Timeline: The Evolution of Fellowship Training in Micrographic Surgery and Dermatologic Oncology

August 2022 | Volume 21 | Issue 8 | 861 | Copyright © August 2022


Published online July 28, 2022

C. William Hanke MD MPHa, Clark C. Otley MDb, Philip L. Bailin MDc, Thomas Stasko MDd, Suzanne Olbricht MDe, John A. Zitelli MDf

aAscension St. Vincent Hospital, Indianapolis, IN
bMayo Clinic, Rochester, MN
cDepartment of Dermatology, The Cleveland Clinic, Cleveland, OH
dDepartment of Dermatology, The University of Oklahoma, Oklahoma City, OK
eBeth Israel Deaconess Medical Center, Boston, MA
fUniversity of Pittsburgh Medical Center, Pittsburgh, PA

Abstract
The Accreditation Council for Graduate Medical Education (ACGME) granted accreditation to the first 5 Procedural Dermatology Fellowship Training Programs in 2004.

The name of the training program was changed from Procedural Dermatology to Micrographic Surgery and Dermatologic Oncology by the ACGME/Residency Review Committee for Dermatology in 2014. The American Board of Dermatology/American Board of Medical Specialties conducted the first certification examination in Micrographic Dermatology Surgery in October 2021. This article chronicles the history and development of the subspecialty.

J Drugs Dermatol. 2022;21(8):861-863.: doi:10.36849/JDD.6933

INTRODUCTION

The first 1-year training program in Mohs Surgery was established by Dr Perry Robins at NYU in 1970 (Table 1). Several other training programs were established in the 1970s, including programs at the Cleveland Clinic and UCSF. In 1982, Dr Ed Krull, Chair of the Dept of Dermatology at Henry Ford Hospital, developed the Core Curriculum for Dermatologic Surgery. This document was created to codify the need for surgical experience in all dermatology residency programs and to standardize the training.

In 1983, as the number of 1-year training programs in Mohs Surgery continued to increase, the leadership of the American College of Chemosurgery (later to become the American College of Mohs Surgery) felt that standards should be required for Mohs Surgery Fellowship Training Programs. The Fellowship Training Committee (FTC) of the College (Dr Philip L. Bailin-Chair, Dr Rex Amonette, Dr Ted Tromovitch, and Dr. Gerald Bernstein) met in San Francisco to create structure and requirements for 1-year fellowship training programs. The training requirements were approved by the College Board of Directors, and a formal 1-year fellowship approval process began in 1983. The FTC required site-visits beginning in 1997 in order to more thoroughly assess the structure and quality of training at each program.

Dr Krull was appointed to the Accreditation Committee for Graduate Medical Education (ACGME) Dermatology Residency Review Committee (RRC) in 1984. He served as chair of the RRC from 1987 to 1994. Dr Krull directed a revision of the Core Curriculum for Dermatologic Surgery in 1987 to reflect the changes in dermatologic practice.

In 1990, the RRC, under Dr Krull's leadership, received approval from ACGME for special training requirements for all dermatology residency programs to include complex closures, flaps, grafts, laser surgery, and nail surgery. ACGME also instituted the requirement for a designated surgical program director for each dermatology residency program.

By 1991, 37 Mohs Surgery Training programs had been established under the approval program of the American College of Mohs Surgery and Cutaneous Oncology (the name