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, th 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 frequenly 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 undersood at Diploma level. These are as follows:
- Single advancement
- Twin advancement
- A - T
- Rhomboid
- Rotation
- O - Z / S
- Simple transposition
- Bilobed
- V - Y island advancement
- 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.
Dilpomats 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 the certificate multiple choice examination. A score of 80 or more is required to proceed further. Time allowed is 90 minutes. This exam component is waived for candidates who already have a certificate and scored over 80 at that time. College can advise you if this applies to you.
Next the candidate must sit a 120 minute short answer written exam. There are 20 questions in the exam, - from a large bank of questions. There are 4 pages to the written exam with 5 questions per page. Candidates are asked to answer any 4 questions from the 5 on each page. That is, diploma candidates can choose to not answer one question per page of 5 questions. To pass this section, the candidate must core 60% or more.
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. again, 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 does not run workshops targetted for prospective diplomats. However, courses are available geared to this level, including workshops run by Assistant Professor Dixon. These are held each year in Geelong and details are provided on the Skincanceronly web page.
See a list of current ACSCM Diplomats here.