Background

Dermatological problems are frequently presented by patients in the primary care setting, either as the main complaint or as complications of other illnesses. However, it is widely recognised that there has been relatively little undergraduate training to meet the need of healthcare practitioners in today's primary care setting. As a result, many of them have, over the years, attended various stand alone lectures or seminars in order to improve their skills in looking after skin problems.

This 10-week Certificate Course is designed to provide a comprehensive review of the dermatological problems commonly seen in primary care setting and to update the participants in the diagnosis and management of these conditions.

Objectives

• To present information on clinical dermatology that is practical, concise and relevant to primary care
• To enhance healthcare professionals' knowledge in the recognition, assessment and management of common dermatological problems
• To emphasize the aspects of care that are different for patients with dermatological problems
• To emphasize the importance of prevention and health maintenance in patients with dermatological problems

Course Content

Ten seminars (via Zoom) on the following topics* will be held on Saturday afternoon (2:30 – 4:30 pm) between November 2021 and January 2022 (two topics for each session):

DATE (Saturday)	TOPIC	SPEAKER
8 Oct 2022	Acne and rosacea Allergy and urticaria	Dr Yeung Chi Keung Dr Marco Ho Hok Kung
15 Oct	Diagnostic algorithms for common dermatoses   Contact dermatitis in Hong Kong	Dr Christina Wong Sze Man Dr Lee Tze Yuen
22 Oct	Psoriasis and other scaling eruptions  Scalp, hair and nail disorders	Dr Yeung Chi Keung  Dr Leung Sze Kee
29 Oct	Genital dermatoses Cutaneous manifestation in systemic diseases	Dr Lo Kuen Kong  Dr Mandy Chan Wai Man
5 Nov	Use of Dermoscopy in primary care Common facial dermatoses	TBC Dr Leung Sze Kee
12 Nov	Paediatric skin diseases  Geriatric skin disorders	Dr Francis Ip Fong Cheng Dr Laura Lau
19 Nov	Common dermatological therapy and advance in dermatological treatment  Benign and malignant skin tumours and practical tips in skin surgery	Dr Christina Wong Sze Man   Dr George Li Kam Hop
26 Nov	Common cutaneous infections  Sexually transmissible diseases (STD)	Dr Samson Wong Sai Yin   Dr Ho King Man
3 Dec	Dermatology emergency and blistering diseases Cosmetic dermatology – an overview	Prof Henry Chan Hin Lee
10 Dec	Genodermatoses: what primary physician should know  Drug eruption and management	Dr Agnes Chan Wai Sze   Dr Johnny Chan Chun Yin

*Topics may be revised in future

Schedule

The Course requires an attendance of one session (2 hours) per week. The seminars will be held on Saturday afternoon.

2:30 - 3:30 p.m.	First seminar topic
3:30 - 4:30 p.m.	Second seminar topic

Venue

The seminars will be conducted via Zoom, participants are required to have online access for the seminars, the zoom links will be emailed to participants before each seminar. 

Award of Certificate

The Certificate in Clinical Dermatology will be awarded to the participants who have enrolled in the full Course and attended at least 80% of the sessions.

CME Accreditations

Accreditations for CME points will be applied to the Colleges of the Hong Kong Academy of Medicine, Department of Health, Hong Kong Medical Association and Hong Kong Doctors Union.

College /Association	CME Points
	Max for whole function	Per day	CME category
Department of Health	20	2	Non-specialists
Doctors Union	20	2	Non-specialists
Hong Kong Medical Association	20	2	Non-specialists
Hong Kong College of Community Medicine	10	2	-
Hong Kong College of Dental Surgeons	20	2	Cat B
Hong Kong College of Emergency Medicine	12	2	PC
Hong Kong College of Family Physicians	10	2	Cat 5.2
Hong Kong College of Ophthalmologists	1	-	Passive
Hong Kong College of Paediatricians	-	2	Cat E
Hong Kong College of Pathologists	15	2	PP
Hong Kong College of Physicians	6	-	-
Hong Kong College of Radiologists	20	2	Cat B
Hong Kong College of Surgeons	18	2	Passive

* Past CME record (for reference only)  

Academic Director

Dr LAM Tai Pong
Principal Clinical Practitioner, Department of Family Medicine and Primary Care, School of Clinical Medicine, The University of Hong Kong

Course Advisors

Prof Wong Kwok On
Specialist in Dermatology & Venereology

Prof CHAN Hin Lee Henry
Specialist in Dermatology & Venereology
Honorary Clinical Professor, Department of Medicine, School of Clinical Medicine, The University of Hong Kong

Course Co-ordinator

Dr WONG Sze Man Christina
Associate Consultant, Queen Mary Hospital
Honorary Clinical Assistant Professor, Department of Medicine, School of Clinical Medicine, The University of Hong Kong

List of Speakers

Dr YEUNG Chi Keung
Specialist in Dermatology & Venereology

Honorary Clinical Associate Professor, Department of Medicine, School of Clinical Medicine, The University of Hong Kong

 

Dr LEE Tze Yuen
Specialist in Dermatology & Venereology

 

Dr LEUNG Sze Kee
Specialist in Dermatology & Venereology

 

Dr LO Kuen Kong
Specialist in Dermatology & Venereology

Honorary Clinical Associate Professor, Department of Medicine, The University of Hong Kong

 

Dr HO King Man

Specialist in Dermatology & Venereology

Honorary Clinical Associate Professor, Department of Medicine, School of Clinical Medicine, The University of Hong Kong

 

Dr LI Kam Hop George
Specialist in Plastic Surgery

Honorary Clinical Associate Professor, Department of Surgery, School of Clinical Medicine, The University of Hong Kong

 

Dr HO Hok Kung Marco
Specialist in Paediatric Immunology & Infectious Diseases

Honorary Clinical Associate Professor, Department of Paediatrics and Adolescent Medicine, School of Clinical Medicine, The University of Hong Kong

 

Dr WONG Sai Yin Samson
Specialist in Clinical Microbiology and Infection

Clinical Associate Professor, Department of Microbiology, School of Clinical Medicine, The University of Hong Kong

 

Dr IP Fong Cheng Francis

Specialist in Dermatology & Venereology

Honorary Clinical Assistant Professor, Department of Paediatrics and Adolescent Medicine, School of Clinical Medicine, The University of Hong Kong

 

Dr Laura Lau

Specialist in Dermatology & Venereology

Senior Medical Officer, Department of Health, HKSAR

 

Dr CHAN Chun Yin Johnny
Specialist in Dermatology & Venereology

Honorary Clinical Assistant Professor, Department of Medicine, School of Clinical Medicine, The University of Hong Kong

 

Dr CHAN Wai Man Mandy
Specialist in Dermatology & Venereology

Honorary Clinical Assistant Professor, Department of Medicine, School of Clinical Medicine, The University of Hong Kong

 

Dr CHAN Wai Sze Agnes
Specialist in Dermatology & Venereology

Clinical Assistant Professor, Department of Medicine and Therapeutics, The Chinese University of Hong Kong

Executive Summary

Background

There is an increasing worldwide trend to strengthen the quality of primary care doctors by further postgraduate studies. Although overseas experiences have indicated improvements in doctors’ clinical practice and other areas after taking postgraduate courses, little is known about the possible effect of these courses in enabling doctors to handle cases which would reduce burden of specialists and their participation in more demanding community healthcare activities. A study that aimed to fill the gap in this respect was conducted in 2008 and the Certificate Course in Clinical Dermatology (CCCD) was selected as its main subject.

Aims

1. To examine the learning outcomes of the CCCD, including improvement in clinical skill, patient care and participation in community healthcare
2. To document the practice characteristics of the graduates before and after the Course, including the number of patients and cases handled in relation to the course subject, level of confidence and the percentage of referral to dermatologists
3. To examine the doctors’ expectations of postgraduate studies, and the long-term effect upon graduation, e.g. lifelong learning and updating of medical knowledge, initiative in further contribution to community heathcar

Methods

A quantitative survey and a pre- and post-Course quiz assessment were used to evaluate the learning outcomes of the students.

A questionnaire designed by the research team was sent to all graduates of CCCD of year 2007 between August and December 2008 after its pilot test in mid-July of the same year. To enhance the response rate, three rounds of invitation were sent followed by telephone reminders. The questionnaire itself was anonymous but was coded with a reference number to identify the respondent for the lucky draw prizes or for deletion from the next round of invitation.

The students of CCCD of the class Oct-Dec 2008, who were still studying the course in that period, were invited to take a pre-Course quiz at the first session on 8 October 2008 and a post-Course quiz at the final session on 17 December 2008. The two quizzes were exactly the same, with 20 questions in multiple-choice format (5 options), given 30 seconds answering time for each question.

Results

Questionnaire survey

Out of the 163 questionnaires sent to the graduates, 2 postal addresses were invalid. We have received 69 replies after three rounds of invitation, with a response rate of 42.9% (69/161). Of the respondents, 65.7% were male and 34.3% female, 78.5% were in community practice while 21.5% in hospital practice, 66.2% were in private service and 33.8% were in public service. Majority (82.5%) of the respondents were primary doctors, and the mean years after graduation from medical school was 17.3±10.70.

The respondents rated the reasons for studying the Course in descending order of importance: 1) Update clinical knowledge (98.6%), 2) Improve care for patients with dermatological problems (97.1%), 3) Lifelong learning (94.2%), 4) Interest in clinical dermatology (90.7%), 5) Meet job demand (69.1%) and 6) CME accreditations (39.7%).

The rated major learning outcomes, in descending order of agree?ment: 1) I have paid more attention to patients with dermatological problems (86.9%), 2) I have increased my confidence in distinguishing different types of dermatological problems (85.5%), 3) I have modified my approach to patients with dermatological problems (85.5%), 4) I have increased my interest in lifelong learning through additional training (78.3%), 5) I have increased my interest in pursuing other postgraduate studies (68.1%) and 6) My career opportunities have enhanced (36.7%).

There were significant changes in the number of patients with dermatological problems seen by the respondents per day before and after the Course. More respondents saw a larger number of patients with dermatological problems after the Course. Of the 33 respondents who were not on a fixed salary, there were significant increases in the percentage of income contributed by seeing these patients after the Course.

Respondents rated their confidence in diagnosing and managing common dermatological problems. Before the Course, less than two-third of the respondents were confident of diagnosing (61.8%) and managing (58.0%) common dermatological problems such as eczema, allergy, drug eruptions, cutaneous infections. After the Course, most graduates were confident of diagnosing (91.2%) and managing (88.4%) common dermatological problems.

We also asked if the graduates were confident in diagnosing malignant skin tumors. Only 45.5% of respondents were confident in this before the Course. The proportion of respondents being confident increased to 72.1% after the Course.

There were significant changes in the percentage of referrals of patients with dermatological problems to dermatologist after the Course. The mean of the percentage of referrals decreased from 31.9% to 23.5% after the Course. There were also significant changes in the percentage of patients being referred to dermatologist at first consultation after the Course. The mean of the percentage of patients being referred to dermatologist at first consultation decreased from 34.1% to 24.6% after the Course.

Graduates were asked if they were interested in following up patients with chronic dermatological problems. The combined percentage of agree and strongly agree increased from 60.3% to 77.9% after the Course.

Most (84.0%) respondents were satisfied with this Course, and 81.1% would recommend it to other doctors. increased confidence or knowledge in caring dermatological problems were considered as the most important impact of the Course.

Pre- and post-Course quiz assessment

Out of the 27 students of the class Oct-Dec 2008, 17 had participated in both the pre- and post-Course quiz assessment, giving a response rate of 63.0%. Of the 20 questions with a total score 20, most (82.4%) participants had improvement in score with an average of 3.2 marks after the Course.

Conclusion

The results show that the Course is effective in improving primary care doctors’ knowledge, confidence and attitude towards looking after patients with common dermatological problems. There are significant changes in the practice characteristics of the graduates after the Course, including increased number of patients and cases handled in relation to dermatology, and decreased percentage of referral to dermatologist. Besides, most graduates have increased their interest in lifelong learning through additional training or pursuing other postgraduate studies.

Lam TP, Yeung CK, Lam KF. What are the learning outcomes of a short postgraduate training course in dermatology for primary care doctors?. BMC Medical Education 2011, 11:20
http://www.biomedcentral.com/content/pdf/1472-6920-11-20.pdf

Contact person: Ms Tang

Tel: (852) 2518 5682

Fax: (852) 2814 7475

Email: cccd@hku.hk

Address: 3/F, Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong