An International Perspective on Mohs Surgical Training

Mohs micrographic surgery (MMS) is the gold standard for complete margin analysis of skin cancer in the United States; however, its global acceptance varies. Limited information exists regarding international MMS practices.

This study aimed to gather information regarding the education, training, and practice of MMS worldwide, recognize variances in practices, and understand challenges international Mohs surgeons encounter.

Providers outside the United States practicing MMS were surveyed from 8/2023-5/2024. The online survey compromised 47 questions addressing participants' certification/accreditation, practice of MMS in their current country, and potential barriers to practice.

One hundred fifty-eight participants representing 31 countries were included. In total, 95.6% participants completed primary training in dermatology. Certification/accreditation requirements varied, with 32.3% and 27.2% completing a minimum of 100 MMS cases and repairs as primary surgeon, respectively. Barriers to increasing patient volume include lack of public knowledge regarding MMS (41.1%), limited infrastructure (40.5%), and minimal/no reimbursement (31.0%).

This study highlights the diverse challenges in expanding the global recognition of MMS. A comprehensive international survey and registry is critical to understand the current state of MMS training and practice internationally. This knowledge can help promote universal standards, ensure competent training, and foster collaborations that elevate the recognition of MMS globally.