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Fellowship-Trained Mohs Surgeons (i.e., American College of Mohs Surgery (ACMS)) vs Mohs Society (ASMS)

There are distinct differences in how a Dermatologist can go about becoming a “Mohs Certified Surgeon.” Essentially there are two routes: One is by way of the American College of Mohs Surgery (ACMS); the other is via the American Society for Mohs Surgery (ASMS).  The details of how a surgeon earned their certification is often lost in translation and is overlooked by skin cancer patients.  Please allow me to give you a quick synopsis.

American College of Mohs Surgery (ACMS)

The ACMS was founded by Dr. Frederick Mohs himself back in 1967.

Mohs Fellows who are enrolled in the ACMS 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 1-2 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.


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 skin flap and grafts

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.

American Society for Mohs Surgery (ASMS)

The ASMS was founded in 1990 by a small group of Dermatologists in Southern California, all of whom had received Mohs training in Residency and had 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 who did not participate in a fellowship.

How do you become a certified member of the society?

  • You need to have completed your residency in Dermatology or a related field
  • Along with the $350, you need to have documentation for a minimum of 75 Mohs cases performed as the primary surgeon (a maximum of 45 of these cases may have been performed as part of applicant’s dermatology Residency training)
  • Two letters of character references from other Board certified Dermatologists
    Submission of 2 complete Mohs cases for evaluation, including glass slides, Mohs map, operative report and perioperative photographs which must be performed in applicant’s post-Residency practice, and within the past two years
  • Upon granting of membership, the applicant is required to participate in the ASMS annual Peer Review program for four additional years.

 

As the patient, you have the right to know the “Mohs College difference”.  Some non-fellowship trained Dermatologists will use phrases like:

                  “I didn’t complete a fellowship, but had extensive Mohs training in my residency.”

                  “A fellowship isn’t necessary to do Mohs.”

                  “I use a “modified” Mohs technique in my practice.”

You’ve got options and ultimately, it is your choice to make.  After finishing my residency in Dermatology at the University of Washington, I completed my Mohs Surgery Fellowship at Yale University and had extensive reconstruction training in simple closures, skin flaps, and grafts.  Currently, I am a Fellow in the ACMS and have performed over 7,000 Mohs surgeries in private practice.