• Application for Accreditation of a Mohs Surgery Training Position

    This form should be completed by the Supervisor of Training with reference to the Accreditation Standards for Mohs Surgery Training Positions.

  • TRAINING FACILITY DETAILS

  • 2. Will any part of the training position be undertaken at satellite facilities?*

  • If yes, please provide details of each satellite facility and how much time is spent at each during the week, e.g. 0.2FTE:

  • CANDIDATE DETAILS

  • 8. Is the training position full-time?*

  • STANDARD 1 TRAINING AND EDUCATION

  • 9. Mohs candidate timetable (Attachment 1)

    Please append a weekly timetable for the Mohs candidate at your facility:

    The timetable should include all clinic, surgery sessions, dermatopathology instruction sessions, and educational activities. Each clinic entry should specify the type of clinic and the name of the Clinical Supervisor/s. Insert 'Unsupervised' in lieu of Clinic Supervisor's name or 'Observer', if the candidate will not actively participate in the clinic.

    Please attach multiple weekly tables if the candidate will have a ortnightly or monthly timetable. 

  • 11. Will the Mohs candidate be able to participate in at least 500 Mohs surgery cases each year, and be the primary surgeon in at least 200 of these cases?*
  • 12. Will the Mohs candidate be able to participate in at least 50 Mohs cases each year which are referrals from other medical and surgical specialists?*
  • 14. Will the Mohs candidate have one session each month of protected study/research time?*

  • STANDARD 2 SUPERVISION AND COORDINATION

  • 16. Has the Supervisor of Training been approved for inclusion on the ACD Approved Mohs Surgeons Register?*
  • 17. Has the Supervisor of Training five years post Mohs training program surgery experience?*
  • 18. Has the Supervisor of Training completed at least 200 Mohs surgery cases in each of the two years prior to this application?*
  • 19. Is the Supervisor of Training enrolled in the RCPA QAP frozen section technical module?*
  • 21. Is the Supervisor of Training of good standing with the AHPRA without restrictions on registration?*
  • 22. Has the Supervisor of Training attended ACD Supervisor Training within the last 5 years?
  • 23. Is the Supervisor of Training aware of the duties of their role as describes in the Training Program Handbook Mohs?*
  • 24. Does the Supervisor of Training agree to submit their annual logbooks to satisfy the Mohs committee that they are teaching and supervising within the expected professional standards?*

  • 25. Name and qualifications of Clinical Supervisors (CS)

  • 26. Has each Clinical Supervisor been approved for inclusion on the ACD Approved Mohs Surgeons Register?*
  • 27. Has each Clinical Supervisor completed at least 100 Mohs cases in the years prior to this application?*
  • 28. Is each Clinical Supervisor of good standing with the AHPRA without restriction on registration?*
  • 29. Has each Clinical Supervisor attended ACD Supervisor Training within the last 5 years?*
  • 30. Is each Clinical Supervisor aware of the duties of their role as described in the Training Program Mohs Surgery?*
  • 31. Will all patient care at the training facility be supervised by qualified clinical supervisors?
  • 33. Do you acknowledge that the Mohs candidate must undertake a program of formative and summative assessments as outlined in the Mohs Surgery Training Program Curriculum, and that the Supervisor of Training and Clinical Supervisors must be involved in these?*

  • STANDARD 3 EQUIPMENT AND FACILITIES

  • 34. Will the following equipment be available to the Mohs candidate? 

    Select Yes/No as appropriate

  • Resuscitation equipment*
  • Microscope*
  • Cryostat*
  • Electrosurgical devices*

  • STANDARD 4 LEARNING AND WORK ENVIRONMENT

  • 35. Can the training facility demonstrate sufficient case load to enable the Mohs candidate to obtain the breadth and depth of experience defined by the curriculum?*
  • 36. Is the training facility a licensed day surgery that has achieved accreditation to NSQHS standards?*
  • 37. Is there an orientation package/program which will be provided to the Mohs candidate?*
  • 38. Is there a case review/audit system?*
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