Diploma

The College Diploma certifies that a medical practitioner can manage most skin cancers that present to his / her practice.

The Diploma level has been designed with the vast rural areas of Australia in mind.  In rural and remote Australia patients frequently expect their country doctor to manage their problems locally.  A holder of the College Diploma will be able to manage most of their patient's skin cancers in their own town.  In towns that have a hospital, the Diploma indicates the doctor has the knowledge to safely effect skin cancer surgery in the hospital's facilities.

Doctors working in urban and regional skin cancer clinics also frequently work towards the College Diploma.  For these doctors the Diploma indicates the knowledge and skills to manage most skin cancers that present to the clinic.

Diplomats are not expected to manage all skin cancers.  More difficult malignancies will frequently be referred to ACSCM Fellows or Fellows of other learned Colleges.

Knoweldge and skills required at Diploma level?

All knowledge requirements of the Certficate level are required, but at a more sound and substantial level.

Knowledge and skills of full thickness and partial thickness skin grafts is now required.

Skin flap knowledge and skills are now also required. The ACSCM has identified 10 core flaps to be understood at Diploma level. These are as follows:

1. Single advancement
2. Twin advancement
3. A - T
4. Rhomboid
5. Rotation
6. O - Z / S
7. Simple transposition
8. Bilobed
9. V - Y island advancement
10. ROM

These flaps have been chosen as statistically they will allow a doctor to close 95% of defects that he / she might be faced with in clinical skin cancer practice.  Most defects will however be closed directly.

Diplomats are also required to have a sound knowledge of facial anatomy including the facial nerve, trigeminal nerve, arteries on the face and facial landmarks.

No histology / dermatopathology skills are required at Diploma level . These skills are only required of Fellow candidates.

Diplomats are expected to know a little of some rarer skin cancers such as atypical fibroxanthoma, merkel cell tumour and sebaceous carcinoma.  However knowledge of management of these tumours is not required at Diploma level. Again, these skills are required of College Fellows.

Diplomats are expected to have a sound knowledge of photodynamic therapy, usage of topical imiquimod and 5 fluoro uracil and diclofenac.  A range of skills with the dermal curette are also required at diploma level.

Recommended reading

Examination

The examination for Diploma has multiple components.

First the candidate must sit a multiple choice examination of 142 questions.  Time allocated is 150 minutes and pass rate is 100 correct questions.

Next the candidate sits a multiple choice examination in dermoscopy.  This is a more difficult dermoscopy exam than that offered to certificate candidates  - 30 minutes.   The pass mark is 60%.  This dermoscopy exam involves 16 dermoscopic images.  Candidates are asked to select their preferred diagnosis and preferred management plan.  A list of options with codes is provided.  Candidates may choose to provide a second diagnosis as a differential and may choose to provide an alternate management plan where they feel such is appropriate.

Finally the candidate is asked to simulate 2 tasks on pigs trotters in front of the examiners.  Clinical scenarios are put to the candidate to manage surgically on the pig's skin.  Any of the above flaps might be asked of the candidate.  Examiners will be looking for competence with the procedure as well as the absence of unsafe practices such as poor needle handling and poor scalpel control.

Workshops

It is College policy that no candidate is required to attend any College educational event.  The College does not believe that certification should involve candidates attending workshops or seminars that they may not need.

However, prospective candidates may wish to attend workshops designed to cover the core knowledge base required at the diploma level.  ACSCM runs workshops targetted for prospective diplomats.  Courses are also available geared to this level, including workshops run by Associate Professor Dixon.  These are held each year in Geelong and details are provided on the Skincanceronly web page.

See a list of current  ACSCM Diplomates here.