CLINICAL, ACADEMIC AND SCHOLARLY CONTENT OF THE PROGRAM The clinical, academic and scholarly content of the program must be appropriate for university postgraduate education and adequately prepare residents to fulfill all of the CanMEDS Roles of the specialist. The quality of scholarship in the Page 4 of 6

5 program will, in part, be demonstrated by a spirit of enquiry during clinical discussions, at the bedside, in clinics or in the community, and in seminars, rounds, and conferences. Scholarship implies an in-depth understanding of basic mechanisms of normal and abnormal states and the application of current knowledge to practice. Please refer to Standard B5 in the General Standards of Accreditation, the Objectives of Training, the Subspecialty Training Requirements in Dermatology and the CanMEDS Framework for the interpretation of this standard. Each program is expected to develop a curriculum for each of the CanMEDS roles, which reflects the uniqueness of the program and its particular environment. Specific additional requirements are listed below. 1. Medical Expert In addition to the General Standards of Accreditation, the following requirement applies. - In addition to a formal basic science teaching program, there should be regular teaching rounds, pathology rounds, and specific reading assignments. 2. Communicator 3. Collaborator 4. Manager 5. Health Advocate 6. Scholar 7. Professional STANDARD B6: EVALUATION OF RESIDENT PERFORMANCE There must be mechanisms in place to ensure the systematic collection and interpretation of evaluation data on each resident enrolled in the program. Please refer to Standard B6 in the General Standards of Accreditation for the interpretation of this standard. Page 5 of 6

6 1. In-Training Evaluation Reports An In-Training Evaluation Report based on the goals and objectives of the program must be completed at the end of each rotation. This must be done at the end of each rotation or at a minimum frequency of every six months for each resident. These evaluations should have input from all supervising teaching staff. The evaluation must be reviewed with the residents soon after the rotation is completed and sent to the program director. 2. Written and Oral Examinations Each resident must be given an examination (oral, written or combined) formulated by the program committee at least once a year. Results of these examinations must be recorded on the In-Training Evaluation Report. Adopted by Council Revised November 2002 Revised Education Committee Revised SSRC February 2009 Editorial SC February 2011 Page 6 of 6