Entry to dermatology training in Australia is through the state faculties of the Australasian College of Dermatologists, with structured panels or multiple mini interviews depending on the state, and it is among the most competitive selections in medicine. Candidate reports are fewer than for the large programmes, so this guide is built from the college's curriculum, the published selection criteria and the generic registrar pattern, and it says where it is inferring.
The format
A state faculty panel of dermatologists, criterion mapped, or an MMI with several short stations. Panels assess sustained commitment and research record, clinical reasoning, communication and professionalism, and commitment to public hospital work including rural and Aboriginal health. Check your state's published process.
Commitment and research
- Why dermatology, and what have you done over several years to show your commitment to it?
- Tell us about your research and publications in dermatology and what they taught you.
- What do you know about the ACD training programme, its examinations and the rotations, including rural and public commitments?
- Dermatology is one of the most competitive programmes. Why should we select you over the other candidates?
- Which areas of dermatology interest you, including procedural and public hospital work?
- What would you do if you were not selected this year?
The panel wants years of evidence: attachments, research with outputs, presentations at college meetings, teaching, outreach, the examinations studied for. Say what each taught you. The "why you" question is answered with evidence and a sentence on what you would bring, not with comparison to others. Have a realistic plan for not being selected, because most candidates are not on the first attempt.
The clinical scenarios
- A patient presents with a rapidly spreading blistering rash, mouth ulcers and fever after starting a new drug.
- A patient presents with a changing pigmented lesion.
- A patient with psoriasis has become erythrodermic.
- A child presents with a widespread itchy rash and a fever.
- A patient on a biologic for psoriasis develops a cough and night sweats.
The dermatological emergencies are what the panel tests: the severe cutaneous adverse reaction recognised and the drug stopped, the patient admitted and the supportive care and the specialist involvement; the erythroderma as a medical emergency with its fluid, temperature and sepsis risks; the melanoma recognised and the pathway to excision and staging; the infection in the immunosuppressed patient. Structure: recognise, assess, treat and escalate, explain to the patient, and say what you would do if the first step failed.
Communication
- Explain to a patient that the lesion you removed was a melanoma and what happens next.
- A teenager with severe acne is distressed and withdrawn. How do you approach the consultation?
- A patient is convinced they have a parasite infestation that you cannot find.
SPIKES for the melanoma. For the teenager, the psychological burden of skin disease taken seriously, the effective treatments offered, and the follow up. For delusional infestation, respect, no argument about the belief, the examination done properly, the relationship kept, and the route to psychiatric help introduced carefully.
Ethics and public health
- A patient asks you to prescribe isotretinoin without the required pregnancy counselling.
- How would you improve dermatology access for rural and Aboriginal patients?
- A cosmetic clinic offers you lucrative sessional work during training.
The isotretinoin question tests whether you know the pregnancy prevention requirements and will not skip them. The access question tests whether you see dermatology as a public responsibility: teledermatology, outreach, training GPs and rural generalists, the particular burden of skin infection and skin cancer in Aboriginal and remote communities. The cosmetic question tests priorities and the college's expectations.
System questions
The challenges facing public dermatology services, the skin cancer burden in Australia and what it means for the specialty, and the role of the dermatologist in the public hospital.
What the panels score
Sustained commitment with evidence, research understood rather than listed, recognition of the emergencies, communication that takes skin disease seriously, professional judgement, and a public health view of the specialty. The common failures are a research record the candidate cannot explain and a view of dermatology as a private cosmetic specialty.
Preparing
Build the evidence over years, not months. Learn the emergencies. Practise the melanoma and the teenager conversations. Prepare a two minute answer to each question. The bank on this site is marked lower evidence for dermatology; if you are interviewed, tell us what you were asked.