MOHS Surgery Certificate of Added Qualification
ELIGIBILITY REQUIREMENTS AND INSTRUCTIONS FOR EXAMINATION IN MOHS MICROGRAPHIC SURGERY (MMS)
PLEASE READ CAREFULLY
The following are requirements that must be met in order to be eligible for examination in Mohs Micrographic Surgery (MMS) by the American Osteopathic Board of Dermatology (AOBD). Please read this information carefully and complete the required application for examination along with submission of the required documents as specified below and on the application checklist. Candidates who successfully complete the examination process will then be eligible to receive a Certificate of Added Qualification in MMS from the American Osteopathic Association (AOA)/American Osteopathic Board of Dermatology (AOBD).
I. BASIC REQUIREMENTS
To be eligible for examination and certification in MMS, the applicant must meet all of the following minimum requirements. Click here to register for application process. Once registered, all required materials are listed in and should be submitted to http://aobd.instructure.com using the login and email provided to you. The applicant must:
- Be a graduate of an AOA-approved college of osteopathic medicine. A copy of the applicant’s medical school diploma must be submitted with their application.
- Be licensed to practice medicine in the state or territory where his/her practice is conducted. A copy of the applicant’s medical license must be submitted with their application.
- Be board certified in dermatology by the AOA/AOBD. A copy of the applicant’s Dermatology Board Certification Certificate must be submitted with their application.
- Have been a member in good standing of the AOA or Canadian Osteopathic Association (COA) for a continuous period of at least two (2) years immediately prior to the date of certification. The applicant must submit proof of AOA or COA membership with their application.
- Be able to show evidence of conformity to the standards set in the Code of Ethics of the AOA.
- Submit with their application payment of the required $1800.00 examination fee. This fee is non-refundable.
II. PERFORMANCE OF MOHS MICROGRAPHIC SURGERY
In order to qualify for recognition as a Mohs micrographic surgeon and apply as a candidate for certification examination in MMS, the applicant must practice and perform the complete MMS procedure. That is, the Mohs micrographic surgeon must excise the tissue sections by the Mohs technique and tissue processing must be completed by the MMS method, providing horizontal sections for complete margin examination. The Mohs micrographic surgeon must work in direct “face to face” communication with the Mohs histotechnician, overseeing the tissue processing activities of the MMS laboratory and must formally evaluate and interpret the histologic sections and map the findings appropriately. All of these activities are implicit to the MMS technique and are the direct responsibility of the Mohs micrographic surgeon. Eligibility for examination requires that the Mohs micrographic surgeon be registered to perform the procedure under CLIA regulations. The applicant must submit a copy of their CLIA laboratory certificate with the application.
III. TRAINING AND EXPERIENCE DOCUMENTATION
Special training in MMS includes completion of a recognized fellowship program (one year minimum) in MMS. This includes programs provided by the allopathic profession through the American College of Mohs Surgery (ACMS), programs meeting the requirements for accreditation in Procedural Dermatology by the American Board of Dermatology, as well as programs that are approved by the AOA. An additional path way is provided for those individuals who have received their training through residency or during practice and who are fellows of the American Society for Mohs Surgery. Applicants eligible to sit for the certification examination for MMS include:
- An applicant who has completed recognized fellowship training in and can provide documentation of specialty training in MMS, including their fellowship certificate or diploma and the complete surgical case log from the fellowship program. It is required that the MMS fellowship program provide the trainee with active participation in a minimum of 400 cases of MMS during the training period.
- An osteopathic dermatologist who has completed the “Fundamentals of Moh’s Surgery Course” sponsored by the American Society for Mohs Surgery and has attained fellowship status within that organization and has submitted a log documenting a minimum of 200 cases of MMS performed in clinical practice within a period of time not to exceed two years may be eligible to sit for the examination.
All candidates for certification examination in MMS must submit a formal letter indicating the nature of their training in MMS, provide documentation of MMS training and submit their complete log of MMS cases performed in clinical practice. The log must indicate a confidential method of patient identification, the tumor type, preoperative tumor size, tumor location, number of stages and postoperative wound size.
IV. WRITTEN EXAMINATION
The candidate must pass a written examination. The examination will include testing on several areas including: tumor biology and cutaneous oncology indications for MMS surgical technique, surgical anatomy, local and regional anesthesia, preoperative evaluation, histological technique, wound care and wound healing, dermatopathology, surgical complications, and instrumentation. The core references used to construct the examination include the standard texts on Mohs Surgery, Dermatology, and Dermatologic Surgery as well as peer-reviewed journals on Dermatology, Dermatologic Surgery, Cutaneous Oncology and Reconstruction, and additional references.
V. PRACTICAL EXAMINATION (EVALUATION OF REPRESENTATIVE CASES)
The applicant must provide for review at the time of the examination:
- Documentation of six (6) MMS cases within the past two years. Any candidate retaking the slide portion of the exam must submit 6 different Mohs cases (not previously submitted) performed within the last 2 years.
- The submitted cases must involve at least four (4) separate anatomic areas from the head and neck region.
- All cases must have a minimum of two (2) MMS stages and at least one of the cases must have three (3) MMS stages
- One case must be a tumor other than a basal cell carcinoma
Documentation must include:
- Patient records inclusive of pre-operative evaluation, operative reports and post- operative follow-up records
- Mohs surgical maps
- All corresponding histologic slides. Cases should be brought to the exam site in cardboard slide trays arranged by case.
- While not required, photographs are also helpful to include
All submitted cases must have been performed by the applicant during their clinical practice (after completion of training in dermatology and MMS). These cases will be evaluated by members of the examination committee (Subcommittee on Mohs Micrographic Surgery Certification and Training) and the AOBD and graded based on quality and completeness of slide preparation and accuracy of interpretation. As deemed necessary, any given applicant may be asked to provide oral explanation of any cases or answer specific questions regarding a case as part of the overall examination.
VI. APPLICATION SUBMISSION
The application and all substantiating documentation, except for practical examination slides and documents, must be submitted no later than August 1 of the year of the exam.
VII. PRACTICAL EXAMINATION DOCUMENTATION
Patient records, maps and slides (see Article V) shall be submitted at the time of examination for review by the test committee. It is the RESPONSIBILITY of the candidate to bring these articles to the test site.
FAILURE TO SUPPLY THE REQUIRED CASES FOR THE PRACTICAL EXAMINATION WILL DISQUALIFY THE CANDIDATE FROM SITTING FOR THE WRITTEN EXAMINATION.
All licenses, memberships and certificates MUST be valid as of the date of the test.