1
UEMS SECTION OF MEDICAL BIOPATHOLOGY CORE TRAINING PROGRAMME AND TRAINING RECORD FOR MEDICAL MICROBIOLOGY
(INCLUDES BACTERIOLOGY, VIROLOGY, MYCOLOGY AND PARASITOLOGY). INTRODUCTION GENERAL AIM to produce trained medical microbiologists to provide specialist opinion in their clinical discipline and who
should have developed the appropriate management skills to lead a department, if required. The trained
medical microbiologist should be competent to:
1. Give advice as a physician on the diagnosis, treatment and prevention of microbial diseases.
2. provide a scientific basis for laboratory diagnosis; to set protocols and to maintain standards within the laboratory.
3. undertake the management responsibilities required from the director of a medical microbiology laboratory.
4. take charge of infection control in hospitals
5. propose hospital policies on the control of antibiotic usage and on the prevention of hospital acquired infection
6. collaborate with national surveillance organisations and public health authoroties and to provide services for these organisations
7. participate in the training programs for medical microbiologists, infection control doctors and other experts in the field of microbial diseases.
8. undertake research and development in the specialty of microbiological biopathology
OBJECTIVES Over a minimum 5 year period the trainee should acquire or develop:
a) Specialised factual knowledge of the natural history of those diseases upon which the chosen discipline is based.
b) Interpretative skills so that a clinically useful opinion can be derived from laboratory data. Emphasis should be made on the importance of clinical training and multidisiplinary care together with clinical and pathological conferences.
c) Technical knowledge, gained from close acquaintance with laboratory technology, so that methodology appropriate to a clinical problem can be chosen, and so that quality control and quality assurance procedures can be implemented.
d) Research and development experience Original thought and critical assessment of published work are important to allow the trainee to contribute in a team, and individually, to the development of the service.
e) The life-long habits of reading, literature-searches, consultation with colleagues attendance at scientific meetings, and the presentation of scientific work as part of continuing medical education (CME).
f) Data management skills to evaluate information derived from the population served and from the technical procedures applied in the laboratory. These skills should include familiarity with IT and the use of spreadsheets, databases and statistical packages etc.
g) Management and communication skills. The trainee must gain experience, under supervision, in planning departmental policies and develop the leadership skills necessary to implement them.
2
f) Familiarity with all aspects of health and safety requirements for laboratories.
SUPERVISION AND REVIEW OF PROGRESS IN TRAINING Trainees are required to keep a training record detailing their training experience. This will be inspected on a regular basis by their Educational Supervisor i.e. the consultant in charge of training. Trainees will be regularly informed of their progress and, in addition, trainees must be encouraged and given every opportunity to discuss any deficiencies in the training programme. The Educational Supervisor should discuss the trainee's progress with each consultant (trainer) with whom a trainee spends a period of one month or more. Trainees should agree a training programme with their supervisor soon after appointment.
The trainee should have supportive appraisal twice a year:
a) an informal meeting involving the Educational Supervisor and trainee, should be held every six months and the record of training should be signed by the Educational Supervisor;
b) an assessment by a panel approved by the Postgraduate Dean and/or a national board or committee for the registration of medical specialists on completion of each year's training or similar. Any reports or appraisals prepared during the year should be available to the trainee.
Educational Supervisors would be expected to have substantial experience in the specialty, to have demonstrated an interest in training, to have appropriate teaching resources, to be involved in appropriate regional training committees, to be involved in annual reviews and to liaise closely with the national board or committee for the registration of medical specialists.
MANAGERIAL TOPICS WHICH ARE PART OF CORE TRAINING 1. Management
Aspects of management - strategic planning, preparation of a business plan, contracting processes, service level agreements, departmental and directorate budgeting etc. - should be part of training. The trainees should be encouraged to attend appropriate management courses in which the programme will be sustained by professional managers. Trainees may, as "colleagues", be permitted to sit in on departmental, directorate and other local committee meetings as observers. The aims and objectives of this should be to provide them with some experience of committee procedures, aspects of confidentiality, decision making at a local level and the importance of maintaining good inter-personal relationships.
2. Health and Safety
Irrespective of discipline, each trainee should, from the start, become fully familiar with all aspects of Health and Safety in the laboratory and should be made aware of the legal obligations and the role of the Health and Safety Executive or equivalent national body requirements which have to be met to obtain and retain full laboratory accreditation.
3. IT and Communication Skills
The trainee should, from the start, become familiar with fundamental aspects of computing within the laboratory - databases, spread sheets, internet etc. - and how these are used on a day to day basis.
4. Audit and Quality Assessment
All trainees must, from the start, become familiar with audit procedures and should participate in regular clinical audit. Trainees should gain understanding of quality control and quality assurance. At the end of formal training they should have a full understanding in these two areas; they should have an understanding of external quality assessment and the processing of data by these schemes.
3
CORE TRAINING PROGRAMMES: This document sets out a curriculum for medical microbiologists which cover the scientific base of medical microbiology, as well as applied aspects, including related fields such as infectious diseases and communicable diseases control. Some element of medical microbiology training is common to the training of consultants in communicable diseases control and of infectious diseases physicians. AIMS OF TRAINING The core training programme aims to provide the trainee with both the theoretical foundation and the practical, technical, clinical and managerial skills necessary for the independent specialist practice of medical microbiology in a clinical environment and for the advancement of the subject. Although some information relating to the appropriate clinical experience is listed in section 11, it must be appreciated that laboratory work and clinical experience must be closely integrated, therefore laboratory associated clinical duties are an essential component of the training programme. SUPERVISION Programmes based on this curriculum should be appropriate to the needs and previous experience of the trainee and should set out educational objectives against which the trainees' progress can be assessed. The trainee should have an educational supervisor at each site of any rotation. The training programme should identify how specific areas of training not covered by the departments involved will be obtained (eg secondment for experience in virology, communicable diseases/epidemiology, public health microbiology) together with any courses deemed necessary.
4
A CORE TRAINING PROGRAMME: MEDICAL MICROBIOLOGY 1. Scientific basis of medical microbiology
Trainees should have an understanding of the principles of the following, together with how they may be applied to clinical and research problems:
a) microbial structure, physiology and genetics;
b) microbial taxonomy, classification and typing methods;
c) host defence mechanisms, the immune system and immunity to infection;
d) microbial pathogenicity;
e) epidemiology of infectious diseases - their surveillance and control;
f) antimicrobial agents, their mode of action and mechanisms of microbial resistance.
2. Laboratory safety
Prior to any "hands on" experience of laboratory work, the trainee should be instructed in basic safety requirements including correct laboratory dress and laboratory hygiene. Instruction should also be given on the immediate handling and disposal of specimens and contaminated articles (eg inoculating loops, pipettes) at the laboratory bench, the dangers of aerosols and the procedure for dealing with spillages.
At the end of formal training, the microbiologist should be familiar with:
a) local procedures for the safe transport of specimens or cultures and also with national and international postal and packaging regulations for such material;
b) current requirements and recommendations of the National Advisory Committee on safety in microbiological laboratories.
c) the principles and operation of microbiological safety cabinets containment level III facilities and the procedures for their safe use, decontamination and monitoring of air flow.
3. Sterilisation and Disinfection
At the end of formal training, the microbiologist should understand the principles and uses of sterilisation and disinfection procedures for the preparation of media and instruments and for microbiological waste disposal. Trainees should be familiar with methods of monitoring and be capable of formulating a policy on the use of sterilisation and disinfection in the laboratory, hospital or community.
4. Handling of specimens
At the end of formal training, the microbiologist should:
a) be aware, for each specimen type, of the optimal methods for collection, transport (including transport media), storage, reception, identification and documentation, including the requirements for high-risk specimens.
The trainee should develop a sense of the continuity of identification of specimens from collection, through culture and further testing to the issuing of a final report. He or she needs to be aware of critical points in processing where this continuity may fail and be able to minimise the risk of this.
b) be able to assess degrees of urgency for the processing of specimens, including the provision for an out of hours service and the communication of preliminary results as applicable;
c) be able to decide upon further testing or processing of a specimen as appropriate;
5
d) be aware of existing reference facilities and their appropriate use.
5. Microscopy
At the end of formal training, the microbiologist should:
a) understand the principles of light, darkground, phase contract, fluorescent and electron microscopy and be able to set up a light microscope with dark ground and phase contrast facilities;
b) be able to perform routine staining techniques including fluorescent dyes;
c) be familiar with the appearance of stained preparations and be able to recognise artefacts and their possible origin.
6. Culture methods
At the end of formal training, the microbiologist should:
a) have a basic understanding of the diversity of microbial metabolism;
b) be aware of the wide range of selective, enrichment and inhibitory media available for general and specialised use and be able to choose relevant media in common use or in medical and environmental laboratories;
c) be familiar with physical growth requirements of micro-organisms including atmosphere and optimal temperature and have an appreciation of the growth kinetics of both solid phase and broth cultures. It is important in this context to know those micro-organisms and clinical situations in which detectable growth may require prolonged incubations;
d) be familiar with the preparation of media in common use and have an understanding of internal quality control of such preparations;
e) be able to process all common specimens, recognise potential pathogens from a mixture of colonies on culture plates, separate such colonies in order to achieve the pure growth necessary for further work.
7. Further processing of cultures
At the end of formal training, the microbiologist should:
a) be able to perform tests leading to the identification of all common pathogens including the use of commercially produced kits (eg. kits for enzyme assays) and rapid diagnostic kits, ELIZA, latex agglutination;
b) understand the principles of identification media and be able to use them appropriately;
c) understand the principles behind multipoint identification technology.
8. Antimicrobial investigations
At the end of formal training, the microbiologist should:
a) be aware of available reference facilities for further identification including serotyping and all other typing schemes both phenotypic and genotypic;
b) be able to test the antibiotic sensitivities of an isolate using the common techniques of disc testing and break points and to be aware of the principles behind multipoint sensitivity technology;
c) be able to perform and interpret MIC and MBC tests as appropriate;
d) be able to perform antimicrobial assays using biological and automated techniques;
6
e) have an understanding of antimicrobial assays and their relationship to the therapeutic and toxic effects on a patient and be able to advise on dosage regimens accordingly.
9. Emerging technologies
At the end of formal training, the microbiologist should:
a) be aware of all major new technologies available in medical microbiology based on DNA techniques (eg PCR) and monoclonal antibodies;
b) be aware of automated, rapid techniques available to medical microbiology;
c) be able to evaluate critically the need for emerging techniques within the laboratory including cost effectiveness and effects on staffing levels and working practices.
10. Data handling
At the end of formal training, the microbiologist should:
a) have a basic understanding of information technology and in particular, computerised data handling. He or she should have an appreciation of the advantages and disadvantages of such systems and a basic understanding of the need for data protection;
b) be aware of available technologies for data broadcasting.
11. Clinical experience
At the end of formal training, the microbiologist should:
a) have gained experience of liaison with clinical colleagues through regular ward visits and participation in collaborative clinical activities. In particular, a close relationship with high dependency units (eg ICU, NICU) and specialist units (eg haematology, paediatrics, transplantation etc.) where available;
b) have gained experience of liaison with general practitioners;
c) have participated in on-call rotas (including weekends) with consultant cover;
d) have participated in postgraduate educational meetings such as Grand Rounds and lunchtime case presentations;
e) be able to provide informed advice on vaccination and immunisation with all products normally available in the EU.
12. Infection control in hospital and community
At the end of formal training, the microbiologist should:
a) have had first hand experience of local infection control problems, including, outbreaks of infection and their management;
b) be familiar with the workings of infection control meetings including local and regional infection control committees;
c) be aware of those areas of hospital and community health that require infection control policies;
d) have worked closely with the infection control nurse both in day to day duties and in the education of those involved with infection control issues;
e) have participated in visits to clinical and non-clinical areas to advise on infection control. These should include kitchen inspections especially those conducted by environmental health officers.
7
Relationships should be developed with key personnel in the central sterilisation unit, pharmacy and laundry;
f) have an understanding of the principles of patient isolation and their application;
g) be familiar with any national documents relevant to infection control. Also a knowledge of any existing working party recommendations (eg MRSA, Shigella, Clostridium difficile);
h) gained some experience of public health microbiology with secondment if necessary to a Public Health Laboratory;
i) have had some experience of communicable disease control in the community working Environmental Health Officers.
j) become familar with the physical and chemical agents used in hospital infection control.
13 Antimicrobial usage
At the end of formal training, a microbiologist should have knowledge of:
a) empiric, directed and prophylactic antimicrobial use.
b) the means of prevention of emergence of resistance
c) surveillance of antibiotic resistance
14. Virology
At the end of formal training, a microbiologist should have knowledge of:
a) basic diagnostic and screening virology methodology;
b) interpretation of results, both for clinical and infection control purposes;
c) virology policies in relation to health care workers, pregnancy, transplantation and immunisation;
d) when to refer to or request specialist virological expertise.
A period of six months to one year in total should be spent in a specialised virology laboratory during training.
15 Mycology
At the end of formal training, a microbiologist should have knowledge of:
a) basic diagnostic mycology methodology;
b) interpretation of results, both for clinical and infection control purposes;
c) special problems associated with the immunocompromised host
16 Parasitology
At the end of formal training, a microbiologist should have knowledge of:
a) basic diagnostic parasitology methodology;
b) interpretation of results, both for clinical and infection control purposes;
c) special problems associated with the immunocompromised host
8
17. Quality control
At the end of formal training, the microbiologist should:
a) have an understanding of quality control and quality assurance;
b) have had experience of the regular processing of specimens, distributed by an organisation for external quality control.
c) have an understanding of the existing external quality control schemes and the processing of data by these schemes.
18. Audit
At the end of formal training, the microbiologist should:
a) have an understanding of the principles of audit;
b) have participated in microbiological audit both in house and in the microbiological audit of clinical specialties. The trainee should have also participated in clinical audit led by other specialties.
19. Accreditation
At the end of formal training, the microbiologist should have knowledge of the requirements of any existing laboratory accreditation schemes and the process whereby accreditation is conferred.
20. Management
At the end of formal training, the microbiologist should have achieved a basic knowledge of important aspects of laboratory management including budget control,personnel management and administration. Attendance at local or national management courses should be strongly encouraged.
B-9
If there is insufficient space in any section, please continue on the blank page overleaf.
TRAINING RECORD &
TRAINING PROGRAMME
Medical Microbiology
Name……………………………………..
GMC No………………………………….
B-10
If there is insufficient space in any section, please continue on the blank page overleaf.
Table of Contents Scope of this manual .......................................................................................................... Training programme - a description.................................................................................... Introduction .................................................................................................................... Aims of training.............................................................................................................. Training supervision ...................................................................................................... Training locations........................................................................................................... General structure of training.......................................................................................... Qualifications of the trainee at the end of training......................................................... Training record .................................................................................................................... Trainee details ............................................................................................................... Base laboratories........................................................................................................... Customized training programme................................................................................... Periods of training in laboratories or units outside base laboratory .............................. Record of In-training Assessment Interviews................................................................ Courses and meetings attended ................................................................................... Qualifications obtained during Microbiology training..................................................... Detailed subject coverage ............................................................................................. Instructions for completion of numbered sections ................................................... Health and safety at work ........................................................................................ Clinical experience ................................................................................................... Infection control in hospital and the community....................................................... Sterilization and disinfection..................................................................................... Specimen procurement and handling...................................................................... Specimen microscopy.............................................................................................. Culture methods....................................................................................................... Further processing of cultures ................................................................................. Susceptibility testing and antimicrobial assays........................................................ Laboratory techniques in virology for microbiology trainees ................................... Environmental microbiology for microbiology trainees ............................................ Parasitology for microbiology trainees..................................................................... Mycology for microbiology trainees ......................................................................... Epidemiology and statistics...................................................................................... Data handling ........................................................................................................... Quality Assurance.................................................................................................... Emerging technologies ............................................................................................ Research and development..................................................................................... Teaching and training............................................................................................... Laboratory management and legislation ................................................................. Additional topics .......................................................................................................
B-11
If there is insufficient space in any section, please continue on the blank page overleaf.
Scope of this manualthis manual This manual is designed to provide a record of the training received by junior medical microbiologists during the whole of their period of training. It is intended to assist the trainee and his/her designated supervisor in considering the whole range of skills required of a newly appointed consultant medical microbiologist in a district general hospital or in a teaching hospital. Consideration is also given to training in communicable disease control and in environmental, food and water microbiology. In view of the diverse nature of the subject, the list of techniques and points covered is not necessarily comprehensive, but is designed to provide a framework for fuller discussion of each topic. The first section outlines the aims of the training, starting on page (1), the resources required and a suggested general structure of training. However, the suggested structure may be amended to suit local circumstances after approval of any significant changes are agreed by the Postgraduate Dean and/or any official board or committee on the registration of medical specialists. The background and qualifications of the trainee at the commencement of training in Microbiology should be recorded. An individual programme should be constructed for each trainee planned around the past experience, aptitudes and aspirations of the trainee. It should be designed after discussion between the trainee, the designated trainer and the Postgraduate Dean and/or any official board or committee on the registration of medical specialists. This programme is intended to outline the structure of the training and should be planned and reviewed at least annually. Instructions for completing the training record can be found on page B18, followed by the training record. The assessments of "Stage reached" are NOT intended to be used to grade the trainee, but to provide a guide to the completion of any outstanding topics. The completion of the training record should be complemented with Individual Performance Reviews (IPR) where appraisal of progress can be undertaken and where the trainee's opinions of the training being received should be considered.
B-12
If there is insufficient space in any section, please continue on the blank page overleaf.
Training programme - a description- a description 1 Introduction This document sets out a curriculum for trainee medical microbiologists. 1.2 The general outline is complemented by a training record in which specific items are listed in some detail. 2 Aims of training training 2.1The aims of training should be to develop the knowledge, skills and attitudes required of medical microbiologists and to give wide experience of the practice of medical microbiology. The curriculum should centre on training in the following areas (the eight main tasks of the microbiologist as defined by the Microbiology Commission in Helsinki in 1996) to ensure competence to: a) Give advice as a physician on the diagnosis, treatment and prevention of microbial diseases. b) Provide a scientific basis for laboratory diagnosis; to set protocols and to maintain standards
within the laboratory. c) Undertake the management responsibilities required from the director of a medical microbiology
laboratory. d) Take charge of infection controls in hospitals. e) Propose hospital policies on the control of antibiotic usage and on the prevention of hospital
acquired infection. f) Collaborate with national surveillance organisations and public health authorities and to provide
laboratory services for these organisations. g) Participate in the training programmes for medical microbiologist, infection control practitioners
and other experts in the field of microbial diseases. h) Undertake research and development in the specialty of microbiological biopathology.
B-13
If there is insufficient space in any section, please continue on the blank page overleaf.
2.2The precise composition of an individual's training programme should be structured around the past experience and aspirations of each trainee. The programme should be designed, and continually reviewed, by discussion between the trainee, the trainer and, at regular intervals, the Postgraduate Dean and/or any official board or committee on the registration of medical specialists. 2.3Each trainee will have to successfully acquire skills in each of the following categories: 2.3.1specialized factual knowledge of the natural history of infection and its clinical presentation; 2.3.2technical ability, to enable the trainee to select appropriate methodology and laboratory instrumentation based on practical skills and experience derived from close acquaintance with laboratory technology acquired during training, which includes quality control procedures and quality assurance; 2.3.3data management skills, including the statistical evaluation of data referring to the populations of patients served and the technical procedures applied in the laboratory as well as familiarity with the application of information technology within the laboratory and familiarity with the use of spreadsheets, databases and statistical packages; 2.3.4management and communication skills, including experience, under supervision, in formulating departmental policies and applying the leadership and team-work skills necessary to implement them, report writing and report presentation, costing procedures, preparing budgets and acquaintance with contracting procedures; 2.3.5research and development experience, as this is important for developing skills in independent and team-driven problem solving and in the critical assessment of published work; 2.3.6presentation skills, both oral and written; 2.3.7knowledge of health and safety at work requirements for laboratories including control of substances hazardous to health regulations; 2.3.8continuing study, leading to continuing medical education (CME) beyond the training post stage. This will enhance the acquisition of life-long habits of reading, literature searches, consultation with colleagues, attendance at scientific meetings, and the presentation of scientific work as part of continuing professional development (CPD). 3Training supervision 3.1Every trainee must have a designated trainer of Consultant status at the trainee's base laboratory who will be personally responsible for the trainee's day-to-day training and who will be accountable to the Postgraduate Dean and/or any official board or committee on the registration of medical specialists. 3.2When referred to another location for training, a Consultant, or Scientist of equivalent status, should be identified as being responsible for training for the duration of the attachment. 3.3Before agreeing to become a trainer, a Consultant must be able and prepared to set aside sufficient time to undertake this demanding duty. Each trainee should anticipate a
B-14
If there is insufficient space in any section, please continue on the blank page overleaf.
weekly, regular, formal one hour tutorial session as a minimum. Furthermore, in addition, there should be training in benchwork and in clinical liaison/ward rounds by the trainer/another consultant or qualified SpR* (delegation of certain duties to a senior SpR does not abrogate trainer's responsibility) as well as frequent open access on an ad hoc basis. 3.4All trainees must have Consultant cover (preferably on-site) at all times. 3.5For more junior trainees, the trainer must be responsible for identifying publishable projects suited to the trainee's experience and interests, for arranging resources, and for overseeing the project up to publication. 3.6The progress of training should be reviewed with the trainer, and where relevant the laboratory head, and separately with the Postgraduate Dean and/or any official board or committee on the registration of medical specialists on at least an annual basis, or more frequently if requested. This review should be undertaken on a formal basis, with clear agreed goals and achievement reviews. 4Training locations 4.1Before a laboratory can be designated as a training site, the suitability of the site must be carefully considered. 4.2Each post and laboratory must have appropriate recognition. 4.3Each laboratory should ideally have the full appropriate accreditation. 4.4There should be sufficient non-training grade staff in a laboratory to carry out the routine clinical work. While trainees will often undertake routine work, they must not be relied upon for the running of the laboratory as this will interfere with the training programme. 4.5In addition to the suitability of the laboratory, consideration must be given to the scope of clinical material available. In laboratories attached to hospitals with a relatively small range of clinical services, rotation to laboratories at other hospitals will be necessary. 4.6Ideally, trainees should be based in laboratories specializing in training which will have more than one trainee. This will facilitate the suggested training structure outlined in section 0, below. In this situation, trainees can discuss cases and issues in medical microbiology with others who are also actively studying for examinations (or who have recently been doing so). This process is also of value to the more senior trainees who themselves begin to learn how to become effective trainers. 4.7Resources which must be available before a trainee is allocated to a laboratory: Reasonable quiet office space with a telephone line from where confidential clinical conversations can be carried out; sole use of a desk; filing cabinet and shelf space;
B-15
If there is insufficient space in any section, please continue on the blank page overleaf.
ready access to computing facilities (at least one computer between every two trainees) with appropriate software (e.g. wp; spreadsheet; epi-info; reference manager) and connected printer; internet access; a range of suitable up-to-date reference texts within the laboratory, e.g. Principles and Practice of Infectious Disease (Mandel et al), The Use of Antibiotics (Kucers et al), Principles and Practice of Clinical Virology (Zuckerman et al), Manson's Tropical Diseases (Manson-Bahr et al). 5General structure of trainingof training 5.1The structure of training needs to be flexible to allow for individual trainee and service requirements. A suggested training structure follows which may be used as a guideline to best practice. It is not intended to be prescriptive. If an alternative training schedule is already in place, this may be followed, subject to approval by the Postgraduate Dean and/or any official board or committee on the registration of medical specialists. 5.2A significant part of training should be performed on an apprenticeship basis, with the trainee shadowing the trainer, another consultant or a qualified SpR in service laboratory and clinical duties (referred to as service work). 5.3Adequate time should be allowed for non-service benchwork, private study, attending courses and research (referred to as elective work). 5.4The proportion of service to elective work should vary between 1:1 and 1:2. It is essential that time for elective work should be allocated in blocks of sufficient length to allow the trainee to make maximum use of the elective time. The elective period should not be used exclusively for annual leave or for covering colleagues' planned annual/study leave. A suitable arrangement could entail a rotation (say every three months) of 'first on-call' for clinical duties between three trainees on one site, allowing the other two a clear six months for elective work in every nine months. 6Qualifications of the trainee at the end of training Required of the trainee: 6.1- Gaining knowledge and experience - At the end of training the trainee should have gained experience in the following areas:
B-16
If there is insufficient space in any section, please continue on the blank page overleaf.
a. possess theoretical and practical knowledge , skillfulness and experience in bacteriology, virology, parasitology, mycology and serology, so that he/she is capable of independently arranging the content and organisation of a microbiological study for the benefit of patient care resulting in clinical consultation and a hospital epidemiological study;
The trainee should among other things: b. be able to assess relevant scientific literature and to apply (adjust) it for use in diagnostical scientific research; c. have sufficient theoretical and practical knowledge of molecular biology and immunology, to be able to assess (adjust) the developments and to use these for medical microbiological diagnostic scientific research; d. make sure that he/she possesses sufficient knowledge of management methods, so that these can be used for organisation, management and personal policy of a medical microbiological laboratory; e. orientate themselves to function in the field of prevention and the fight against infectious diseases; f. acquire sufficient knowledge to be able to execute or give guidance in hospital hygiene and hospital epidemiology programmes. 6.2-Cursory education – The trainee should through work placements and/or participating in courses have obtained insight in the parasitology, mycology, immunology, statistic/epidemiology, management and public health. 6.3 -Educational duties – The trainee should have given information and fulfilled educational tasks to medical students, co-assistants, trainee - nurses and paramedical staff. 6.4-Participating in discussions and meetings- The trainee should gain experience through regular attendance of clinical and pathological conferences.
B-17
If there is insufficient space in any section, please continue on the blank page overleaf.
Training record Log bookbook:
Trainee details,
personal development plans,
and achievements
B-18
If there is insufficient space in any section, please continue on the blank page overleaf.
Instructions for completion of numbered sectionsInstructions for completion of numbered sectionsfor completion of numbered sectionscompletion of numbered sectionscompletion of numbered sections Appropriate sections of the logbook should be completed at intervals no less frequently than monthly. Where only part of a section has been covered at a session, the "Comments" column should be used to indicate the subject matter discussed. A number of spare sheets have been included at the end to allow trainees and trainers the opportunity to include further topics as desired. It must be emphasized that the "Stage reached" columns should be used to record the depth to which the topic has been discussed. It is NOT intended to grade the level of knowledge of the trainee but to provide a useful checklist of any uncompleted topics at each stage of the trainee's training period. The "Stage reached" section is divided into four columns, numbered 1 to 4. Once a topic has been discussed, the appropriate box should be completed by the trainer with his initial and date. Topics covered at outside lectures, such as at an MSc course, may be entered individually for each topic at the appropriate stage. These numbers refer to the following stages: 1 A subject has been discussed at a basic level. It would be expected that the
trainee would need help and supervision most of the time in performing task/dealing with subject
2 The theory behind a subject has been discussed at a level sufficient to enable the trainee to troubleshoot the procedure or to enable him to cope with performing the task/dealing with subject under close supervision
3 The subject has been discussed comprehensively, such that the trainee should be able to cope with performing the task/dealing with subject with limited supervision
4 The subject has been discussed comprehensively and the trainee has a knowledge of the associated literature and should be competent to perform the procedure/deal with subject independently
Following the core topics, several blank lines are allowed for the completion by the trainee and the trainer for any other topics as desired. For some topics it would be inappropriate to complete the "Stage reached" column for each entry at any particular level. In such cases, the appropriate comments line can be used. Similarly, for other topics (e.g. management) it may be felt inappropriate to broach the subjects until stages 3 or 4. As an example, extracts from a Training record of a hypothetical trainee who commenced training on 01.01.90 is given on the following page.
1
Clin
ical
exp
erie
nce
- exa
mpl
e of
logb
ook
entry
To
pic
Stag
e re
ache
d (w
hen
appl
icab
le) -
Tr
aine
r's in
itial
s an
d da
te
Com
men
ts
1
2 3
4
Has
gai
ned
expe
rienc
e of
liai
son
with
clin
ical
col
leag
ues
thro
ugh
regu
lar w
ard
visi
ts, i
n pa
rticu
lar w
ith s
taff
on h
igh
depe
nden
cy u
nits
(e.g
. IC
U)
- 1/
12/9
0 A.
B.
15/6
/93
C.D
. 1/
2/94
E.F
.
Und
erst
ands
the
man
agem
ent o
f inf
ectio
n in
var
ious
org
an
syst
ems
and
patie
nt ty
pes
-
See
belo
w
Has
gai
ned
expe
rienc
e of
dea
ling
with
clin
ical
pro
blem
s in
sp
ecia
list c
linic
al a
reas
:
paed
iatri
cs in
clud
ing
ICU
-
30
/6/9
3 C
.D.
30
/6/9
4 E.
F.
Entri
es m
ade
at e
nd o
f app
ropr
iate
clin
ical
at
tach
men
t
ob
stet
rics
-
30/6
/93
C.D
. 30
/6/9
4 E.
F.
orth
opae
dics
20
/12/
92 A
.B.
30/6
/94
E.F.
se
xual
ly tr
ansm
itted
dis
ease
s, in
clud
ing
AID
S
2/
2/93
J.K
. 30
/6/9
4 E.
F.
orga
n tra
nspl
anta
tion
30/6
/93
C.D
. 15
/11/
95 G
.H.
haem
atol
ogy
(pro
foun
d ne
utro
peni
a)
30/6
/93
C.D
. 15
/11/
95 G
.H.
H
as g
aine
d ex
perie
nce
of li
aiso
n w
ith g
ener
al p
ract
ition
ers,
pa
rticu
larly
by
prov
idin
g te
leph
one
advi
ce w
hen
requ
este
d
30
/6/9
3 C
.D.
30/6
/94
E.F.
Has
par
ticip
ated
in o
n-ca
ll ro
tas
(with
con
sulta
nt c
over
)
30/6
/93
C.D
. 15
/11/
95 G
.H.
Has
par
ticip
ated
in p
ostg
radu
ate
educ
atio
nal m
eetin
gs
-
12/9
/90
C.D
. 14
/4/9
2 C
.D.
17/1
0/93
E.F
.
Is a
ble
to p
rovi
de in
form
ed a
dvic
e on
vac
cina
tion
and
imm
uniz
atio
n w
ith a
ll pr
oduc
ts n
orm
ally
ava
ilabl
e in
the
EC
- -
30/6
/93
C.D
. 15
/11/
95 G
.H.
Urin
ary
tract
infe
ctio
n -
2/4/
90 A
.B.
3/8/
92 A
.B.
12/1
1/94
E.F
.
Endo
card
itis
- 7/
12/9
0 A.
B.
25/2
/93
E.F.
11
/10/
94 G
.H.
C
omm
unity
acq
uire
d pn
eum
onia
-
9/4/
90 A
.B.
2/2/
92 M
Sc
10/1
0/92
MSc
Hos
pita
l acq
uire
d pn
eum
onia
-
1/9/
90 A
.B.
14/3
/92
MSc
3/
7/92
MSc
Vira
l hae
mor
rhag
ic fe
ver
- -
12/1
2/92
A.B
. 17
/5/9
4 E.
F.
En
tries
in it
alic
scr
ipt a
re in
tend
ed to
indi
cate
han
dwrit
ten
entri
es
2
1 H
ealth
and
saf
ety
at w
ork
safe
ty a
t wor
k
Topi
c St
age
reac
hed
(whe
n ap
plic
able
) -
Trai
ner's
initi
als
and
date
C
omm
ents
1
2 3
4
Rec
eive
d lo
cal l
abor
ator
y sa
fety
not
es
Acqu
aint
ed w
ith lo
cal f
ire s
afet
y ru
les
Acqu
aint
ed w
ith lo
cal a
ccid
ent r
epor
ting
polic
y
Acqu
aint
ed w
ith w
orki
ng o
f Saf
ety
Com
mitt
ee
Acqu
aint
ed w
ith S
afet
y re
gula
tions
Acqu
aint
ed w
ith C
ateg
oriz
atio
n of
Pat
hoge
ns
Fam
iliar w
ith in
dica
tions
for u
se a
nd c
orre
ct o
pera
tion
of C
lass
1,
2 a
nd 3
saf
ety
cabi
nets
Fam
iliar w
ith re
gula
tions
rela
ting
to C
ateg
ory
III la
bora
tory
Fam
iliar w
ith in
tern
atio
nal a
nd n
atio
nal p
osta
l reg
ulat
ions
3
2 C
linic
al e
xper
ienc
e
Topi
c St
age
reac
hed
(whe
n ap
plic
able
) -
Trai
ner's
initi
als
and
date
C
omm
ents
1
2 3
4
Has
gai
ned
expe
rienc
e of
liai
son
with
clin
ical
col
leag
ues
thro
ugh
regu
lar w
ard
visi
ts, i
n pa
rticu
lar w
ith s
taff
on h
igh
depe
nden
cy u
nits
(e.g
. IC
U)
Und
erst
ands
the
man
agem
ent o
f inf
ectio
n in
var
ious
org
an
syst
ems
and
patie
nt ty
pes
Has
gai
ned
expe
rienc
e of
dea
ling
with
clin
ical
pro
blem
s in
sp
ecia
list c
linic
al a
reas
:
Paed
iatri
cs in
clud
ing
ICU
O
bste
trics
O
rthop
aedi
cs
Se
xual
ly tr
ansm
itted
dis
ease
s, in
clud
ing
AID
S
O
rgan
tran
spla
ntat
ion
H
aem
atol
ogy
(pro
foun
d ne
utro
peni
a)
Has
gai
ned
expe
rienc
e of
liai
son
with
gen
eral
pra
ctiti
oner
s,
parti
cula
rly b
y pr
ovid
ing
tele
phon
e ad
vice
whe
n re
ques
ted
Has
par
ticip
ated
in o
n-ca
ll ro
tas
(with
con
sulta
nt c
over
)
Has
par
ticip
ated
in p
ostg
radu
ate
educ
atio
nal m
eetin
gs
Has
par
ticip
ate
in th
e m
ultid
isci
plin
ary
appr
oach
of p
atie
ntca
re
4
3 In
fect
ion
cont
rol i
n ho
spita
l and
the
com
mun
ityin
hos
pita
l and
the
com
mun
ity
Topi
c St
age
reac
hed
(whe
n ap
plic
able
) -
Trai
ner's
initi
als
and
date
C
omm
ents
1
2 3
4
Has
had
firs
t han
d ex
perie
nce
of lo
cal i
nfec
tion
cont
rol
prob
lem
s in
clud
ing
outb
reak
s of
infe
ctio
n an
d th
eir
man
agem
ent
Und
erst
ands
the
poss
ible
impl
icat
ions
on
bed
man
agem
ent o
f us
e of
sid
e ro
oms
and
war
d cl
osur
es
Is fa
milia
r with
the
wor
king
s of
infe
ctio
n co
ntro
l mee
tings
in
clud
ing
loca
l and
dis
trict
infe
ctio
n co
ntro
l com
mitt
ees
Is a
war
e of
thos
e ar
eas
of h
ospi
tal a
nd c
omm
unity
hea
lth th
at
requ
ire in
fect
ion
cont
rol p
olic
ies
Has
wor
ked
clos
ely
with
the
infe
ctio
n co
ntro
l nur
se b
oth
in d
ay
to d
ay d
utie
s an
d in
the
educ
atio
n of
oth
ers
on in
fect
ion
cont
rol
issu
es
Has
par
ticip
ated
in v
isits
to c
linic
al a
nd n
on-c
linic
al a
reas
to
advi
se o
n in
fect
ion
cont
rol,
incl
udin
g ki
tche
n in
spec
tions
co
nduc
ted
by e
nviro
nmen
tal h
ealth
offi
cers
Has
an
unde
rsta
ndin
g of
the
prin
cipl
es o
f pat
ient
isol
atio
n an
d th
e hi
erar
chy
of is
olat
ion
Is fa
milia
r with
any
doc
umen
ts re
leva
nt to
infe
ctio
n co
ntro
l suc
h as
repo
rts o
f Com
mitt
ees
of E
nqui
ry a
nd w
ith a
ny e
xist
ing
wor
king
par
ty re
com
men
datio
ns
Has
som
e un
ders
tand
ing
of h
ospi
tal d
esig
n an
d en
gine
erin
g pr
oble
ms
Und
erst
ands
the
indi
catio
ns fo
r mon
itorin
g th
eatre
air
supp
lies
Is a
ble
to p
rovi
de in
form
ed a
dvic
e on
vac
cina
tion
and
imm
uniz
atio
n w
ith a
ll pr
oduc
ts n
orm
ally
ava
ilabl
e in
the
EC
5
4 St
eriliz
atio
n an
d di
sinf
ectio
ndis
infe
ctio
n To
pic
Stag
e re
ache
d (w
hen
appl
icab
le) -
Tr
aine
r's in
itial
s an
d da
te
Com
men
ts
1
2 3
4
Und
erst
ands
prin
cipl
es o
f ste
riliz
atio
n us
ing
moi
st h
eat
Und
erst
ands
prin
cipl
es o
f ste
riliz
atio
n us
ing
dry
heat
Und
erst
ands
prin
cipl
es o
f ste
riliz
atio
n us
ing
othe
r met
hods
Und
erst
ands
prin
cipl
es o
f dis
infe
ctio
n us
ing
vario
us c
hem
ical
s in
labo
rato
ry s
ettin
g
Und
erst
ands
prin
cipl
es o
f dis
infe
ctio
n us
ing
vario
us c
hem
ical
s in
hos
pita
l war
d se
tting
Und
erst
ands
prin
cipl
es o
f dis
infe
ctio
n us
ing
vario
us c
hem
ical
s in
spe
cial
hos
pita
l set
tings
(e.g
. end
osco
py u
nits
)
Und
erst
ands
prin
cipl
es o
f dis
infe
ctio
n us
ing
vario
us c
hem
ical
s in
gen
eral
pra
ctic
e se
tting
Und
erst
ands
the
func
tions
and
man
agem
ent o
f Cen
tral
Ster
ilisat
ion
Uni
t
6
5 Sp
ecim
en p
rocu
rem
ent a
nd h
andl
inga
nd h
andl
ing
Topi
c St
age
reac
hed
(whe
n ap
plic
able
) -
Trai
ner's
initi
als
and
date
C
omm
ents
1
2 3
4
For e
ach
spec
imen
type
, is
awar
e of
opt
imal
met
hods
of
colle
ctio
n, tr
ansp
orta
tion
(incl
udin
g tra
nspo
rt m
edia
), st
orag
e,
rece
ptio
n, id
entif
icat
ion
and
docu
men
tatio
n
Is a
ble
to a
sses
s de
gree
s of
urg
ency
for t
he p
roce
ssin
g of
sp
ecim
ens,
incl
udin
g th
e pr
ovis
ion
of o
ut-o
f-hou
rs s
ervi
ce a
nd
the
com
mun
icat
ion
of p
relim
inar
y re
sults
as
appl
icab
le
Is a
ble
to d
ecid
e up
on fu
rther
test
ing
or p
roce
ssin
g of
a
spec
imen
as
appr
opria
te
Is a
war
e of
exi
stin
g re
fere
nce
faci
litie
s an
d th
eir a
ppro
pria
te u
se
7
6 La
bora
tory
tech
niqu
es in
mic
robi
olog
y: S
peci
men
mic
rosc
opy
Topi
c St
age
reac
hed
(whe
n ap
plic
able
) -
Trai
ner's
initi
als
and
date
C
omm
ents
1
2 3
4
Und
erst
ands
the
prin
cipl
es o
f lig
ht, d
arkg
roun
d, p
hase
con
trast
, flu
ores
cent
and
ele
ctro
n m
icro
scop
y, a
nd is
abl
e to
set
up
a lig
ht m
icro
scop
e w
ith d
ark
grou
nd a
nd p
hase
con
trast
faci
litie
s
Is a
ble
to p
erfo
rm ro
utin
e st
aini
ng te
chni
ques
incl
udin
g us
ing
fluor
esce
nt d
yes
Is fa
milia
r with
the
appe
aran
ce o
f sta
ined
pre
para
tions
and
is
able
to re
cogn
ize
artif
acts
and
thei
r pos
sibl
e or
igin
8
7 La
bora
tory
tech
niqu
es in
mic
robi
olog
y: C
ultu
re m
etho
ds
Topi
c St
age
reac
hed
(whe
n ap
plic
able
) -
Trai
ner's
initi
als
and
date
C
omm
ents
1
2 3
4
Has
a b
asic
und
erst
andi
ng o
f the
div
ersi
ty o
f mic
robi
al
met
abol
ism
Is a
war
e of
the
wid
e ra
nge
of s
elec
tive,
enr
ichm
ent a
nd
inhi
bito
ry m
edia
ava
ilabl
e fo
r gen
eral
and
spe
cial
ized
use
and
is
able
to c
hose
rele
vant
med
ia in
com
mon
use
or i
n m
edic
al a
nd
envi
ronm
enta
l lab
orat
orie
s
Is fa
milia
r with
phy
sica
l gro
wth
requ
irem
ents
of m
icro
-or
gani
sms
incl
udin
g op
timal
tem
pera
ture
and
has
an
appr
ecia
tion
of th
e gr
owth
kin
etic
s of
bot
h so
lid p
hase
and
bro
th
cultu
res
Is fa
milia
r with
the
prep
arat
ion
of m
edia
in c
omm
on u
se a
nd
has
an u
nder
stan
ding
of i
nter
nal q
ualit
y co
ntro
l of s
uch
prep
arat
ions
Is a
ble
to p
roce
ss a
ll co
mm
on s
peci
men
s, to
reco
gniz
e po
tent
ial p
atho
gens
from
mix
ture
of c
olon
ies
on c
ultu
re p
late
s,
and
to s
epar
ate
such
col
onie
s in
ord
er to
ach
ieve
the
pure
gr
owth
nec
essa
ry fo
r fur
ther
wor
k
9
8 La
bora
tory
tech
niqu
es in
mic
robi
olog
y: F
urth
er p
roce
ssin
g of
cul
ture
sof c
ultu
res
Topi
c St
age
reac
hed
(whe
n ap
plic
able
) -
Trai
ner's
initi
als
and
date
C
omm
ents
1
2 3
4
Is a
ble
to p
erfo
rm te
sts
lead
ing
to th
e id
entif
icat
ion
of a
ll co
mm
on p
atho
gens
, inc
ludi
ng th
e us
e of
com
mer
cial
ly
prod
uced
kits
[ide
ntifi
catio
n of
eac
h ge
nus/
spec
ies
may
be
liste
d se
para
tely
, bel
ow. T
his
may
be
parti
cula
rly u
sefu
l for
m
ore
unus
ual o
rgan
ism
s]
Und
erst
ands
the
prin
cipl
es o
f ide
ntifi
catio
n m
edia
and
is a
ble
to
use
them
app
ropr
iate
ly
Und
erst
ands
the
prin
cipl
es b
ehin
d m
ultip
oint
iden
tific
atio
n te
chno
logy
Is a
war
e of
f ava
ilabl
e re
fere
nce
faci
litie
s fo
r fin
er id
entif
icat
ion
incl
udin
g se
roty
ping
and
oth
er p
heno
typi
c an
d ge
noty
pic
typi
ng
met
hods
10
9 La
bora
tory
tech
niqu
es in
mic
robi
olog
y: S
usce
ptib
ility
test
ing
and
antim
icro
bial
ass
aysa
nd a
ntim
icro
bial
ass
ays
Topi
c St
age
reac
hed
(whe
n ap
plic
able
) -
Trai
ner’s
initi
als
and
date
C
omm
ents
1
2 3
4
Is a
ble
to te
st th
e an
tibio
tic s
usce
ptib
ilitie
s of
an
isol
ate
usin
g th
e co
mm
on te
chni
ques
of d
isc
test
ing
and
brea
kpoi
nts
and
unde
rsta
nds
of th
e pr
inci
ples
beh
ind
mul
tipoi
nt s
usce
ptib
ility
test
ing
tech
nolo
gy
Is a
ble
to p
erfo
rm a
nd in
terp
ret M
IC a
nd M
BC te
sts
as
appr
opria
te
Is a
ble
to p
erfo
rm fu
ll an
d ha
lf ch
eque
rboa
rd ti
tratio
ns
Is a
ble
to c
arry
out
ser
um c
idal
leve
ls
Is a
ble
to p
erfo
rm a
ntim
icro
bial
ass
ays
usin
g bi
olog
ical
and
au
tom
ated
tech
niqu
es
Has
an
unde
rsta
ndin
g of
ant
imic
robi
al a
ssay
s an
d th
eir
rela
tions
hip
to th
e th
erap
eutic
and
toxi
c ef
fect
s on
a p
atie
nt a
nd
be a
ble
to a
dvis
e on
dos
age
regi
men
s ac
cord
ingl
y
11
10
Labo
rato
ry te
chni
ques
in v
irolo
gy fo
r mic
robi
olog
y tra
inee
sin
viro
logy
for m
icro
biol
ogy
train
ees
Topi
c St
age
reac
hed
(whe
n ap
plic
able
) -
Trai
ner's
initi
als
and
date
C
omm
ents
1
2 3
4
Und
erst
ands
prin
cipl
es o
f com
mon
ser
olog
ical
test
ing
met
hods
, in
clud
ing
com
plem
ent f
ixat
ion
test
, enz
yme
linke
d im
mun
osor
bent
ass
ay, s
ingl
e ra
dial
hae
mol
ysis
, par
ticle
ag
glut
inat
ion,
imm
unob
lot a
ssay
Und
erst
ands
the
prin
cipl
es b
ehin
d vi
rus
isol
atio
n us
ing
cell
cultu
re, i
nclu
ding
pre
para
tion
and
prop
agat
ion
of c
ell l
ines
, ch
oice
of c
ell l
ine,
inoc
ulat
ion
of c
linic
al s
peci
men
s, re
cogn
ition
of
cyt
opat
hic
effe
cts,
use
of n
eutra
lizat
ion
and
othe
r co
nfirm
ator
y te
sts
Is a
war
e of
the
prin
cipl
es o
f ele
ctro
n m
icro
scop
y, in
clud
ing
dire
ct d
etec
tion,
con
cent
ratio
n m
etho
ds a
nd m
ore
spec
ializ
ed
uses
and
the
indi
catio
ns fo
r its
use
Und
erst
ands
prin
cipl
es b
ehin
d an
tigen
/DN
A/R
NA
dete
ctio
n us
ing
e.g.
imm
unof
luor
esce
nce,
PC
R, E
LISA
12
11
Envi
ronm
enta
l mic
robi
olog
y fo
r mic
robi
olog
y tra
inee
sfor
mic
robi
olog
y tra
inee
s To
pic
Stag
e re
ache
d (w
hen
appl
icab
le) -
Tr
aine
r's in
itial
s an
d da
te
Com
men
ts
1
2 3
4
Is a
war
e of
the
exis
tenc
e of
sta
tuto
ry re
quire
men
ts fo
r cer
tain
fo
od, w
ater
or m
ilk ty
pes
Is a
war
e of
the
exis
tenc
e of
sta
tuto
ry s
tand
ards
for b
acte
rial
and
vira
l cou
nts
in b
athi
ng w
ater
s
Is a
ble
to e
xam
ine
com
mon
type
s of
food
, wat
er a
nd m
ilk fo
r to
tal c
ount
s, s
peci
fic o
rgan
ism
det
ectio
n an
d sp
ecia
l tes
ts
Is a
war
e of
ava
ilabl
e te
chno
logi
es fo
r the
det
ectio
n of
C
rypt
ospo
ridiu
m s
p. a
nd v
iruse
s fro
m fo
od o
r wat
er s
ampl
es
Und
erst
ands
the
prin
cipl
es b
ehin
d in
terp
reta
tion
of re
sults
on
diffe
rent
food
type
s an
d ca
n ad
vise
env
ironm
enta
l hea
lth
offic
ers
and
othe
rs a
ccor
ding
ly
Is a
war
e of
met
hods
for d
etec
tion
of L
egio
nella
sp.
13
12
Para
sito
logy
for m
icro
biol
ogy
train
eesm
icro
biol
ogy
train
ees
Topi
c St
age
reac
hed
(whe
n ap
plic
able
) -
Trai
ner's
initi
als
and
date
C
omm
ents
1
2 3
4
Is a
ble
to e
xam
ine
appr
opria
te s
ampl
es in
clud
ing
faec
es, u
rine
and
bloo
d fo
r par
asite
s an
d w
hen
to re
fer s
peci
men
s to
sp
ecia
list l
abor
ator
ies
for f
urth
er e
xam
inat
ion
Is a
war
e of
the
rang
e of
ser
olog
ical
inve
stig
atio
ns a
nd w
here
th
ey a
re p
erfo
rmed
Has
gai
ned
expe
rienc
e in
the
clin
ical
man
agem
ent o
f pat
ient
s w
ith p
aras
ite in
fect
ion
Is fa
milia
r with
the
man
agem
ent o
f ect
opar
asite
infe
ctio
n,
incl
udin
g sc
abie
s
14
13
Myc
olog
y fo
r mic
robi
olog
y tra
inee
smic
robi
olog
y tra
inee
s To
pic
Stag
e re
ache
d (w
hen
appl
icab
le) -
Tr
aine
r's in
itial
s an
d da
te
Com
men
ts
1
2 3
4
Is a
ble
to e
xam
ine
appr
opria
te s
ampl
es fo
r fun
gi a
nd k
now
s w
hen
to re
fer s
peci
men
s to
spe
cial
ist l
abor
ator
ies
for f
urth
er
iden
tific
atio
n an
d su
scep
tibilit
y
Is a
war
e of
the
rang
e of
ser
olog
ical
inve
stig
atio
ns a
nd w
here
th
ey a
re p
erfo
rmed
Has
gai
ned
expe
rienc
e in
the
clin
ical
man
agem
ent o
f pat
ient
s w
ith fu
ngal
infe
ctio
n
15
14
Epid
emio
logy
and
sta
tistic
ssta
tistic
s To
pic
Stag
e re
ache
d (w
hen
appl
icab
le) -
Tr
aine
r's in
itial
s an
d da
te
Com
men
ts
1
2 3
4
Und
erst
ands
the
vario
us m
etho
ds o
f col
lect
ing
data
abo
ut
com
mun
icab
le d
isea
ses,
and
the
limita
tions
of s
uch
data
Und
erst
ands
the
prin
cipl
es o
f cas
e co
ntro
l and
coh
ort s
tudi
es
Is a
ble
to c
onst
ruct
bas
ic d
ata
colle
ctio
n qu
estio
nnai
res
usin
g ap
prop
riate
sof
twar
e pa
ckag
es, e
.g. e
pi-in
fo
Und
erst
ands
the
role
of t
he lo
cal p
ublic
hea
lth la
bora
tory
Has
take
n pa
rt in
the
man
agem
ent o
f com
mun
ity o
utbr
eaks
of
infe
ctio
n, e
.g. f
ood
pois
onin
g am
ong
gues
ts fo
llow
ing
a fu
nctio
n
Und
erst
ands
the
impo
rtanc
e of
sta
tistic
s in
the
plan
ning
and
ex
ecut
ion
of s
tudi
es a
nd k
now
s w
hen
to s
eek
expe
rt as
sist
ance
fo
rm a
sta
tistic
ian
Is a
war
e of
the
stat
istic
al p
robl
ems
enco
unte
red
in c
linic
al tr
ials
, an
d of
the
type
s of
sta
tistic
al e
rrors
Can
sel
ect a
nd p
erfo
rm a
ppro
pria
te b
asic
sta
tistic
al a
naly
ses,
in
clud
ing
t-tes
t, ch
i-squ
are
test
, reg
ress
ion
and
corre
latio
n
16
15
Dat
a ha
ndlin
g To
pic
Stag
e re
ache
d (w
hen
appl
icab
le) -
Tr
aine
r's in
itial
s an
d da
te
Com
men
ts
1
2 3
4
Has
a b
asic
und
erst
andi
ng o
f inf
orm
atio
n te
chno
logy
and
, in
parti
cula
r, co
mpu
teriz
ed la
bora
tory
dat
a ha
ndlin
g
Is fa
milia
r with
sta
ndar
d w
ord
proc
esso
r, sp
read
shee
t, re
latio
nal
data
base
, sta
tistic
s an
d ep
idem
iolo
gy s
oftw
are
pack
ages
Is fa
milia
r with
the
basi
c m
etho
ds fo
r ele
ctro
nic
data
tran
sfer
w
ith lo
cal a
nd re
mot
e co
mpu
ter s
yste
ms
Is fa
milia
r with
the
requ
irem
ents
of d
ata
prot
ectio
n
Is a
war
e of
ava
ilabl
e te
chno
logi
es fo
r dat
a br
oadc
astin
g
Und
erst
ands
the
impo
rtanc
e of
a s
tand
ardi
zed
codi
ng s
yste
m
17
16
Qua
lity
Assu
ranc
e To
pic
Stag
e re
ache
d (w
hen
appl
icab
le) -
Tr
aine
r's in
itial
s an
d da
te
Com
men
ts
1
2 3
4
Und
erst
ands
the
diffe
renc
e be
twee
n qu
ality
con
trol a
nd q
ualit
y as
sura
nce
Has
exp
erie
nce
of q
ualit
y co
ntro
l usi
ng a
vaila
ble
sche
mes
Und
erst
ands
the
nece
ssity
for,
and
has
take
n pa
rt in
, clin
ical
au
dit,
both
inte
rnal
ly w
ithin
the
labo
rato
ry a
nd in
the
clin
ical
se
tting
in a
ssoc
iatio
n w
ith c
linic
al c
olle
ague
s
Und
erst
ands
the
proc
edur
es o
f lab
orat
ory
accr
edita
tion
18
17
Emer
ging
tech
nolo
gies
Topi
c St
age
reac
hed
(whe
n ap
plic
able
) -
Trai
ner's
initi
als
and
date
C
omm
ents
1
2 3
4
Is a
war
e of
all
maj
or n
ew te
chno
logi
es a
vaila
ble
to m
edic
al
mic
robi
olog
y (e
.g. m
onoc
lona
l ant
ibod
ies
and
poly
mer
ase
chai
n re
actio
n)
Is a
war
e of
all
avai
labl
e au
tom
ated
, rap
id te
chni
ques
ava
ilabl
e to
med
ical
mic
robi
olog
y
Is a
ble
to c
ritic
ally
eva
luat
e th
e ne
ed fo
r em
ergi
ng te
chni
ques
w
ithin
the
labo
rato
ry, i
nclu
ding
cos
t effe
ctiv
enes
s an
d ef
fect
s on
st
affin
g le
vels
and
wor
king
pra
ctic
es
Awar
enes
s of
use
of n
ear-p
atie
nt te
sts
19
18
Res
earc
h an
d de
velo
pmen
tdev
elop
men
t To
pic
Stag
e re
ache
d (w
hen
appl
icab
le) -
Tr
aine
r's in
itial
s an
d da
te
Com
men
ts
1
2 3
4
Has
und
erta
ken
rese
arch
pro
ject
s ap
prop
riate
to g
rade
and
tra
inin
g st
age
Has
sub
mitt
ed p
aper
(s) f
or p
ublic
atio
n in
pee
r rev
iew
jour
nals
Is a
war
e of
sou
rces
of f
undi
ng fo
r res
earc
h pr
ojec
ts a
nd
unde
rsta
nds
the
proc
esse
s in
volv
ed in
obt
aini
ng g
rant
s fo
r re
sear
ch a
ctiv
ities
Can
eva
luat
e cr
itica
lly th
e pu
blis
hed
wor
k of
oth
ers
20
19
Teac
hing
and
trai
ning
train
ing
Topi
c St
age
reac
hed
(whe
n ap
plic
able
) -
Trai
ner's
initi
als
and
date
C
omm
ents
1
2 3
4
Has
had
exp
erie
nce
of te
achi
ng u
nder
grad
uate
med
ical
st
uden
ts in
tuto
rials
gro
ups
and,
if p
ossi
ble,
form
al le
ctur
es
Has
had
exp
erie
nce
of te
achi
ng d
octo
rs fr
om o
ther
spe
cial
ities
(w
hen
suita
bly
seni
or )
Has
had
exp
erie
nce
of te
achi
ng n
urse
s (u
sual
ly o
n in
fect
ion
cont
rol t
opic
s)
Has
had
exp
erie
nce
of tr
aini
ng ju
nior
and
Sci
entif
ic s
taff
Whe
n ap
prop
riate
ly s
enio
r, ha
s ha
d ex
perie
nce
of tr
aini
ng
juni
or m
edic
ally
qua
lifie
d m
icro
biol
ogis
ts a
nd v
irolo
gist
s
21
20
Labo
rato
ry m
anag
emen
t and
legi
slat
iona
nd le
gisl
atio
n To
pic
Stag
e re
ache
d (w
hen
appl
icab
le) -
Tr
aine
r's in
itial
s an
d da
te
Com
men
ts
1
2 3
4
Und
erst
ands
the
nece
ssity
for,
and
has
acqu
ired
the
inte
r-pe
rson
al s
kills
nec
essa
ry to
dea
l with
oth
er m
embe
rs o
f sta
ff bo
th in
the
labo
rato
ry a
nd o
utsi
de
Has
regu
larly
atte
nded
dep
artm
enta
l man
agem
ent m
eetin
gs
and
has
been
giv
en d
eleg
ated
resp
onsi
bilit
y
Has
regu
larly
atte
nded
div
isio
nal m
anag
emen
t mee
tings
and
ha
s be
en g
iven
del
egat
ed re
spon
sibi
lity
Has
regu
larly
atte
nded
regi
onal
con
sulta
nt m
icro
biol
ogis
ts'
mee
tings
and
has
bee
n gi
ven
dele
gate
d re
spon
sibi
lity
Has
regu
larly
atte
nded
hos
pita
l inf
ectio
n co
ntro
l com
mitt
ee
mee
tings
and
has
bee
n gi
ven
dele
gate
d re
spon
sibi
lity
Has
regu
larly
atte
nded
dru
gs a
nd th
erap
eutic
s co
mm
ittee
m
eetin
gs (w
hen
antim
icro
bial
/ant
ivira
l age
nts
are
disc
usse
d)
and
has
been
giv
en d
eleg
ated
resp
onsi
bilit
y
Und
erst
ands
the
finan
cing
of a
labo
rato
ry a
nd h
ow to
allo
cate
re
sour
ces
with
in th
e la
bora
tory
Und
erst
ands
the
prin
cipl
es o
f per
sonn
el re
crui
tmen
t and
se
lect
ion
and
has
join
ed a
ppoi
ntm
ents
com
mitt
ees
Has
a c
lear
und
erst
andi
ng o
f ind
ivid
ual p
erfo
rman
ce re
view
and
ha
s ga
ined
som
e ex
perie
nce
in it
s ap
plic
atio
n
Has
atte
nded
a s
uita
ble
man
agem
ent c
ours
e
Und
erst
ands
the
nece
ssity
for a
nd th
e w
orki
ngs
of th
e N
atio
nal
Con
tinui
ng M
edic
al E
duca
tion
sche
me
Is a
war
e of
the
dutie
s of
con
fiden
tialit
y of
per
sona
l med
ical
in
form
atio
n
Any
othe
r rel
evan
t leg
al re
quire
men
ts
22
21
Addi
tiona
l top
ics
Topi
c St
age
reac
hed
(whe
n ap
plic
able
) -
Trai
ner's
initi
als
and
date
C
omm
ents
1
2 3
4
Has
bas
ic k
now
ledg
e of
the
imm
unol
ogic
al re
spon
se to
in
fect
ion
and
labo
rato
ry m
etho
ds to
stu
dy im
mun
ity
Has
exp
erie
nce
in m
olec
ular
bio
logy
tech
nolo
gy