Written, oral and other in use to assure satisfactory mastery of core knowledge:
Residents take the in-training evaluation exam of the American Board of Dermatology yearly. In addition, there is a clinical exam for all residents conducted yearly which follows the format of the Royal College examination and includes pathology. As well, the appropriate teaching staff evaluates residents during their rotations both informally and with written assessments sent to the program director. The stated goal for training is that candidates acquire clinical and technical skills and attitudes consistent with the capability for independent consultant practice. In addition to the examinations conducted above, residents are essentially examined on a weekly basis during the patient presentations when they are required to assess clinical problems and, in a public forum before their peers and teachers, formulate an opinion as to diagnosis, approach for further investigation, and treatment. The development of these clinical skills is readily apparent in this setting and it is usually very clear by the third year that the candidates are approaching consultant level.
Clinical skills are evaluated on a continual basis by the staff with whom residents are working. More formal methods are incorporated into the annual mock examinations. In addition to this, the weekly patient presentations require that the residents see the patients beforehand and then, in a public forum, defend their differential diagnosis and plan of management.
Communication skills are similarly evaluated. Residents are constantly presenting academic material or clinical opinions to their peers and teachers as well as to other consultants on other services. This is both written and verbal and that required for their academic presentation forms part of a written record. Deficiencies in presentation that would detract from consultant practice are seen relatively early and suggestions made for improvement. This is particularly apparent in the annual mock oral examinations when clarity, precision, decisiveness, and honesty are particularly important. Candidates’ tendencies to be combative are also discussed. Although assertiveness is essential, it is the view of this program that the willingness to listen to colleagues and, in particular, to deal professionally with dissenting opinions is an important and essential component of responsible consultant practice.