Supervisor’s Report
for Anatomical Pathology
Please review the Trainee’s portfolio and logbook before completing this report
Name of Trainee (please print)
RCPA ID no.
Name of organisation
Year of training
1
2
3
4
5
If >5, please specify
Training period - provide full, accurate
dates for accreditation of training
______/_____/_____ to ___/______/_______
 Full Time or
Specify hours per week employed
 Part Time
Leave (taken or planned within this
training period
Is this a pre-examination report?
 Annual
……..weeks or …….days
 Study leave
……..weeks or …….days
 Sick leave
……..weeks or …….days
 Parental/maternity
……..weeks or …….days
 No
 Yes
Name of supervisor (please print)
Leave taken by supervisor during
this training period ___ weeks
Only required for Part II examinations
Supervisor RCPA ID no.
Arrangements made for supervision of training during
period of leave
_____________________________________________
_____________________________________________
23 Feb 2016
1
Please inspect the Trainee’s portfolio and use the Table below to record the number of forms that
indicate satisfactory performance. Please also check that the portfolio includes the de-identified
laboratory reports that correspond to the forms (remove/obscure the patient name and medical
record number).
Forms and laboratory reports in the portfolio
Number in
Previous current Cumulative
total
year or
Total
rotation
Autopsies
performed
For information
Minimum prior
to Part I
adult
No minimum
paediatric or
neonatal
No minimum
Autopsy
assessment
Cut-up
Complexity 2-3
Specimens
5
4 in Year 1
2 in Year 2
1 in Year 3
1 in Year 4
1 in Year 5
No minimum
4
No minimum
20
No minimum
20
5
Total 10
(inc. those for
Part 1)
5 per year
Total of 50
(incl those for
Part I)
No minimum
50 gynae & 50
non-gynae incl.
10 FNA
3 months
No minimum
Period spent
Clinical
meetings +
case lists
10 per year
Safety
checklist
Total of 50
(incl those for
Part I)
1 only
Previous
supervisor’s
reports
23 Feb 2016
10
1
Complexity 4
Complexity
levels - see
Complexity 5-7
Appendix 8
Histochemical
stains
Surgical cases
Complexity < 5
+ de-identified
laboratory
Complexity = or >5
reports
Synoptic
reports
Frozen
sections + deidentified
laboratory
reports
Cytology +
de-identified
laboratory
reports
Minimum for
Part II preexam
Supervisor’s
report
all
2
all
Please inspect the Trainee’s logbook and use the Table below to record the number of cases logged.
Cases recorded in the logbook
Number in
current
year or
rotation
Previous
total
Cumulative
Total
Surgical cases
Immuno techniques
EM
Molecular techniques
Minimum for
Part I pre-exam
Supervisor’s
report
No minimum
No minimum
No minimum
No minimum
Minimum for
Part II pre-exam
Supervisor’s
report
3000
No minimum
No minimum
No minimum
Professional qualities: e-Learning modules
Date completed
Please specify whether RCPA module or workplace training
Cultural competence
Ethics
Management
Quality
Please inspect the Trainee’s portfolio use the Table below to record completion of the required
number/type of items providing evidence of personal professional development (PPD).
Personal professional development
Previous
total
Number in
current
year or
rotation
Cumulative
Total
Minimum for
Part I pre-exam
Supervisor’s
report
Minimum for
Part II pre-exam
Supervisor’s
report
A TOTAL OF EIGHT (8) ITEMS MUST BE SUPPLIED
Category A
Published article or
submitted manuscript
Oral paper – national or
international meeting
Poster - national or
international meeting
Formal research proposal
No minimum
Minimum 2 items
but up to eight (8)
can be included,
of which only one
(1) can be a
research proposal
Category B – only required if fewer than eight (8) Category A items
Oral presentation at
hospital or regional mtg
Written report of audit
activity
Written report of complex
case
Teaching session
No minimum
Maximum 2
No minimum
Maximum 2
No minimum
Maximum 3
No minimum
Maximum 2
For pre-examination supervisor’s reports:
Does the print-out of the portfolio summary spreadsheet accurately record the contents of the portfolio?
Yes
23 Feb 2016
No
3
Please score the Trainee’s performance using this scale
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.
Score
(1-5)
Microscopy
Quality of descriptions and ability at histological diagnosis
Knowledge and use of appropriate ancillary techniques (eg, special stains, immunochemistry)
Quality of clincopathological correlation
Professional attitudes and behaviours
Work organisation: time management, reliability, ability to prioritise, follow up, complete tasks
Ability to follow supervisor’s instructions
Awareness of own limitations - consults when needs help, receptive to feedback & other views
Confidence and initiative
Attention to professional confidentiality, ethical standards, medico-legal obligations
Able to critically analyse current literature
Interactions with others (peers, seniors, clerical and laboratory staff, supervisor, clinicians)
Presentations at clinical meetings, eg, grand rounds, clinical meetings
Involvement in teaching and/or supervision
Research (where applicable)
Knowledge of basic and clinical research
Capacity to analyse published research including statistical analysis
Knowledge of special research techniques
Ability to prepare manuscript
23 Feb 2016
4
Overall evaluation
Areas of strength in professional practice (please summarise)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Areas for development in professional practice (please summarise)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Is specific further professional development required? If yes, please outline process
Yes
No
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
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.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Other comments
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
23 Feb 2016
5
Signatures
Trainee
(please PRINT name and sign)
RCPA Supervisor
Date
Date
(please PRINT name and sign)
Other senior staff member/second Supervisor (if applicable)
Date
(please PRINT name and sign)
Head of Department
Date
(please PRINT name and sign)
Comments by trainee:
Signature
Registrar/Deputy Registrar, Board of Censors
23 Feb 2016
Date
6