Supervisor’s Report for Trainees in General Morphological Pathology
Information for Trainees and Supervisors
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It is the Trainee’s responsibility to ensure that this form is completed and submitted by the due
date. Failure to do so may jeopardise the accreditation of training time or finalisation of
examination results.
At least one Supervisor’s Report is due annually for all Trainees.
For Trainees who participate in rotational programs, one report should be completed for each
period of rotation at a different institution.
For Trainees sitting for Part I or Part II examinations, an additional pre-exam report is due by
15 July. Reports must be available for consideration at the viva examinations.
For all other Trainees, the Report must be submitted every year or, for rotations within a year, on
completion of each rotation. If the Trainee is not taking an examination, the annual Report may
be submitted with the annual registration for the subsequent year.
Trainees are advised to keep accurate records of work undertaken for the period of time spent in
each category of activity. A log book is an effective way in which this can be achieved. If precise
figures are unavailable, a best estimate should be given.
Trainees must keep a copy in their Training Portfolio of each year’s completed report. Please do
not contact the College for the previous year’s report.
Completing the form
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It is desirable that all specialists who supervise Trainees participate in the evaluation process and
completion of the form.
Supervisors are asked to rank the performance in each area of activity even if the time spent in it
is small. If there has been no exposure to a particular activity please write “Not Applicable” across
the space allocated for ranking.
Performance for skills in each area of training listed in the form should be assessed on a sliding
scale of 1 to 5 as indicated below.
1 = Performance currently falls far short of expected standards for level of training.
There is a serious problem that may have implications for accreditation of the current training
period. The problem must be stated clearly on the final page.
2 = Performance currently falls short of expected standards for level of training.
There is an area of lower than expected performance. The problem must be stated clearly on
the final page.
3 = Performance is consistent with the expected level of training.
About 80% of trainees will merit this grade.
4 = Performance is better than expected for level of training.
About 10% of trainees will merit this grade.
5 = Performance is exceptional.
Very few trainees will merit this grade.
Please return this form by the due date above, by mail to:
The Royal College of Pathologists of Australasia
207 Albion Street
Surry Hills NSW 2010 AUSTRALIA
Faxed reports will not be accepted.
Thank you
February 2016
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THE ROYAL COLLEGE OF PATHOLOGISTS OF AUSTRALASIA
Supervisor’s Report for Trainees in General Morphological Pathology
Name of Trainee (Please print): ____________________________________ RCPA ID No _______
Organisation: _____________________________________________________________
Year of Training:
1
2
3
4
5
6
7
Training Period:
______/______/__________ to ______/______/__________
(Please provide full and accurate dates for accreditation of training)
Full Time  or Part Time  ……………… hours per week
Leave (taken or planned within this training period
Annual ……… weeks/days
Other ……… weeks/days (eg. Sick, Study, Parental, Maternity)
Sitting for RCPA examination this year?
No
Yes
If yes:
(Please tick)
General Clinical
General Morphology
Please see key on Page 1
A.
KNOWLEDGE BASE AND SKILLS
AUTOPSY PATHOLOGY
1.
No. of autopsies done:
During assessment period: Adult: _________ Paediatric and Neonatal:________
Cumulative total:
Adult: _________ Paediatric and Neonatal:________
1
3
4
5
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Autopsy clinicopathological correlation
____
____
____
____
____
Ability to summarise relevant clinical
information and laboratory data
____
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____
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6.
Verbal presentation of autopsy findings
____
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7.
Ability to complete reports within period
specified by Departmental policy
____
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8.
Knowledge and use of special stains
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2.
Quality of autopsy techniques and
detailed dissection of organs
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Quality of written reports (gross, micro,
final diagnosis)
4.
5.
3.
February 2016
2
2
SURGICAL PATHOLOGY
1.
2.
ESTIMATE OF NUMBER OF BIOPSY
CASES REPORTED
1.1
During assessment period
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1.2
Cumulative total:
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FROZEN SECTIONS
2.1
During assessment period:
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2.2
Cumulative total:
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1
3.
4
5
Selection of blocks for frozen sections
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2.4
Ability to make diagnosis
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2.5
Communication with surgeons
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2.6
Ability to cut and stain frozen sections
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3
4
5
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GROSS SPECIMENS
3.1
February 2016
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2.3
1
4.
2
Gross description and block selection
2
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MICROSCOPY
1
2
3
4
5
4.1
Quality of description
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4.2
Ability at histological diagnosis
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4.3
Knowledge and use of appropriate
ancillary techniques (eg., special stains,
immunohistochemistry)
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4.4
Follow-up and completion of assigned task ____
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4.5
Quality of clinico-pathological correlation
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3
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CYTOLOGY
1.
2.
3.
Number of fine-needle aspirations (FNAs) performed and reported:
1.1
During assessment period
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1.2
Cumulative total
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1
2
Knowledge and use of cytological
preparatory techniques and their interpretation
(eg., cytospins, filters, cell blocks)
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Knowledge of criteria for satisfactory
and unsatisfactory specimens
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3
4
5
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4.
Interpretive skills for exfoliative cytology
(eg., cervical smear interpretation)
5.
Performance and interpretative skills for
FNAs
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Knowledge and use of appropriate special stains
and special techniques (eg., immuno, EM)
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7.
Follow-up and completion of assigned tasks
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8.
Knowledge of clinical-cytopathological
correlation, clinical relevance of diagnosis,
appropriate follow-up required
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1
2
3
4
5
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1
2
3
4
5
6.
OTHER
1.
Electron microscopy: applications, techniques,
interpretation
RESEARCH (where applicable)
1.
Knowledge of basic and clinical research
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2.
Capacity to analyse published research
Including statistical analysis
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3.
Knowledge of special research techniques
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4.
Ability to prepare manuscript
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February 2016
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GENERAL REMARKS
1
2
3
4
5
1.
Organisational skills
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2.
Presentation at clinical meetings (eg., grand rounds)
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3.
Knowledge of current literature
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4.
Knowledge of laboratory management
and safety, and quality assurance
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5.
Attention to professional confidentiality
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B.
PROFESSIONAL ATTITUDES
1
2
3
4
5
1.
Interactive skills with:
1.1
Peers
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1.2
Supervisors
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1.3
Clerical and laboratory staff
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1.4
Clinicians
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2.
Confidence and initiative
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3.
Reliability
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4.
Ability to follow supervisor instructions
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5.
Does the trainee consult
appropriately when he or she needs help?
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6.
Is the trainee receptive to new ideas?
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Completion of professional qualities e-Learning modules ((please specify whether RCPA
online module or workplace training)
•
Cultural competence
date completed ………….………………………………..
•
Ethics
date completed ………….………………………………..
•
Management
date completed ………….………………………………..
•
Quality
date completed ………….………………………………..
February 2016
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C.
OVERALL EVALUATION
Areas of strength in professional practice
(Please summarise)
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
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Areas for development in professional practice
(Please summarise)
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Is specific further professional development required?
Yes
No
If yes, please outline process: _____________________________________________
______________________________________________________________________
______________________________________________________________________
If a score of 1 or 2 is given please identify any specific issue that needs to be addressed with
respect to the trainee’s progress and/or the training environment. In this case the form must
be signed by the supervisor plus at least one senior colleague and a plan for
remediation attached.
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
February 2016
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OTHER COMMENTS
(if insufficient space, please attach sheet)
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
COMMENTS BY TRAINEE:
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
______________________________________________________________________
Signatures
Trainee
(please PRINT name and sign)
RCPA designated supervisor
(please PRINT name and sign)
Other senior staff member/second Supervisor (if applicable)
(please PRINT name and sign)
Head of Department
(please PRINT name and sign)
Registrar/ Deputy Registrar Board of Censors
February 2016
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Date
Date
Date
Date
Date