An International Perspective on Mohs Surgical Training

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.