Professional Certificate of Skin Cancer Medicine

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The course is delivered fully online with the option to attend a practical workshop. The modules are set up in such a way that you are not required to be online at specific times but can view and replay video lectures at your convenience. The suggested timeline is weekly learning over 15 weeks, with 12 weeks of teaching followed by the submission of required activities.  There are no face-to-face requirements for exams which can be conveniently completed online.

Course Outline

Module 1 – The foundations

Unit one introduces the foundation information required for skin cancer medicine and outlines the content of the module.

Unit two describes the BEST protocol (BEnign or Suspicious Test) and divides lesions into benign or suspicious with guidelines and clinical images of pigmented skin lesions. Benign lesions require no action and suspicious lesions require biopsy or referral. A quiz with clinical and dermoscopic images to select benign or suspicious lesions is provided, with contextual answers as part of this unit.

This unit discusses the importance of skin checks and commences with a table dividing assessment of skin cancer risk into three categories: high, medium and low risk and includes patient self-examination and opportunistic skin check. The unit describes how to perform a skin examination and necessary information including lesion history, general medical history, allergies and current medications. The unit includes a video of a systemic total skin examination.
This final unit describes partial and complete punch and shave biopsy techniques. The unit concludes with a patient case showing cylindrical portion of skin bearing a dark pigmented surface for which biopsy is recommended. The pathology report is provided as the lesion was partially excised and sent for examination.

Module 2 – Pigmented skin lesions

Unit one discusses common benign lesions including freckles, solar lentigo, seborrheic keratosis, haemangioma, dermatofibroma and blue nevi. Normal and dermoscopic clinical images are provided to demonstrate patterns and assists with analysis. Benign lesions can mimic skin cancers and careful examination is required to decide the management steps. The signs of common benign lesions that may be skin cancer are discussed in detail. A medico-legal case is included for a patient where a melanoma was masquerading as a benign lesion.

Unit two begins with the description of dermoscopy including examples of dermoscopic devices used for this technique. The 3-point checklist consists of asymmetry in colour or structures, atypical network and blue-white structures (white scar-like depigmentation or blue pepper-like, globular or structure-less areas), showing various clinical dermoscopic images of lesions.

This unit covers dysplastic nevi and melanoma. A table is shown of the relationship between nevus, dysplastic nevus and melanoma and includes a table of relative risk factors for melanoma. Several types of melanomas and treatment options are listed and supported by clinical images. The unit concludes with key points for detecting benign or suspicious lesions.

Module 3 – Non-pigmented skin cancer lesions

This unit starts with a clinical description of solar keratosis and outlines treatment options including field treatment. Attention is also paid to Bowen’s disease (a very early form of skin cancer), including symptoms, diagnosis (punch biopsy) and treatment. Dermoscopic images of both conditions are provided.

This unit describes keratocanthoma, a low-grade malignancy that requires a deep incision biopsy and also discusses squamous cell carcinoma, a common cancer due to chronic, cumulative, sun exposure. Treatment options include surgery, curettage and cautery, specialist referral or radiation therapy. Clinical images of both conditions are provided.

Unit three describes basal cell carcinoma, the most common human cancer due to intermittent excessive sun exposure. BCC can be classified as non-aggressive (superficial, nodular) or aggressive (sclerosing/infiltrating/ micronodular/multifocal/solid). Diagnosis and treatment options and clinical images of the different types of basal cell carcinoma are included.

Module 4 – Dermatopathology

This module assists the medical practitioner in the best approach to pathology requests and how to interpret pathology reports. This unit list the steps that occur when a skin sample is sent for pathology testing. The module then continues with images of pathology processing of a punch, shave or excision biopsy. The report interpretation is discussed, including interobserver agreement, clues to pathologist uncertainty, reconciliation of unexpected results, assessment of margins and errors that occur in dermatopathology.

Module 5 – Topical treatments/medico-legal issues

This unit describes topical treatments, the (contra-)indications and dose of Imiquimod 5% cream used for treating superficial basal cell carcinomas, and 5-fluorouracil (5-FU) 5% cream used for preventing and treating SCC and Bowen’s disease. A table of topical treatment regimens in primary care for solar keratosis is provided. An extensive list of tips including cost, pre-treatment and patient-education is provided. The unit looks at different treatment options for solar keratosis. Clinical images of lesions at the initiation visit, during and after topical treatment are shown.

Medico-legal tips and resources are listed in unit two. The importance of detailed medical record keeping, follow up and recall systems and patient consent are included. The unit concludes with a medico-legal case of a middle-aged man with a past medical history of non-melanoma skin cancer, the resulting investigation and the problems in how the case was managed that resulted in medico-legal action.

Module 6 – Preparation for surgical treatment

The first unit outlines the fundamental principles when preparing for and performing skin cancer surgery. The fundamentals include an aseptic approach using sterile equipment, sutures and dressings and emphasizes the importance of clean skin, operator and environment. The unit then looks at local anaesthetics and haemostasis. Equipment for wound closure and sutures are listed including the fundamentals of closing the defect. Recommended suture removal times and the suture techniques, use of prophylactic antibiotics and anticoagulants conclude this unit.

Unit two describes the punch and shave biopsy and includes a video and clinical images of these procedures.

Module 7 – Excision and repair

Unit one lists the instruments used for wound closure and sutures used for skin closure, including suture technique and removal times. Drawings and description of the simple interrupted suture are discussed, including a recording of this procedure.

Unit two emphasizes the importance of using an absorbable suture and shows drawings of a conventional buried dermal suture. The unit concludes with a recording of this procedure.

Unit three the preparation for an elliptical excision, including placement of excisions for the best cosmetic result. It outlines the steps leading to performing the ellipse including surgical marking up. The procedure is described, illustrated by drawings of the incision considering maximal skin tension lines and fusiform excision lines. The unit concludes with a video of this procedure.

Module 8 – Medicare billing

Unit one commences with a list of billings items and has a quick reference card of skin cancer item number guide.

Unit two details what is included in each applicable procedural item number and describes the multiple services rule as well as bulk billed fee for a procedure. Billing of punch and shave biopsy are explained as well as non-surgical procedures including cryotherapy (benign or pre-malignant), serial curettage and lesion removal, considering site, size and type. The unit concludes with billing of post operative care and treatment after a procedure.

Additional information: Workflow management

Part one describes an efficient process for diagnosing and treating skin cancer in a general practice. A suggested basic skin cancer workflow plan is listed that includes an appointment system, dividing consults and procedures and maximising operational efficiency and minimising time wastage.

Part two describes how to set up your facility. Consulting room requirements are listed, including essential examination tools and equipment for skin cancer medicine. This includes patient information sheets, consent forms and brochures for topical preparations.

The final part summarises how to efficiently prepare to incorporate skin cancer medicine into a clinic.

COURSE INCLUSIONS

For your one-off investment, you will receive unlimited access to all course content, additional learning materials, ongoing post-course support and more.

• Online pre-course activity to be completed in your own time.
• Eight online video modules to be viewed, replayed and completed at your convenience.
• All presentation slides and further learning materials available for permanent access and download.
• Instruments and consumables for practical sessions in the optional practical workshop.
• Post-course online assessment to be completed in your own time within six months of the course start date.
• Ongoing post-course support in monthly webinars with the opportunity to discuss cases with course presenters.
• Access to the HealthCert Community with additional free learning opportunities, special offers and other benefits.

If you choose to attend the optional practical workshop and there is cause for postponement or you cannot travel due to Covid-19 restrictions, full workshop refund, transfer or alternative learning opportunities will be available for you. View full refunds and cancellation policy here.

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