Dermatology CESR Portfolio Guide

• Aware of, and adheres to, the GMC professional requirements
• Aware of public health issues including population health, social determinants of health and global health perspectives
• Demonstrates effective clinical leadership
• Demonstrates promotion of an open and transparent culture
• Keeps up to date through learning and teaching
• Demonstrates engagement in career planning
• Demonstrates capabilities in dealing with complexity and uncertainty
• Aware of the role and processes for commissioning
• Aware of the need to use resources wisely

• Aware of national legislation and legal responsibilities, including safeguarding vulnerable groups
• Behaves in accordance with ethical and legal requirements
• Demonstrates ability to offer apology or explanation when appropriate
• Demonstrate ability to lead the clinical team in ensuring that ethical and legal factors are considered openly and consistently

• Communicates clearly with patients and carers in a variety of settings
• Communicates effectively with clinical and other professional colleagues
• Identifies and manages barriers to communication (e.g. cognitive impairment, speech and hearing problems, capacity issues)
• Demonstrates effective consultation skills including effective verbal and non-verbal interpersonal skills
• Shares decision making by informing the patient, prioritising the patient’s goals and wishes, and respecting the patient’s beliefs, concerns and expectations
• Shares decision making with children and young people
• Applies management and team working skills appropriately, including influencing, negotiating, re-assessing priorities and effectively managing complex, dynamic situations

• Makes patient safety a priority in clinical practice
• Raises and escalates concerns where there is an issue with patient safety or quality of care
• Demonstrates commitment to learning from patient safety investigations and complaints
• Shares good practice appropriately
• Contributes to and delivers quality improvement
• Understands basic Human Factors principles and practice at individual, team, organisational and system levels
• Understands the importance of non-technical skills and crisis resource management
• Recognises and works within limit of personal competence
• Avoids organising unnecessary investigations or prescribing poorly evidenced treatments

• Manages clinical information / data appropriately
• Understands principles of research and academic writing
• Demonstrates ability to carry out critical appraisal of the literature
• Understands the role of evidence in clinical practice and demonstrates shared decision making with patients
• Understands public health epidemiology and global health patterns
• Demonstrates appropriate knowledge of research methods, including qualitative and quantitative approaches in scientific enquiry
• Demonstrates appropriate knowledge of research principles and concepts and the translation of research into practice
• Follows guidelines on ethical conduct in research and consent for research
• Recognises potential of applied informatics, genomics, stratified risk and personalised medicine and seeks advice for patient benefit when appropriate

• Delivers effective teaching and training to medical students, junior doctors and other healthcare professionals
• Delivers effective feedback with action plan
• Able to supervise less experienced trainees in their clinical assessment and management of patients
• Able to supervise less experienced trainees in carrying out appropriate practical procedures
• Able to act as a clinical supervisor to doctors in earlier stages of training

• Demonstrate professional behaviour with regards to patients, carers, colleagues and others
• Demonstrates effective consultation skills
• Demonstrates high level clinical skills and use of appropriate investigational tools to establish dermatological diagnoses in secondary care
• Demonstrates appropriate use of assessment tools with regards to disease severity and impact on quality of life (e.g. PASI, EASI, MASI, PEST, HiSCR, DLQI)
• Demonstrates understanding of dermatopathology and laboratory techniques, ensuring appropriate investigation and clinicopathological correlation as necessary
• Formulates and explains an appropriate management plan, taking into account patient preferences with focus on patient-centred care and shared decision making
• Practices holistically in understanding psychosocial impact and mental health issues relating to dermatological disease
• Liaises with other specialty and primary care services when appropriate
• Demonstrates ability to supervise multidisciplinary and multi-professional teams to deliver outpatient dermatology service
• Demonstrates appropriate awareness of comorbidities and complex medical disease in relation to patients’ dermatology conditions to enable holistic patient management, including how inflammatory skin diseases affect patients systemically e.g. severe psoriasis associated with cardiovascular disease
• Demonstrates understanding of and follows local and national guidelines and clinical trial protocols
• Demonstrates safe and effective prescription, management and monitoring of advanced systemic dermatological therapeutics such as immunomodulators, immunosuppressants, biologics, antimalarials, and retinoids, as well as topical therapy
• Demonstrates awareness of the role of research (including immunological research) in understanding and management of dermatological disease
• Demonstrates efficient time management skills in the general secondary outpatient clinic (indicative numbers 5 new and 8 review patients per clinic at end of training) and ability to discharge appropriately
• Shows awareness of patient journey and appropriate grading of referrals, ensuring patients are seen at the right place and right time
• Demonstrates understanding of importance of clinical and educational

• Demonstrates professional behaviour with regards to patients, carers, colleagues and others
• Demonstrates prompt assessment and safe management of common and rare dermatological emergencies encountered in all settings
• Demonstrates good clinical judgement and appropriate telephone advice to colleagues on management of dermatologic disease
• Demonstrates appropriate dermatological management of inpatients under the care of other specialties
• Formulates and explains an appropriate diagnostic and management plan, taking into account level of urgency and clinical risk
• Demonstrates appropriate understanding of investigational tools and dematopathology required in the acute setting with recognition of need for clinicopathological correlation as necessary
• Demonstrates clinical leadership, complex decision-making and risk management to ensure safe, effective, holistic and timely care for patients
• Demonstrates effective telephone and teledermatology assessment and triage of referrals from GP and other specialties
• Demonstrates understanding of and follows local and national guidelines and clinical trial protocols
• Delivers patient-centred care including shared decision making
• Appropriate management of dermatology inpatients with common and rare skin disease, including management of related or unrelated medical comorbidities
• Provides clinical leadership and good team working skills with dermatology inpatients, including those with complex medical conditions
• Recognises the need to liaise with other specialty services where appropriate
• Recognises and manages the deteriorating patient and refers appropriately to intensive care or high dependency unit
• Demonstrates safe prescription and delivery of specialist dermatological treatments, with recognition and management of complications
• Ensures continuity of patient care through appropriate transfer of information with safe and effective handover and discharge planning

• Demonstrates professional behaviour with regards to patients, carers, colleagues and others
• Demonstrates ability to deliver holistic dermatology care across the primary-secondary care interface with understanding of leadership and management of teams of allied health professionals
• Understands and takes into account psychosocial impact and mental health issues relating to dermatological disease
• Able to communicate with primary care teams appropriately with understanding of what primary care can offer
• Demonstrates effective telephone and teledermatology assessment with triage of referrals from GPs and multi-professional colleagues
• Demonstrates appropriate telephone advice to colleagues for diagnosis and management of dermatologic disease
• Recognises need for escalation from primary to secondary care for dermatological conditions
• Demonstrates engagement with public health issues relating to dermatological disease and promotion of skin health
• Understands issues relating to migrant populations and delivery of dermatological care in areas with poor resource
• Demonstrates safe prescribing and monitoring of topical and systemic therapies using shared-care protocols

• Able to diagnose and manage primary malignant disease of the skin including common and rare tumours, using the dermatoscope as appropriate
• Able to diagnose and manage benign tumours of the skin and its appendages including common and rare lesions, using the dermatoscope as appropriate, thus avoiding unnecessary procedures
• Able to accurately assess loco-regional and metastatic skin cancer and manage with a multi-professional approach
• Able to identify, assess and effectively manage high risk skin cancer patients, e.g. immunosuppressed patients, dysplastic naevus syndrome, genodermatoses
• Demonstrates understanding of skin cancer prevention and screening
• Follows local and national guidelines and clinical trial protocols
• Understands non-surgical methods of skin cancer management e.g. radiotherapy dermoscopy, photography, CT or MRI scans
• Demonstrates professional behaviour with regards to patients, carers, colleagues and others
• Delivers patient-centred care including shared decision making
• Demonstrates effective consultation skills including challenging circumstances and breaking bad news
• Ability to lead and work collaboratively within a skin cancer multidisciplinary team containing allied surgical specialties, oncologists, radiologists, histopathologists
• Able to effectively manage an outpatient skin cancer 2 week wait clinic, including appropriate triage and discharge (indicative number: 15 new patients per clinic by end of training, when trainee reviewing patients without personally performing surgical procedures)
• Understands advanced topical and systemic medical management of skin cancer, including immunotherapy and signalling pathway inhibitors
• Safe and effective prescription, management and monitoring of dermatological medical therapeutics relating to skin cancer and pre-cancer
• Demonstrates ability to supervise multidisciplinary and multi-professional teams to deliver outpatient dermatology 2 week wait service

• Understands clinical differential diagnoses prior to skin surgery to optimise care
• Understands indications for full scope of dermatology surgical procedures
• Able to appropriately perform surgical diagnostic procedures safely e.g. punch, shave, simple excision
• Demonstrates knowledge of dermatopathological issues underpinning diagnostic biopsy to maximise outcome
• Able to perform appropriate surgical procedures for skin cancer management e.g. wide excision.
• Demonstrates compliance with national guidelines on excision margins
• Understands indications for advanced surgical procedures e.g. Mohs micrographic surgery, flaps and graft repairs
• Able to obtain valid consent, including understanding of capacity
• Able to manage post-operative care, wound healing and complications
• Able to perform cryotherapy for benign and precancerous or malignant lesions appropriately
• Demonstrates ability to lead team delivering a surgical dermatology service
• Understands use of laser therapy in dermatological disease and refers appropriately
• Understands cosmetic dermatological procedures and can provide evidence-based counselling
• Can diagnose complications from nonsurgical cosmetic procedures and counsel appropriately

• Demonstrates professional behaviour in relation to paediatric patients and their carers
• Demonstrates ability to take relevant paediatric history from patients and their carers
• Able to diagnose and manage the same range of common and rare dermatologic disease in children as are found in adults, with the exception of occupational dermatoses
• Able to diagnose and manage common and rare conditions unique to neonatal, infant and paediatric population such as genodermatoses, congenital lesions, infectious disease
• Able to triage and prioritise urgency of skin disease in paediatric population, escalate care when required and discharge appropriately
• Formulates and explains an appropriate management plan, taking into account patient and family preferences with focus on patient-centred care and shared decision making
• Shows safe and effective prescription, management and monitoring of topical and advanced systemic dermatological therapeutics in children with understanding of evidence for off-license use
• Demonstrates understanding of and follows local and national guidelines and clinical trial protocols
• Demonstrates appropriate understanding of dematopathology and laboratory techniques with clinicopathological correlation as necessary
• Demonstrates appropriate use of assessment tools with regards to normal development, disease severity and impact on quality of life
• Understands and takes into account psychosocial impact and mental health issues relating to dermatological disease in paediatric patient
• Demonstrates ability to identify vulnerable children and engage in appropriate safeguarding
• Demonstrates appropriate liaison with primary care and paediatric services
• Demonstrates appropriate communication skills, sensitivity and professional behaviour towards paediatric patients, carers and multidisciplinary team

• Ability to select patients appropriately for cutaneous allergy investigation
• Ability to perform standard contact dermatitis investigations appropriately including allergen selection, test interpretation and communication of avoidance advice
• Ability to diagnose and manage all forms of urticaria including use of advanced therapeutics e.g. biologics
• Ability to refer patients with cutaneous allergy appropriately for tertiary care

• Ability to counsel and select patients appropriately for phototherapy and photochemotherapy
• Ability to supervise safe and appropriate delivery of phototherapy and photochemotherapy by allied health professionals
• Ability to counsel and select patients appropriately for photodynamic therapy
• Ability to supervise safe and appropriate delivery of photodynamic therapy by allied health professionals
• Ability to diagnoses and manage photosensitive dermatological disease
• Ability to refer photosensitive disease appropriately for tertiary care

• Ability to diagnose and manage common and rare genital or oral dermatological disease, including premalignancy and malignancy
• Recognises normal and anatomical variants relating to genitalia and oral cavity
• Ability to diagnose and manage cutaneous disease with oral and mucosal manifestations
• Demonstrates understanding of patient confidentiality issues and psychosocial impact of genital and mucosal dermatological disease
• Ability to refer genital and mucosal dermatological disease appropriately for tertiary care
• Ability to liaise with multidisciplinary specialists appropriately
• Understanding of dermatopathology and clinicopathological correlation

• Ability to diagnose and manage common and rare diseases of the hair and nails
• Ability to diagnose and manage cutaneous disease with skin and hair manifestations
• Understanding of dermatopathology and clinicopathological correlation
• Ability to refer appropriately for tertiary care

Currency Window

Evidence of your recent practice will be given more weight to reflect current capabilities and we suggest that approximately 50% of your evidence for a curriculum outcome is drawn from within the last five years of clinical practice (WTE).

Evidence Volume

around 100 electronically uploaded documents