additIonal information for royal australasian college of physicians APPLICANTS - DERmatology	
To assist the RACP to make a fair and robust assessment of the equivalency of your qualifications, training and experience RACP asks that you comprehensively complete the following document in addition to the VOC3. 	
Pease complete every section and type your answers in the boxes below which will expand to allow you to elaborate as necessary	
General information	
Full name: 		
Which medical or paediatric specialty or specialties do you practise?		
In preparation for an application for Fellowship do you give permission for MCNZ to pass your supervision reports to RACP? 	Yes/No	Signature:	
Where do you intend to practise in New Zealand? Describe location and type and size of institution 		
Medical experience before entering training programme	
Describe what was your medical experience before entering formal training? eg rotating internships		
basic Training	
Did you complete a period of basic training in general medicine or general paediatrics? 
If yes complete the following sections	Yes/No	
What was the duration of the training?		
Was there an entry requirement for this training? If yes provide details		
Country/ies of training:
		
Hospital/s Institution/s:		
Position title/s:
		
Name of formal training program:		
Details of rotations completed:		
Details of inpatient duties: 		
Details of continuity of care including from initial assessment to discharge and/or follow up:  		
Details of on call responsibilities: 		
Details of level of supervision:		
Details of procedures performed:		
What in-training assessments were undertaken?		
Was there an exit assessment for this training?		
Any other additional details you wish to provide:		
Advanced Training	
Did you complete a period of advanced specialist training? 
If yes complete the following sections	Yes/No	
Overview of Dermatology training in your country (eg governing body, structure and scope of training)		
What was the duration of the training? 		
Was there an entry requirement for this training? If yes provide details		
In what specialty/ies did you complete your training? 		
Country/ies of training:
		
Hospital/s Institution/s:		
Position title/s:
		
Name of formal training program?		
Details of rotations completed:
eg General or subspecialty clinics; adult or paediatric patients; ward reviews (numbers of patients seen by you per clinic/round)		
Details of inpatient duties:
 		
Details of continuity of care including from initial assessment to discharge and/or follow up:		
Details of on call responsibilities: 		
Details of level of supervision:		
Details of procedures performed:
eg number of excisions in first two years of training		
What in-training assessments were undertaken?		
Was there an exit assessment for this training?		
Do you have formal certification of completion of training including attainment of procedural competence, if applicable?		
Any other additional details you wish to provide:
eg Dermatopathology, skin cancer or other subspecialty experience		
professional experience since completion of training	
Key Professional Experience One	
Position Title:	Start/end date:	
Hospital/institution:
(Please specify private or public)	Country of practice: 	
Areas of expertise and/or special interest:		
Summary of role:		
Details of the nature of your professional relationships with your physician, nursing and allied health colleagues:		
Details of your inpatient and outpatient responsibilities including percentage of time spent in each:	Inpatient details	Percentage	Outpatient details	Percentage	
					
Details of your acute and non-acute responsibilities including percentage of time spent in each:	Acute details	Percentage	Non- acute details	Percentage	
					
Details of your on call responsibilities:		
Details of procedural experience if applicable		
Key Professional Experience Two	
Position Title:	Start/end date:	
Hospital/institution:
(Please specify private or public)	Country of practice 	
Areas of expertise and/or special interest:		
Summary of role:		
Details of the nature of your professional relationships with your physician, nursing and allied health colleagues:		
Details of your inpatient and outpatient responsibilities including percentage of time spent in each:	Inpatient details	Percentage	Outpatient details	Percentage	
					
Details of your acute and non-acute responsibilities including percentage of time spent in each:	Acute details	Percentage	Non- acute details	Percentage	
					
Details of your on call responsibilities		
Details of procedural experience if applicable		
Key Professional Experience Three	
Position Title:	Start/end date:	
Hospital/institution:
(Please specify private or public)	Country of practice: 	
Areas of expertise and/or special interest:		
Summary of role:		
Details of the nature of your professional relationships with your physician, nursing and allied health colleagues:	

Details of your inpatient and outpatient responsibilities including percentage of time spent in each:	Inpatient details	Percentage	Outpatient details	Percentage	
					
Details of your acute and non-acute responsibilities including percentage of time spent in each:	Acute details	Percentage	Non- acute details	Percentage	
					
Details of your on call responsibilities:		
Details of procedural experience if applicable		
Key Professional Experience Four	
Position Title:	Start/end date:	
Hospital/institution:
(Please specify private or public)	Country of practice: 	
Areas of expertise and/or special interest:		
Summary of role:		
Details of the nature of your professional relationships with your physician, nursing and allied health colleagues?		
Details of your inpatient and outpatient responsibilities including percentage of time spent in each:	Inpatient details	  Percentage	Outpatient details	Percentage	
					
Details of your acute and non-acute responsibilities including percentage of time spent in each:	Acute details	Percentage	Non- acute details	Percentage	
					
Details of your on call responsibilities:		
Details of procedural experience if applicable		
Continued medical Education 	
Is there a formal CME/CPD requirement in your current country of practice?  	Yes/No	
Name of formal CME/CPD program participating in?		
Details of formal CME/CPD program requirements:		
Have you successfully completed requirements for each year enrolled?  	Yes/No	
Recertification or revalidation	
Is there a formal recertification or revalidation requirement in your country of practice?  	Yes/No	
What are the formal recertification or revalidation requirements in your country of practice?  		
Have you successfully completed recertification or revalidation requirements?  
	Yes/No	
Details of any formal recertification or revalidation requirement for procedural skills, if relevant, including your compliance with the requirements? 		
JOb offer	

Please provide a copy of your offer of employment and position description if you have been offered a job in New Zealand.

Referee	

If you are currently practising in New Zealand please ensure one of the referees you provide for MCNZ is your supervisor or that you provide additional referee details of your current supervisor
	
Self review against the standard	
Under New Zealand law, the Medical Council of New Zealand may only register an applicant who meets the following requirements:

•       holds a prescribed qualification. A prescribed qualification is an approved medical qualification or an acceptable combination of overseas/New Zealand qualifications, training and experience; and

•       is fit for registration; and

•       is competent to practise within the relevant scope of practice.
 
The prescribed qualifications for vocational registration in Dermatology are either:

•       Fellowship of the Royal Australasian College of Physicians(FRACP); or

•       qualifications, training and experience considered by Council to be equivalent to, or as satisfactory as Fellowship of the Royal              Australasian College of Physicians. 
	
The Medical Council of New Zealand (MCNZ) will ask the Royal Australasian College of Physicians (RACP) to assess whether your qualifications, training and experience are equivalent to, or as satisfactory as Fellowship of RACP in Dermatology

To gain Fellowship of RACP in Dermatology, a New Zealand trained dermatologist will need to successfully complete the following:

•	A medical qualification from an accredited medical school

•	At least one intern year

•	Basic Training which consists of 3 years in a formal, structured, supervised training programme with multiple rotations in general or paediatric medicine as well as a variety of specialties which are completed in a variety of settings. The Basic Training programme is geared towards a postgraduate qualification and uses workplace based formative assessments. Trainees must also successfully complete both written and clinical examinations to complete Basic Training. 

•	Dermatology Advanced Training which consists of four years in a formal, structured supervised training programme. Multiple rotations in general or paediatric dermatology and selected specialty/ies in a variety of settings. Trainees must successfully complete a number of frequent formative assessments of different types, summative evaluations and a regular review of progress.

If there are differences or gaps found in your qualifications and training your professional experience since completion of training and CME/CPD will be assessed as to whether they help mitigate any differences and gaps. The following graph illustrates how your professional experience may be considered.

      Assessing qualifications, training and experience

Qualifications

Experience

Training

Completed advanced specialist training

Time

Retirement

	
Provide a self-review describing how you believe the combination of your qualifications, training and experience demonstrate your equivalency to a New Zealand trained dermatologist with Fellowship of RACP (FRACP) practising in the vocational scope of dermatology. If relevant, detail how you believe your professional experience mitigates any differences in your training. 	
Self-review: