Guidelines

HKCP Higher Physician Training in Dermatology and Venereology Guideline (Chan et al 2025, p.95-100)

I) OBJECTIVES

To provide a broad training, in-depth and updated experience at a level sufficient for trainees to acquire competence and professionalism required of a specialist in Dermatology and Venereology.
To enhance knowledge, clinical skills and procedural competence in Dermatology & Venereology.
To acquire professional competence in training future trainees in Dermatology & Venereology.

II) STRUCTURE

This period consists of a minimum of three years of supervised and accredited training in Dermatology and Venereology.
1. In the three years, the trainee should undergo a minimum of 24 months’ full-time dermatology training in a College-accredited Dermatology & Venereology training institute and a minimum of 6 months’ full time venereology training in a College accredited Dermatology & Venereology training institute. The remaining six months are dedicated to full-time dermatology and/or venereology training or the training detailed in 1.2 below. The trainee should also undergo a minimum of 6 months training in hospital-based dermatology.
2. A maximum of 3 months may be accredited for full-time supervised training or research in a College-accredited institute, or a local or an overseas institute considered by the Specialty Board to be of an equivalent standard, in Leprosy, Dermatopathology, Dermatosurgery, HIV medicine, Aesthetic Dermatology, Allergy, Occupational Dermatology or other specialties which are considered to be relevant by the Specialty Board of Dermatology & Venereology. Prior approval from the Specialty Board must be obtained by the Higher Physician Trainee in Dermatology & Venereology.
Apart from single specialty training in Dermatology and Venereology as stated above, the Higher Physician Trainees in Dermatology and Venereology may also undergo dual training together with a broad-based specialty, defined as either Advanced Internal Medicine (AIM) or Geriatric Medicine. In such dual training programmes, the training in the broad-based specialty ensures the acquisition of a broad-based training for those trainees.
The structures of dual training programmes approved by the College include the following and Trainees must clearly indicate the pathways chosen at the time of application to be registered as Higher Physician Trainee of the College:
1. Concurrent training: A minimum of five years of supervised training is required. The training programme comprises 36 months (cumulative) of training in Dermatology and Venereology and 24 months (cumulative) of core training in a broad-based specialty.
2. Sequential training: The training programme comprises 36 months of training in Dermatology & Venereology and 24 months in a broad-based specialty if it is chosen as a second specialty whereas 36 months in a broad-based specialty if it is chosen as a first specialty. A minimum of five and six years of supervised training is required depends on the training sequence.

III) CONTENTS

(A) Professional and Knowledge Competencies:

Dermatology
Upon completion of the specialist training, trainees in dermatology and venereology are expected to have acquired the Generic Professional Competencies as stated in the Physician Training under the Hong Kong College of Physicians, as well as being able to demonstrate a satisfactory standard of knowledge in this Specialty not limited to but including the following:
1. Fundamentals in dermatology: effective communication, history taking, valid informed consent, dermatological examination, investigations and interpretation, clinical diagnosis and decisions with evidence-based treatment plans, awareness of need for patient confidentiality particularly for sensitive conditions such as STI, leprosy.
2. Dermatopathology
  Ability to interpret the histopathology of key skin conditions such as eczema psoriasis, interpretation of histopathology report, and clinical correlation.
3. Specific topics
  1. Be able to diagnose and manage key skin conditions such as eczema (including contact dermatitis), psoriasis, cutaneous infection, papulosquamous disorders, exanthems, drug eruptions, erythroderma.
  2. Congenital and developmental disorders, pigmentary disorders, hair and nails disorder, oral diseases, anogenital diseases, allergy, and hypersensitivity disorders.
  3. Diagnosis and management of emergency and life threat threatening dermatological conditions such as toxic epidermal necrolysis, DRESS, severe cutaneous infections such as necrotizing fasciitis.
  4. Diagnosis and management of skin malignancies.
  5. Be able to diagnose and manage bullous dermatoses, cutaneous vasculitis, autoimmune conditions.
  6. Diagnose and manage neutrophilic and eosinophilic disorder, histiocytosis, mastocytosis, non-infective granulomatous conditions, subcutaneous fat disorders, disorders of the vascular and lymphatic system.
  7. Diagnose and manage skin manifestation of systemic diseases,
  8. Dermatology in specific patient groups: Psychocutaneous diseases, paediatric dermatology, dermatoses of the elderly, dermatoses in pregnancy
  9. Attachment to leprosy clinic and perform skin smear examination for leprosy.
  10. To possess a working knowledge of newer treatments such as but not limited to biologics, JAK inhibitors.
Sexually Transmitted Infection

At the end of training, the trainee should show an understanding of the following:

Fundamentals of sexually transmitted infection:
1. Diagnosis and management of disease characterized by genital, anal or perianal ulcers (chancroid, genital HSV infections, granuloma inguinale, lymphogranuloma venereum), syphilis.
2. Diagnosis and management of diseases characterized by urethral discharge, epididymitis, vaginal discharge and cervicitis: chlamydia, gonorrhea, bacterial vaginosis, trichomoniasis, vulvovaginal candidiasis, pelvic inflammatory disease.
3. Diagnosis and management of human papillomavirus infection, proctitis, pediculosis pubis and scabies.
4. Be aware of the principles behind partner referral.
5. Management of STI in special populations: pregnant women, adolescent and children, men-who-have-sex-with-men, women-who-have-sex-with-women, transgender, HIV infection detection and management of STI in HIV-infected patients, management of STI patients who have a history of drug allergy, sexual assault
6. Familiarity with clinical prevention and counselling measures, be able to counsel STI patients and their partners.
Procedural Dermatology
1. At the completion of training, the trainees should attain the knowledge and competence in procedural dermatology including, but not limited to the following fundamental aspects of procedural dermatology:
  1. Pre-procedural: pre-procedural assessment, valid informed consent, awareness of anatomical danger zones, lesion and site selection, adequate clinical information is included on the biopsy request form, ensure correct identification of patient and lesion site.
  2. Surgical technique: delivering local anesthetics, correct and safe handling of instruments, equipment and surgical materials, aseptic technique, hemostasis, correct selection of surgical technique.
  3. Post-surgical: after-care and follow-up, management of complications of surgery
  4. At the end of training, the trainee should understand the principles of therapeutic procedures such as phototherapy, wet-wrap therapy, iontophoresis.
  5. At the end of training, the trainee should have observed: Cosmetic procedures such as laser surgery, botulinum toxin injection etc. The trainee should also be able to diagnose and manage complications of cosmetic procedures.

(B) Procedural Competency:

At the end of training, the trainee should be able to perform the following procedures:

Dermatology
1. Diagnostic procedures: Skin scraping for microscopy for fungus and scabies, dermoscopy, trichoscopy/hair pull test, patch test application and interpretation, Wood’s light examination, lumbar puncture.
2. Surgical procedures: punch/incision/excision skin biopsy, electrodessication, scissoring, curettage, cryosurgery, intralesional steroid injection via needle/Dermojet, scalp and genital skin surgery.
Venereology

Gram-staining and wet smear examination for pus cell, Trichomonas vaginalis and Gonococcus, specimen taking for sexually transmitted infections, speculum examination and proctoscopy.

IV) INSTITUTIONAL REQUIREMENTS

The accredited Dermatology/Venereology training institute of the training programme should fulfil the following criteria.

Dermatology training Institution should have the following features.
1. A day-care centre with out-patient clinics with accessible service which accepts referrals from a wide spectrum of health services. The volume of cases must be adequate; the range of cases type must be wide: from common dermatoses to rare dermatoses; from mild dermatosis to severe; from simple to complicated. Emphasis is given to the volume of cases with severe and complicated dermatosis.
2. The day-care centre should be installed with facilities, equipment and materials to enable all the procedures in dermatology (Section 3) to be carried out. The facilities and equipment must be well maintained and operated to enable medical procedures to be carried out in a safe and high-quality manner.
3. For a training institute not offer training in cosmetic procedures, arrangement must be made for trainees to be seconded to a College-approved unit to receive training in cosmetic procedures.
4. The dermatology training institutes must possess a full range, updated and necessary pharmaceutical agents which enable comprehensive pharmaceutical management of patients.
5. The dermatology training institute must have ready access to a range of supportive service enabling comprehensive diagnostic and therapeutic activities to be carried out. Supportive services include, but not limited to: pathology (histopathology, chemical pathology, haematology, immunology), radiology and microbiology.
6. The dermatology training institute must be affiliated with general hospitals with a full range of specialist services. This enables severe dermatoses to be taken care under in-patient environment and benefits from the immediate input from other specialties. This also enables acquiring of knowledge and experience in diagnosis and management of dermatoses in other specialties through the provision of inpatient dermatology consultation service. The trainee should work in the affiliated hospital for an adequate period under supervision to enable the acquisition of experience in hospital dermatology.
7. Adequate opportunities are provided for the trainee, under the supervision, coaching and evaluation of trainers, to observe, manage, and deliver comprehensive care for patients with a wide variety of dermatological diseases.
8. Adequate opportunities are provided for the trainee, under the supervision and evaluation of trainers, to observe and acquire the skills to deliver safe and effective dermatological procedure for diagnostic and therapeutic purposes.
The Venereology training institute, in addition to the features needed for a dermatology training institute, should have the following features.
1. A day-care centre with out-patient clinics with accessible service which accepts patient self-referral and also referrals from a wide spectrum of health care services.
2. The volume of cases must be adequate; the range of cases type must be wide: from common to rare STI; from simple to complicated.
3. A laboratory attached to the clinic, to provide dark field examination, Gram stain smear microscope examination, and wet smear examination.
4. A counselling & contact training service supported by trained health nurses.
5. For a Dermatology training institute not offering the six months training in venereology, arrangement must be made for trainees to be seconded to an accredited Venereology training institute in order to complete the six months of training in venereology.
6. Adequate opportunities are provided for the trainee, under the supervision, coaching and evaluation of trainers, to observe, manage, and deliver comprehensive care for patients with sexually transmitted infections.
Supervision, coaching and evaluation
1. An accredited trainer is matched to a maximum of two trainees. Trainers are responsible for onsite supervision, coaching and evaluation of the performance of a trainee, reporting to the Specialty Board Chairman of the progress and advise the chairman on the individual needs of a trainee.
2. On-site supervision, coaching and evaluation is essential. It requires the trainer to be of close proximity with the trainee in a significant proportion of the trainee’s training time, be present in the trainee’s clinical sessions and procedural session, and is readily accessible for consultation if not present.
3. Regular and frequent attendances and presentations in the format of journal club, case presentation, clinical-pathological conference etc. is required in the training programme. The trainee should carry out these activities in close consultation of his/her trainer.
4. The dissertation preparation should be prepared in close consultation with the trainer, from the proposal to carrying out study to the final write up.

For more information on the HKCP training guideline, please visit the below website: www.hkcp.org/hkcp/trainees.html

Or the below Guidelines on Postgraduate Training in Internal Medicine: Guidelines on Postgraduate Training in Internal Medicine, Seventh Edition, July 2025.

Reference
Chan W.M. J. and Chan, T.M.D. (eds.) (2025) Guidelines on Postgraduate Training in Internal Medicine. Hong Kong: Hong Kong College of Physcians, p. 95-100.