Continued Learning & CPD

Mohs Surgery

OVERVIEW

Becoming an ACD approved Mohs specialist

To become an ACD approved Mohs specialist in Australia it is necessary to complete an accredited program of Mohs surgery training, either here in Australia or overseas, and hold both specialist recognition to practice as a dermatologist in Australia as well as FACD. A trained specialist Dermatologist must undertake a minimum of 1-2 years approved Mohs surgery training or equivalent Mohs Fellowship program and meet specific requirements.

The College publishes a list of ACD approved Mohs Specialist on its website.

The doctors on the ACD Approved Mohs Specialists register are both Fellows of the Australasian College of Dermatologists (FACD) and accredited Mohs Specialists. They adhere to the following benchmarks of quality by:

  • Ensuring that 90% of Mohs cases are carried out in difficult sites including the head and neck, lower leg, hands, digits or anogenital area
  • Maintaining practical skills by undertaking a minimum number of 50+ Mohs cases per year totalling not less than 150 over a 3-year period
  • 13 or more section cases (MBS 31002 or 31005) should in volume terms make up the minority of practice.
  • Participating in an annual quality assurance program in diagnostic dermatopathology run by the Royal Australasian College of Pathology Quality Assurance Program.
  • Participating in the ACD Mohs group which sets professional standards for the practice of Mohs surgery in Australia under the auspices of the Australian Medical Council.
  • Analysis of 2016-2018 Mohs group caseload data shows the mean number of cases per year was 300. The standard deviation was 200. Members of the group who carry out over 700 cases per year (2 SD above mean) should consider why their practice is different in terms of volume to the majority of colleagues. A reflective review of practice against current guidelines and peer practice should be undertaken. This benchmark will be reviewed annually and Mohs group results promulgated to all college members

Accredited Mohs Surgery Training is usually offered over a 12 month period to a maximum of 2 years.

Candidates develop detailed understanding of the clinical sciences that underpin the practices of Mohs surgery including anatomy, physiology and immunology, cutaneous oncology, histopathology and wound healing.

Candidates develop advanced competence in the identification and management of patients who should be treated by Mohs surgery, including those who need a multi-disciplinary approach with a number of other specialists.

Candidates become competent in all elements of Mohs surgery, including histopathological interpretation and reconstruction of surgical defects.

In Australia, the Australasian College of Dermatologists is the peak body responsible for accrediting Mohs surgery training positions.

Mohs surgery training is undertaken in facilities accredited by the College National Accreditation Committee, with an appropriately qualified Supervisor of Training and other supervisors.

There are currently five accredited Mohs training positions:

State Program Location Supervisor of Training Training Position Information
NSW Skin and Cancer Foundation, Westmead Dr Simon Lee Accepting applications
QLD North West Private Hospital, Everton Park Dr Zoran Gaspar Accepting applications
WA Oxford Day Surgery & Dermatology, Mount Hawthorn Dr Carl Vinciullo Accepting applications
WA South Perth Specialist Skin Cancer Centre, South Perth Dr Tim Elliott Accepting applications
UK St John’s Institute of Dermatology, Guy’s Hospital London Dr Raj Mallipeddi Accepting applications

(Note: All training positions are generally of 12 months duration and will have a nominated commencement date. Not all training positions will commence at the beginning of a calendar year.)

Fellows must meet one of the following criteria in order to be eligible to apply for inclusion on this list:

  1. ACD Fellowship and completion of ACD Mohs Surgery Training Program
  2. ACD Fellowship and completion of an American College of Mohs Surgery (ACMS) Fellowship Program
  3. FRACP Fellowship from New Zealand ONLY if obtained by undertaking the RACP Advanced Training in Dermatology qualification and completion of ACD accredited Mohs Surgery Training Program.click here for Further information on FRACP

It is recommended that internationally trained dermatologists who wish to apply for a Mohs Surgery Training Position must first have their skills and experience assessed to establish that these are substantially comparable to that of an Australian trained dermatologist.

If the doctor is assessed as being not substantially comparable, he/she will need to undertake further upskilling in dermatology through the ACD Dermatology Training Program.

Once FACD has been obtained, you may apply for a Mohs Surgery Training Position.

Mohs surgery training positions are generally advertised on the College website.

To apply for a position on the Mohs training Program you must complete the online application form.

click here to apply

Your application will then be assessed by the relevant Training Supervisor and the ACD Mohs Committee.

If your application is successful you will be informed on the training site and start time.

There is a $500 administrative fee for this program.

An invoice will be sent out on commencement of a Mohs training position.

I completed the Mohs Surgery Fellowship at The Skin Hospitals in New South Wales. The program was conducted across two sites – Westmead and Darlinghurst – which allowed exposure to different mentors, techniques, theatres and allied staff.The fellowship was orchestrated by Dr Simon Lee who took over the position from the long-serving Associate Professor Paver. Simon is approachable, generous, well-organised and an excellent teacher. The other mentors, with over 60+ years of Mohs surgery experience between them, unsurprisingly provide an enormous breadth of clinical and surgical experience.The case mix was varied, with ample chance to participate in large cases and complex repairs. In particular, there is a close relationship with several visiting oculoplastic surgeons enabling exposure in this field. In addition, once per month, Dr Shawn Richards held a GP list with a focus on chemical peels and ablative laser such as the treatment of rhinophyma.The fellowship was set up to enable learning via surgical assistance for the first three days of the week, then performing Mohs surgery under supervision on the fourth day of week when confident. The fifth day of the week was reserved for one’s own private clinic.I enjoyed my fellowship year immensely. The skills I acquired have helped me to become more confident in all aspects of procedural dermatology and I would not hesitate in recommending this fellowship to anyone with a similar interest.

~Dr Nicholas Stewart FACD


I completed my Mohs Fellowship at Dermatology Specialist Centre/North West Private Hospital in 2016. I was fortunate to have superb mentors in the three training Mohs surgeons (Drs Gaspar, Francis, and Pagliaro). Over the year they closely assessed my skills, both positively and critically, in a fashion that resulted in continued improvement throughout the fellowship. Having worked as a general dermatologist for the three years prior to the fellowship, in hindsight my ability to perform more complex procedures was limited, and I very much value the skill set acquired during this 12 months. Each of the three training fellows approaches problems with a different philosophy and surgical technique, adding valuable depth to the experience.

~Dr Dougal Coates
FACD


I have completed my accredited Mohs Fellowship at the Skin & Cancer Foundation Australia in January 2015.  The friendly and professional surgical team, led by Associate Professor Robert Paver, was extremely supportive during the course of my training.  The training provided exposure to a large number of cases with a breadth of complexities, and the opportunities to participate in the treatment of highly challenging cases with large tumour bulk and complex repairs, under close supervision, have been invaluable.  In addition, there were opportunities to constantly improve one’s individual surgical competence through challenging cases performed under independent settings, with the knowledge that assistance will be available if required.

The fellowship also included training in the use of lasers for the management of surgical scars and other dermatological conditions.

I would recommend this fellowship to anyone who aspires to become a competent Mohs Micrographic Surgeon.

~Dr. Chin-Yun Lin
BSc(Med), MBBS(1st Hons), FRACP, FNZDS


I completed my Mohs Micrographic Surgery Fellowship at Oxford Day Surgery and Dermatology in Perth, Western Australia. The training was very well organised and structured. I was very fortunate to have the opportunity to train under five different Mohs Surgeons at the practice – A/Prof Vinciullo, Dr Tai, Dr Smith, Dr Borchard and Dr Cherian. Each of them had their own way of approaching problems, hence adding to the experience of the fellowship. The training offered me exposure to a large number of cases, with different complexities. All staff at Oxford Day Surgery and Dermatology were extremely supportive and helpful. Overall, it was a highly enjoyable Fellowship and a great learning experience. I would highly recommend it to dermatologists who are interested in undertaking a Mohs Micrographic Surgery fellowship.

~Dr Peggy Chen



The ACD Mohs fellowship is a very well organised and structured program ensuring coverage of topics important to the development of a Mohs fellow. Interacting with college staff was painless as they were very efficient and quick to respond to queries.

My fellowship was an enjoyable year with a good variety of cases including multiple complex cases. Surgical faculty were very supportive and approachable throughout my fellowship.

There was a good balance of supervision and independence with an abundance of hands-on surgical time as the primary surgeon.

~Dr. David Lim