Mohs surgery was developed in the 1930s by Fredric Mohs, MD. It is characterized by the meticulous removal of a skin cancer by taking a series of “layers” and examining each microscopically until the tumor is completely eradicated. By using this approach, skin cancer is effectively cured while preserving as much of the normal surrounding skin as possible. This process can be completed in the office. In many cases, the resulting loss of skin is repaired the same day by suturing the wound closed. In other cases, the wound may heal on its own.
Mohs surgery provides the best treatment for many types of skin cancer, offering up to a 99% cure rate. This is important, as the ideal is to minimize the chance that any cancer could be left behind, and then regrow. Mohs is recommended for the removal of skin cancer on the head and neck, scalp, hands, shins, and other areas, as well as in more aggressive forms of skin cancer.
Fellowship training in Mohs surgery involves an additional 1-2 years of training after the completion of a dermatology residency. In many cases, this training involves hundreds and even over a thousand cases of cancer removal, microscopic examination of tissue, and reconstruction while the fellow is paired with one, or multiple, skilled and experienced surgeons. These fellowships are regulated by the American College of Graduate Medical Education, and meet all the stringent guidelines required as such. Through this instructor and fellow teaching model, great experience is gained in the removal and reconstruction required to manage skin cancer. This training is important, as the Mohs surgeon functions in the surgical excision of the tumor, examining the tissue microscopically (histopathology), and in the reconstruction.
A fellowship is additional medical training that occurs after the completion of medical school, an internship, and residency. In the case of Dr. Tarantola, she completed her internship, then her residency in dermatology, and then was accepted into a fellowship training program in Mohs Surgery and procedural dermatology at Mayo Clinic in Rochester, Minnesota. It is not required to complete a fellowship to perform Mohs surgery in the state of Florida, but Dr. Tarantola elected to complete this more extensive training.