The ACCO Diploma in Skin Cancer Surgery certifies that a medical practitioner can manage most skin cancers that present to his / her practice. The examination is available to those having completed the flaps and grafts workshop.
The ACCO Diploma level has been designed with the vast rural areas of Australia in mind. In rural and remote Australia patients frequently expect their doctor to manage their problems locally. A holder of the ACCO Diploma will be able to manage most of their patient's skin cancers in their own town. In towns that have a hospital, the ACCO Diploma indicates the doctor has the knowledge to safely effect skin cancer surgery in the hospital's facilities.
For urban and regional doctors the ACCO Diploma indicates the knowledge and surgical 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 more senior colleagues.
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 inccluding halo grafts.
Skin flap knowledge and skills are required. The ACCO has identified 10 core flaps to be understood 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.
ACCO 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.
Basic dermatopathology skills are also required at Diploma level . The exam includes histology photomicrographs of common cutaneous malignancies. Understanding therse histology features is explained in the flaps and grafts workshop.
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.
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.
Examination
The examination for ACCO Diploma in Skin Cancer Surgery involves demonstrating surgical skills during the flap and graft workshop as well as passing the ACCO on-line examination.
The on-line examination has 200 multiple choice questions. Time allocated is 240 minutes and pass requirement is 140 correct answers. The exam involves theory questions as well as recognising clinical images, dermoscopic images and some histology photomicrographs. Details of the on-line exam can be found here.