APPLICATION FOR ACCREDITATION OF LABORATORY
FOR TRAINING CANDIDATES IN ORAL AND MAXILLOFACIAL PATHOLOGY
Please refer to policies when preparing your application. All information will be treated with strictest
confidence by the Board of Education and Assessment (BEA)
Note: No application will be considered without the following:
(1) Attachment of a Training Program with detail of progression through the 5 years of training.
(2) Detail of how competency will be maintained in areas not adequately covered in the training
lab.
Please complete all sections of this form, sign and return to College.
Lab Name:
Address:
Area Health Service /
District Health Board
(if applicable):
Telephone (switch):
Fax:
Contact person for
application?
Date:
Email:
Telephone
(direct):
RCPA ID No (if applicable – refer to RCPA lab accreditation letter):
Director / Departmental Head
of Laboratory Service:
If applicable, Director/Head of
Oral and Maxillofacial
Pathology Laboratory Service
Accreditation (NATA, IANZ, IS015189)
Is the Oral and
Maxillofacial Pathology
Diagnostic Laboratory
accredited?
Current accreditation period
Accreditation agency?
From:
External proficiency program(s)
List program(s) that the laboratory currently
participates in (RCPA/ QAP; EMQN; CAP; etc)
Document Number:
1
Document Name: Oral and Maxillofacial Lab Accreditation Application form
Document Path: BOC - Lab accreditation - Forms - Current Accreditation application forms
To:
Supervision
Supervisor(s) of Trainees
(if shared supervision, please
indicate primary supervisor)
Number of funded EFT Pathologist positions with the Oral and Maxillofacial
Pathology Laboratory Service
Pathologists, with their qualifications, contributing to the training program
(add extra lines if required)
Name
Qualifications
Scope(s) of
practice
Date of
appointment
% of week
in
laboratory
Other medically qualified staff providing essential training (add extra lines if required)
Name
Qualifications
Areas of expertise
Date of
appointment
% of week
in
laboratory
Senior Scientific and Tech staff contributing to Trainee supervision (add extra lines if required)
Name
Qualifications
Area of technical expertise
NOTE: The RCPA should be informed of any periods of extended absence, long service leave or sick leave of the
Document Number:
2
Document Name: Oral and Maxillofacial Lab Accreditation Application form
Document Path: BOC - Lab accreditation - Forms - Current Accreditation application forms
supervisor/s. To ensure ongoing continuity of training the RCPA must be informed of the relief arrangement.
Oral and Maxillofacial Pathology Trainees
Please indicate the number of
trainees you wish to accommodate
at any one time
Duration of Training considered
appropriate (in years)?
Please note It is College policy to limit
training in one institution* to a
maximum of four years.
Number of current trainees
Total no. trainees over past 5 years
Summary details of current and past trainees exposed to Oral and Maxillofacial Pathology training
Name
Year
training
started
Discipline
Duration of
training?
Training facilities
Comments (if applicable)
Professional Journals/ Library
Computer/ Internet facilities
Other (e.g. learning and
teaching aids, etc)
Laboratory workload
Number of Oral and Maxillofacial Pathology Reports per annum:
Number of Oral Cytology Reports per annum:
Number of Consultation Cases per annum:
Number of Anatomical Pathology Reports per annum:
Number of frozen sections per annum:
Number of autopsies per annum or explanation of access, to
autopsy pathology & autopsy procedures & interpretation:
Adult
Child
Perinatal
Coronial
Document Number:
3
Document Name: Oral and Maxillofacial Lab Accreditation Application form
Document Path: BOC - Lab accreditation - Forms - Current Accreditation application forms
Exam progress?
Number of Cytology Reports per annum:
Gynaecological
Other
*To ensure that candidates for RCPA qualifications are exposed to more than one style and
philosophy of pathology practice, they are ordinarily limited to spending a maximum of 4 years
training in one laboratory. Where the same members of a pathology service/practice supervise
geographically separate laboratories, this may be viewed as training undertaken in a single
laboratory and may not fulfil the College requirements for employment in a different institution
unless significant differences in practice and supervision can be demonstrated.
To assist the College in monitoring the above policy, please list all regular rotation arrangements
below, specifying whether they are internal or external (i.e. to an operationally distinct service or
geographically separate site with different management, practice and supervision). Please note
that if Trainees participate in an external rotation, that site is required to be separately accredited.
Discipline
Site
Type of Rotation
Internal
External
Internal
External
Internal
External
Internal
External
Internal
External
Internal
External
Purpose of Rotation
Please indicate any additional areas listed under the discipline check lists in the Trainee Handbook
for which your laboratory is unable to provide training on site. Please state how these areas
are/will be covered.
Signature: ________________________________________ Date: _____________________
Completed application forms, together with all relevant training programs and other supporting
documentation, should be forwarded to the Registrar at the Royal College of Pathologists of
Australasia. You will be advised of your accreditation status following the next meeting of the
Board of Education and assessment (BEA)/ and or determination by the Chief Examiner.
Email to lab@rcpa.edu.au fax to +61 2 8356 5828 or mail to RCPA, 207 Albion Street, Surry Hills
NSW 2010 Australia.
Thank you for your support of pathology training.
Document Number:
4
Document Name: Oral and Maxillofacial Lab Accreditation Application form
Document Path: BOC - Lab accreditation - Forms - Current Accreditation application forms
PLEASE NOTE THAT YOUR APPLICATION WILL NOT BE
ACCEPTED WITHOUT A TRAINING PROGRAM
Document Number:
5
Document Name: Oral and Maxillofacial Lab Accreditation Application form
Document Path: BOC - Lab accreditation - Forms - Current Accreditation application forms