Diversifying the Mohs Workforce: Understanding Barriers of Applicants to Mohs Micrographic Surgery Fellowship
May 2023 | Volume 22 | Issue 5 | 471 | Copyright © May 2023
Published online April 28, 2023
Lauren Hoffman MDa, Gabrielle Benesh MDa, Yssra Soliman MDb, David H. Ciocon MDa, Ramone F. Williams MD MPhilc
aAlbert Einstein College of Medicine and Montefiore Medical Center, Department of Medicine, Division of Dermatology, Bronx, NY
bColumbia University Department of Dermatology, New York, NY
cMassachusetts General Hospital, Department of Dermatology, Boston, MA
Abstract
Background: The population of the United States is becoming increasingly diverse, yet dermatology, especially Mohs micrographic surgery (MMS), lags behind.
Objective: This survey study investigates perceived barriers of underrepresented groups in medicine (URM) who are pursuing fellowship in Mohs micrographic surgery and dermatologic oncology (MSDO).
Methods and Materials: An IRB-approved survey was distributed electronically to accredited dermatology residencies between December 2020 and April 2021.
Results: One hundred and thirty-three dermatology residents responded to the survey and of the participants, 21% identified as a URM. There was no significant difference in those interested in applying for MSDO fellowship between URMs and non-URMs. URMs rated the following factors significantly higher when deciding to pursue MSDO fellowship: lack of perceived diversity in target patient population (mean 3.61, SD 1.66), race/ethnicity/gender of past MSDO fellows (mean 3.25, SD 1.71), perceived attitudes of MSDO fellowships towards an applicant’s race or ethnicity (mean 3.25, 1.65 SD), and lack of diversity of trainees and faculty in MMS (mean 3.61, SD 1.47).
Conclusion: This study is one of the first to evaluate perceived barriers to diversifying the MMS workforce. The perceived barriers we have identified are complex and require concerted efforts for improvement.
J Drugs Dermatol. 2023;22(5): doi:10.36849/JDD.7083
Hoffman L, Benesh G, Soliman Y, et al. Diversifying the Mohs workforce: understanding barriers of applicants to mohs micrographic surgery fellowship.
J Drugs Dermatol. 2023;22(5):471-474. doi:10.36849/JDD.7083
INTRODUCTION
The population of the United States is becoming increasingly diverse. Dermatology lags, particularly amongst Mohs micrographic surgeons, where less than 4.5% identify as underrepresented in medicine (URM).1 It is important to understand this stark discrepancy as skin cancer morbidity and mortality are highest among African Americans and Hispanics. Recently, several calls to action have been proposed to better understand barriers that minority students may face when deciding to pursue dermatology, and we propose that the same undertaking should be done for URM groups pursuing fellowship in Mohs micrographic surgery and dermatologic oncology (MSDO).2-5 This survey study investigates perceived barriers to URM groups pursuing fellowship in MSDO.
MATERIALS AND METHODS
An IRB-approved survey (IRB2019-10116) was conducted between December 2020 and April 2021. The anonymous 23-item survey was electronically distributed via the Association of Professors of Dermatology (APD) listserv, consisting of 130 program directors, with a request to forward it to dermatology residents. Demographic information was collected, and participants were queried regarding robustness of surgical training and exposure to Mohs micrographic surgery (MMS) during residency. Participants were asked to rate potential barriers to pursuing MSDO fellowship on a Likert scale (1 = not important and 5 = very important). The Accreditation Council for Graduate Medical Education (ACGME) has enacted several "Common Program Requirements" addressing issues of diversity, equity, and inclusion. The ACGME, as the major institutional governing
