Adam Lueken
In our series of blogs discussing Mohs surgery, we’ve talked about the ins and outs of Mohs certification and how it can benefit you and your patients. With skin cancer still on the rise, Mohs surgery is regarded by most as the best way to remove basal cell carcinomas and squamous cell carcinomas while keeping the greatest amount of healthy tissue possible.
If you’re looking into Mohs surgery continuing education and certification, you may have noticed there are two major paths to become a certified Mohs surgeon – completing a fellowship with the American College of Mohs Surgery and becoming a certified member of the American Society for Mohs Surgery. So what path to Mohs surgery certification is right for you? Let’s take a look at the similarities and differences between the two.
American College of Mohs Surgery
The American College of Mohs Surgery (ACMS) was founded by Dr. Frederick Mohs and a small group of surgeons in 1967. Today, the College has around 1,500 members who have completed their fellowship training in Mohs surgery. According to their website, the ACMS is the only organization that requires its members to have successfully completed an extensive one- to two-year fellowship training program in Mohs surgery after they have completed their years of dermatology residency training. During their fellowships, physicians participate in at least 500 Mohs surgery cases under the supervision of an experienced Mohs surgeon.
Once they’ve completed a residency, dermatologists can apply to participate in an ACMS-approved program. Qualified candidates undergo an extremely-competitive review process before being selected. Programs are accredited by the ACMS, the Accreditation Council for Graduate Medical Education (ACGME) or the Australasian College of Dermatologists (ACD). ACGME and ACD programs are recognized by the ACMS. Programs have a structured curriculum that includes graded responsibility, operative and non-operative education, and experience with long-term results and complications.
All fellows-in-training work with an experienced, expert ACMS surgeon. These surgeons work with the students throughout the program and provide direct surgery direction and mentoring. By the end of the program, fellows-in-training have the experience and judgment to take on complicated cases. The program is designed to be comprehensive and challenging, because of the complexity of cancer itself.
To complete an ACMS-approved fellowship, dermatologists must:
- Participate in a minimum of 500 Mohs surgery cases.
- Accurately interpret tissue samples removed during Mohs surgery.
- Perform a variety of reconstructions, from simple closures to more complicated repairs.
Because of the comprehensiveness and quality of the education provided, participants truly receive an unparalleled experience when it comes to gaining Mohs surgery knowledge and expertise.
American Society for Mohs Surgery
The American Society for Mohs Surgery (ASMS) was established in 1990 by a small group of Mohs-experienced dermatologists in Southern California. Their goal was to provide important educational and professional support for the growing number of Mohs surgeons in the country. They sought to create an environment in which members could share Mohs knowledge and experiences with other dermatologists who haven’t trained in Mohs.
Board certification by the American Board of Dermatology (ABD) or the American Osteopathic Board of Dermatology (AOBD) is required for ASMS members. Their board certification candidates have extensive experience in dermatologic surgery and histopathology concepts.
The ASMS requires its fellow membership candidates to submit recent Mohs cases and related documentation for review prior to acceptance in this membership category. Fellow candidates also must pass an examination on Mohs surgery principles and show skills in the interpretation of Mohs histopathology. Specifically, to become a member, dermatologists must:
- As the primary surgeon, perform and document a minimum of 75 Mohs cases.
- Submit two letters of character reference form other board certified dermatologists.
- Submission of two complete Mohs cases, including slides, map, report and preoperative photos. These must have been performed within the last two years.
- Score at least 70% on the written and practical sections of ASMS fellow examination. The exam is offered three times a year.
Also, after becoming a member, participation in peer review for at least four years is required.
In comparing these two paths to Mohs surgery certification, both offer a means to become a fellowship trained Mohs surgeon. But with its thorough approach and mentorship opportunities with expert Mohs surgeons, the American College of Mohs Surgery fellowship program does appear to offer a more comprehensive way to becoming highly-efficient with Mohs.
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