It’s 2016. Skin cancer diagnoses have been on the rise for quite some time now. That bronzed look that sunbathers have long been seeking is now being talked about at length in regards to the danger it poses on your health. And, even in dire attempts to educate people about the effects of UV radiation from the sun and other sources such as tanning beds, the issue still looms large and prevention measures need to be proactively sought and taught.
With the cases of skin cancers popping up at inflated rates, we have also seen an influx in remediation efforts to remove skin cancers with hopes of interrupting the spread of the disease, which, as we know, can ultimately lead to death. Therefore, it’s not a task to be taken lightly. When it comes to the removal of existing cancer cells, you want the practice and the professional that is going to do the best job for you and your health.
Enter Mohs micrographic surgery.
Developed by Dr. Frederick Mohs in the 1930s, Mohs micrographic surgery has, with a few refinements, come to be embraced over the past decade by an increasing number of surgeons for an ever-widening variety of skin cancers.
Today, Mohs surgery has come to be accepted as the single most effective technique for removing Basal Cell Carcinomas and Squamous Cell Carcinomas (BCCs and SCCs), the two most common skin cancers. It accomplishes the nifty trick of sparing the greatest amount of healthy tissue while also most completely expunging cancer cells; cure rates for BCC and SCC are an unparalleled 98 percent or higher with Mohs, significantly better than the rates for standard excision or any other accepted method.
Now that we have that on the table, we wanted to discuss the distinct differences in how a dermatologist can go about becoming a “Mohs Certified Surgeon.”
There are two routes. One is by way of the American College of Mohs Surgery; the other is via the American Society for Mohs Surgery. The detail of how a surgeon earned their certification is often lost in translation and is a minute detail overlooked by a vast majority of skin cancer patients. So, allow us to give you a quick synopsis.
American College of Mohs Surgery:
First things first – The American College of Mohs Surgery (ACMS) was actually founded by Dr. Frederick Mohs himself back in 1967.
Fellows enrolled in the American College of Mohs Surgery undergo an intensive training curriculum. After completing their residency in dermatology, a physician can apply to participate in an ACMS-approved fellowship-training program. Qualified applicants, who have passed an extremely competitive review and selection process, undergo a 1- to 2-year training program that includes operative and non-operative education, pathology, tumor reconstruction, as well as exposure to long-term results, recurrences, and complications.
Each fellow-in-training is paired with an accredited, veteran ACMS surgeon who has demonstrated proficiency and expertise in Mohs surgery. The fellow-in-training receives direct Mohs surgery guidance and mentoring for the duration of the program.
To complete an ACMS-approved fellowship, a physician must:
- Participate in a minimum of 500 Mohs surgery cases during fellowship (surgeries during residency do not count)
- Learn to accurately interpret slides of tissue samples that have been removed during Mohs surgery
- Perform a wide breadth of reconstructions, ranging from simple closures to complicated multi-step repairs
The fellows who choose to participate in the fellowship training programs gain the unparalleled experience and judgment in their studies. The program is comprehensive and rigorous because skin cancer itself occurs in a diversity of forms, degrees, and areas of the body.
For more information visit: www.mohscollege.org
American Society for Mohs Surgery:
“The American Society for Mohs Surgery was founded in 1990 by a small group of dermatologists in Southern California, all of whom had received extensive Mohs training in Residency and had successfully integrated the Mohs technique into their practices. The ASMS was envisioned as a professional medical society that would provide important professional and educational support for the increasing number of Residency-trained Mohs surgeons throughout the country.”
How do you become a certified member of the society?
You need to have completed your residency in dermatology or a related field – similar to the first requirement of the American College of Mohs Surgery. Then, along with $350, you need to fulfill the following requirements:
- Documentation for a minimum of 75 Mohs cases performed as the primary Mohs surgeon. A maximum of 45 of these cases may have been performed as part of applicant’s dermatology Residency training.
- Two letters of character reference from other Board certified dermatologists.
- Submission of two complete Mohs cases for evaluation, including glass slides, Mohs map, operative report and perioperative photographs. These cases must have been performed in applicant’s post-Residency practice, and within the past two years.
- Passing scores of seventy percent each on written and practical portions of ASMS Fellow examination. Exam is currently offered three times per year: during the winter AAD meeting, during the ASMS clinical symposium in May, and during the ASMS Fundamentals of Mohs Surgery course in November. Please see Upcoming Events calendar for exact dates and times.
- Upon granting of Fellow membership, applicant is required to participate in the ASMS annual Peer Review program for four additional years.
- Other Maintenance of Fellow membership requirements will apply following completion of mandatory four-year Peer Review participation.
This is a simple overview of “ACMS” and “ASMS” dermatologists practicing Mohs surgery. You as the patient have the right to know the “Mohs College difference” and sometimes this is difficult to comb through on your own.
For more information visit: www.mohssurgery.org
Lucky for us, our very own lead Mohs physician, Dr. Gary Mendese is an American College of Mohs Surgery Fellowship trained Mohs surgeon. It’s his dedication to his craft, and respect for the Mohs surgical practice that gives us a great deal of pride in being able to offer our patients the very best care in New Hampshire and beyond.
You’ve got options. And ultimately, it’s your choice to make. What we’ve done is just laid some facts on the table for you to consume and consider. At the end of the day, the most important thing for your skin health is getting your skin checked for cancerous lesions so that a cure is an option in the first place (if one is needed). If you’re not protecting yourself and keeping an eye on your skin, the consequences could be grave.