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An International Perspective on Mohs Surgical Training.

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Mohs micrographic surgery (MMS) practices vary globally due to diverse training and accreditation. Key barriers include low public awareness, limited infrastructure, and poor reimbursement, hindering wider adoption of this skin cancer treatment.

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Area of Science:

  • Dermatology
  • Surgical Oncology
  • Global Health

Background:

  • Mohs micrographic surgery (MMS) is the standard for skin cancer treatment in the US, but international adoption is inconsistent.
  • Limited data exists on global MMS education, training, and practice variations.

Purpose of the Study:

  • To investigate worldwide MMS education, training, and practice patterns.
  • To identify international disparities in MMS procedures and surgeon challenges.
  • To understand barriers affecting global MMS implementation.

Main Methods:

  • An online survey was distributed to international MMS practitioners between August 2023 and May 2024.
  • The survey included 47 questions on certification, current practice, and perceived obstacles.
  • Data from 158 participants across 31 countries were analyzed.

Main Results:

  • Most participants (95.6%) had dermatology training; however, certification/accreditation standards differed significantly.
  • Less than a third met criteria for minimum case numbers (100 MMS cases, 27.2% for repairs).
  • Major barriers identified were lack of public knowledge (41.1%), inadequate infrastructure (40.5%), and minimal reimbursement (31.0%).

Conclusions:

  • Significant challenges exist in standardizing and expanding global Mohs micrographic surgery (MMS) recognition.
  • A global MMS survey and registry are essential for understanding current practices and promoting consistent training.
  • Establishing universal standards and fostering international collaboration can enhance MMS globally.