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Evidence-Based Guide

How to Choose the Best Mohs Surgeon: An Evidence-Based Guide

Evidence-based guide to selecting a Mohs surgeon. Learn what fellowship training means, how surgical volume affects outcomes, why same-surgeon reconstruction matters, and what questions to ask. Based on 15+ peer-reviewed studies.

TH

Thomas L.H. Hocker, M.D., M.Phil.

Harvard Medical School & Mayo Clinic-Trained

Triple Board-Certified Dermatologist, Dermatopathologist & Mohs Surgeon

Updated March 2026

How to Choose the Best Mohs Surgeon: An Evidence-Based Guide

🔑 Key Takeaway

The difference between a fellowship-trained Mohs surgeon and a non-fellowship provider is measurable: fellowship-trained surgeons perform nearly three times more Mohs cases annually (370 vs. 138 per year), achieve cure rates of 96–97%, and deliver reconstructions during the same visit. Fellowship training is the single most reliable predictor of surgical quality and reconstructive capability in Mohs micrographic surgery.

Why does it matter who performs your Mohs surgery?

Mohs micrographic surgery offers the highest cure rates available for appropriate skin cancers. But the procedure's effectiveness depends entirely on who performs it. Published data demonstrates that fellowship training, surgical volume, same-surgeon reconstruction, and pathology interpretation capability all directly affect patient outcomes.

Mohs surgery is not a simple procedure. It requires a surgeon to function simultaneously as cancer surgeon, pathologist, and reconstructive specialist — removing skin cancer layer by layer, examining each layer under a microscope in real time, and reconstructing the wound once the cancer is completely cleared. This triple-skill requirement is why training matters more in Mohs surgery than in almost any other outpatient procedure.

The problem patients face is that the title "Mohs surgeon" is not legally protected. Any licensed physician can technically bill for Mohs surgery codes, regardless of whether they completed a dedicated Mohs fellowship. An increasing number of non-dermatologist physicians are performing Mohs surgery, raising questions about training adequacy and patient outcomes.

This guide is built on published, peer-reviewed evidence. Every claim is backed by specific studies, and every recommendation can be independently verified. The goal is to give you the tools to distinguish a world-class Mohs surgeon from one who simply bills the code.


Check Your Understanding: Fellowship Training
What is the single most important credential to verify when choosing a Mohs surgeon?

What training should a Mohs surgeon have?

The gold standard is completion of an ACMS-accredited (American College of Mohs Surgery) fellowship — a one- to two-year post-residency program dedicated exclusively to Mohs micrographic surgery and facial reconstruction. Approximately 90 fellowship positions are offered annually in the United States, making it one of the most competitive surgical training pathways in medicine.

Fellowship training: what it actually involves

After completing a full dermatology residency (four years of medical school plus four years of residency), fellowship-trained Mohs surgeons complete an additional one to two years of intensive surgical training. During fellowship, trainees perform hundreds of Mohs cases and reconstructive procedures under expert mentorship. A 2022 Medicare analysis found that fellowship-trained Mohs surgeons perform a median of 370 Mohs cases per year in practice, compared with just 138 cases per year for non-fellowship physicians who bill for Mohs surgery (Walocko et al., 2022). This nearly threefold volume gap reflects both the higher demand for fellowship-trained surgeons and the greater proportion of their practice dedicated to Mohs surgery.

The volume difference compounds over a career. By the time a fellowship-trained Mohs surgeon has practiced for a decade, they have typically performed thousands of Mohs procedures and reconstructions, nearly all concentrated on the face and neck where the cosmetic stakes are highest. That cumulative experience is irreplaceable.

The credentialing pathway

The American College of Mohs Surgery (ACMS) accredits approximately 90 fellowship positions each year in the United States. As of 2025, there are roughly 2,700 fellowship-trained Mohs surgeons in active practice nationally (Ahn et al., 2025). Graduates are eligible for board certification through the American Board of Dermatology (ABD) in Micrographic Surgery and Dermatologic Oncology (MSDO) — the only ABMS-recognized board certification pathway for Mohs surgery.

ACGME (Accreditation Council for Graduate Medical Education) accreditation of Mohs fellowship programs began in 2004 and has progressively replaced the prior ACMS-only accreditation pathway, standardizing training requirements across all programs. In 2021, the American Board of Dermatology administered the first board certification examination in Micrographic Dermatologic Surgery, creating a formal credentialing pathway for fellowship graduates.

💡 Did You Know

ACMS fellowship acceptance rates are among the lowest in medicine. Out of the approximately 90 positions available each year, there are typically two to three applicants for every spot — all of whom have already completed four years of medical school and four years of dermatology residency before they even apply.

What about non-fellowship Mohs providers?

A growing number of physicians perform Mohs surgery without completing a dedicated fellowship. Some are dermatologists who learned Mohs during residency. Others are non-dermatologists — including general surgeons and family physicians — who have begun billing Mohs surgery codes.

The difference in practice volume is significant. Medicare data shows fellowship-trained surgeons perform nearly three times as many Mohs cases annually as non-fellowship providers (median 370 vs. 138 cases per year). While some non-fellowship providers may develop competence over time, the fellowship pathway provides a verified, standardized baseline of training that patients can independently confirm.

The National Comprehensive Cancer Network (NCCN) and American Academy of Dermatology (AAD) both emphasize that Mohs surgery should be performed by dermatologic surgeons who have specialized training and demonstrated competence in all three components of the procedure: cancer excision, pathologic interpretation, and reconstruction (NCCN BCC Guidelines v1.2025; NCCN SCC Guidelines v1.2025).

How to verify fellowship training

You can verify whether a surgeon completed an ACMS-accredited fellowship in under 30 seconds:

  1. ACMS Directory: Visit mohs.org → "Find a Surgeon" — only fellowship-trained ACMS members appear
  2. ABMS Verification: Visit certificationmatters.org → verify board certification in Micrographic Surgery and Dermatologic Oncology (MSDO)
  3. Ask directly: A fellowship-trained surgeon will readily share their fellowship institution and year of completion

Check Your Understanding: Outcome Benchmarks
What is the approximate 5-year cure rate for primary basal cell carcinoma treated with Mohs surgery according to recent data?

Does surgical volume affect Mohs surgery outcomes?

Yes. The volume-outcome relationship is one of the most consistently demonstrated findings in surgical literature. Surgeons who perform more Mohs procedures demonstrate lower complication rates, more complex reconstructive capability, and better overall outcomes.

What the data shows

A landmark prospective study by Alam and colleagues analyzed 20,821 consecutive Mohs surgery cases and found an overall adverse event rate of just 0.72% — establishing that Mohs surgery is one of the safest outpatient surgical procedures performed in the United States (Alam et al., 2013). Note that this figure represents total adverse events; infections comprise approximately 61% of this total, yielding an estimated infection rate of 0.44%.

Multiple landmark studies have established cure rates for Mohs surgery. A 2024 meta-analysis pooling 17 studies (2 randomized trials and 15 cohort studies, totaling 6,503 tumors) found that Mohs surgery achieved a recurrence rate of 3.1% for both BCC and SCC combined, compared to 5.3% for conventional excision — a 52% reduction in recurrence risk (relative risk 0.48) (Lacerda et al., 2024).

For primary BCC specifically, recent data confirm recurrence rates of approximately 3.8% per several major cohorts (Wehner et al., 2025; Andersen et al., 2025), translating to cure rates of 96–97%. For primary SCC, cure rates approach 97%, with lower rates (91–94%) in recurrent cases and those with high-risk features.

High-volume surgeons demonstrate proportionally more complex reconstruction capability as they gain experience, indicating growing technical confidence (Tan et al., 2023). In other words, high-volume surgeons are not just doing more surgery — they are doing more technically demanding surgery.

What "high volume" means

There is no universally agreed-upon cutoff for "high-volume" Mohs practice, but published benchmarks provide useful context. Fellowship-trained Mohs surgeons in full-time practice typically perform between 1,000 and 3,000 cases per year. A surgeon performing 10 to 15 or more cases per day develops a level of pattern recognition and technical fluency that lower-volume surgeons simply cannot replicate.

💬 In Plain English

Experience is irreplaceable. Fellowship training provides the foundation, but the real mastery comes from cumulative case volume. A full-time Mohs surgeon performing thousands of reconstructions over a career develops an intuition for tissue behavior and scar prediction that no textbook can teach. Volume directly translates to better cosmetic and functional outcomes for you.


Why does it matter if the surgeon performs their own reconstruction?

Same-surgeon reconstruction — where the surgeon who removed the cancer also performs the cosmetic repair in the same visit — is the standard of care in fellowship-trained Mohs practice. National Medicare data shows that Mohs surgeons perform 75.3% of all cutaneous reconstructions in cosmetically sensitive areas of the face, outnumbering all other surgical specialties combined.

The data on who reconstructs

A landmark analysis of Medicare claims data found that Mohs surgeons performed 75.3% of all cutaneous reconstructions in cosmetically and functionally sensitive areas (Tan et al., 2023). This dominance reflects the fact that every Mohs case creates a defect requiring immediate repair. A full-time Mohs surgeon performing 10 to 15 cases per day accumulates more facial reconstruction experience in a single month than many other surgeons gain in a year.

This is not a subtle difference. Mohs surgeons have become the primary providers of facial reconstruction precisely because they are trained to handle every stage of the procedure — from cancer removal through final reconstruction.

Why same-surgeon matters

When the same surgeon performs both cancer removal and reconstruction, three critical advantages emerge:

Continuity of information. The surgeon who removed the cancer understands every layer of tissue involved — the depth, shape, and tissue characteristics of the defect. When reconstruction is handed off to a different surgeon, that information is lost. The second surgeon is interpreting a wound, not the surgery that created it.

Integrated planning. A fellowship-trained Mohs surgeon plans the reconstruction before making the first incision. Flap design, tension vectors, and scar line placement are all considered from the start — not as an afterthought.

Single-visit convenience. Patients have their cancer removed and their wound repaired in one visit, under local anesthesia, without hospital admission, general anesthesia, or the need for a separate surgical appointment weeks later.

Red flag: surgeons who routinely refer reconstruction

If a Mohs surgeon routinely refers patients to plastic surgery or another specialist for reconstruction, that is a significant red flag. Fellowship training specifically prepares surgeons to handle their own reconstructions. Routine referral suggests the surgeon may lack the reconstructive training or confidence that fellowship provides.

Referral to another specialist is occasionally appropriate — for extremely large defects requiring free tissue transfer, cases requiring general anesthesia, or reconstructions involving bone or deep cartilage replacement. But these situations are rare, representing a small percentage of Mohs cases.


Check Your Understanding: Pathology Interpretation
What percentage of the surgical margin is examined in Mohs surgery versus standard (non-Mohs) excision?

Why does it matter if the surgeon reads their own pathology?

In Mohs surgery, the surgeon examines tissue slides under a microscope in real time to determine whether cancer remains. The accuracy of this interpretation directly determines whether all cancer is removed. Published data demonstrates concordance rates of 99.79% between Mohs surgeons' frozen section interpretations and formal dermatopathologist review of the same slides (Kesty et al., 2023).

The built-in quality check

Mohs surgery is unique among surgical procedures because the surgeon serves as both operator and pathologist. During each stage of surgery, the surgeon processes the excised tissue, prepares frozen sections, stains the slides, and examines them under a microscope to map any remaining cancer. This real-time pathology interpretation is what gives Mohs surgery its high cure rates.

Kesty and colleagues evaluated the accuracy of frozen section interpretation in Mohs surgery by having board-certified dermatopathologists independently review the same slides that Mohs surgeons interpreted in real time, finding a 99.79% concordance rate (Kesty et al., 2023). This means that fellowship-trained Mohs surgeons reading their own pathology achieve diagnostic accuracy that is virtually equivalent to formal dermatopathology laboratory interpretation.

The dermatopathology advantage

Some Mohs surgeons hold an additional board certification in dermatopathology — the subspecialty of pathology focused exclusively on skin diseases. This dual certification means the surgeon is not only trained to interpret frozen sections during Mohs surgery, but is formally board-certified to render pathologic diagnoses on skin specimens.

This combination represents an advanced level of training integration: a surgeon who removes cancer, reads the pathology at board-certified dermatopathologist level, and performs the reconstruction — all in one visit, by one physician.

💡 Did You Know

In standard (non-Mohs) skin cancer excision, only an estimated 1–2% of the surgical margin is examined by the pathologist via bread-loaf sectioning. In Mohs surgery, 100% of the margin is examined in real time. This explains why Mohs achieves cure rates of 96–97% for primary basal cell carcinoma — the pathology gap between Mohs and standard excision is enormous.


What infection and recurrence rates should you expect?

Published benchmarks for Mohs surgery show infection rates below 0.5% and recurrence rates of 3–4% for primary basal cell and squamous cell carcinoma. These represent some of the best safety outcomes of any outpatient surgical procedure.

Infection rates

Mohs surgery infection rates are consistently lower than hospital-based surgical procedures. A large Mohs surgery series reported an infection rate of 0.7% (Maragh & Brown, 2008). Alam and colleagues found an overall adverse event rate of 0.72% across more than 20,000 cases, with infections representing approximately 61% of adverse events, yielding an estimated infection rate of 0.44% (Alam et al., 2013).

For comparison, published infection rates for hospital-based cutaneous surgical procedures range from 2.5% to 8.7% — meaning outpatient Mohs surgery achieves infection rates that are significantly lower than hospital-based alternatives. This safety advantage reflects the benefits of a dedicated outpatient surgical environment, local anesthesia (avoiding the risks of general anesthesia), and single-surgeon continuity.

Recurrence rates

For primary (previously untreated) basal cell carcinoma, recent data confirm recurrence rates of 3–4%, translating to 5-year cure rates of approximately 96–97% (Wehner et al., 2025; Lacerda et al., 2024; Andersen et al., 2025).

For primary squamous cell carcinoma, 5-year cure rates are approximately 97%. For recurrent skin cancers (cancers that return after prior treatment), Mohs surgery still achieves cure rates of 91–94%.

A 2024 meta-analysis pooling 17 studies confirmed these outcomes in a real-world setting, demonstrating that Mohs surgery cure rates are consistent across different institutions and countries — not just in individual high-volume practices (Lacerda et al., 2024).

What to ask your surgeon

A confident, high-quality Mohs surgeon should be willing to share their own outcome data. Specific questions to ask:

  • "What is your personal infection rate?" (Benchmark: below 0.5–1%)
  • "What is your recurrence rate?" (Benchmark: 3–4% for primary BCC/SCC)
  • "How many Mohs cases have you performed in total?" (High-volume surgeons will have performed thousands)
  • "Do you track and audit your own outcomes?" (The best surgeons systematically track their data)

What questions should you ask during a consultation?

The right questions can reveal more about a surgeon's training, experience, and capabilities than any marketing website. Here are the most important questions to ask — and the answers that indicate a high-quality Mohs surgeon.

The essential checklist

Question to Ask What a Strong Answer Looks Like Red Flag
"Where did you complete your Mohs fellowship?" Names a specific ACMS-accredited institution Cannot name a fellowship program, or did not complete a fellowship
"Are you board-certified in Mohs surgery (MSDO)?" Yes, through the American Board of Dermatology No board certification, or certification through a non-ABMS body
"Do you perform your own reconstruction?" Yes, on virtually all cases — same day, same surgeon Routinely refers to plastic surgery or another specialist
"Do you read your own pathology slides?" Yes, as part of standard Mohs technique Sends slides to an outside lab
"What is your infection rate?" Below 1%, with tracked data Does not track, or cannot provide a number
"What is your recurrence rate?" 3–4% for primary BCC/SCC (i.e., 96–97% cure rate) Does not track, or cannot provide a number
"How many Mohs cases do you perform per year?" 1,000 or more per year (full-time Mohs practice) Very low volume, or Mohs is a small part of a general derm practice
"Are you a member of the ACMS?" Yes — ACMS membership requires fellowship completion Not a member, or member of a non-equivalent organization
⚠ Don't Miss This

Marketing websites can claim anything. Board certifications, fellowship training, and ACMS membership can be independently verified by patients in minutes. If a surgeon's website makes impressive claims but the claims cannot be confirmed through ACMS or ABMS directories, that is a serious warning sign.


What if there is no fellowship-trained Mohs surgeon near me?

Geographic access to fellowship-trained Mohs surgeons is uneven across the United States. Published mapping studies show that Mohs surgeons concentrate in urban and suburban areas, leaving significant gaps in rural regions. Understanding your options — including whether travel is worthwhile — can meaningfully affect your surgical outcome.

The geographic reality

A 2025 analysis found that approximately 80.4% of U.S. counties lack a Mohs surgeon, with significant concentration in urban corridors and large gaps in rural regions — particularly in the Mountain West, Great Plains, and parts of the Deep South (Olsen et al., 2025). This geographic disparity means that access to specialized Mohs surgery remains uneven, though telemedicine has begun to address initial consultations.

When travel is worth it

For straightforward Mohs cases — small primary basal cell carcinomas in low-risk locations — a well-trained local dermatologist performing standard excision may produce acceptable outcomes if no Mohs surgeon is accessible. But for cases where Mohs surgery is clearly indicated by NCCN guidelines and AAD appropriate use criteria, traveling to a fellowship-trained Mohs surgeon is almost always worthwhile.

Cases where travel to a Mohs specialist is most justified include cancers on the face (especially nose, ears, eyelids, and lips), recurrent cancers that have already been treated once, aggressive histologic subtypes (morpheaform, infiltrative, micronodular BCC; poorly differentiated SCC), large tumors requiring complex reconstruction, and melanoma in situ requiring MART-1 immunostaining and staged margin control.

Telemedicine options

While Mohs surgery itself requires in-person treatment, initial consultations and post-operative follow-up can often be conducted via telemedicine. Many fellowship-trained Mohs surgeons now offer virtual consultations to evaluate whether Mohs surgery is appropriate before a patient commits to travel. This allows patients in underserved areas to access expert surgical opinions without an initial trip.


How do you evaluate a surgeon who also uses immunostaining for melanoma?

MART-1 immunostaining is a specialized laboratory technique that enhances the detection of melanoma cells during Mohs surgery. Not all Mohs surgeons offer this technique, and the ones who do typically represent the highest-volume, most technically sophisticated Mohs practices.

Standard Mohs surgery uses frozen sections stained with hematoxylin and eosin (H&E) — the same stains used in general pathology. For most basal cell and squamous cell carcinomas, H&E staining is sufficient to identify cancer cells. But melanoma cells can be notoriously difficult to identify on frozen sections with H&E alone, because they can resemble normal melanocytes.

MART-1 (Melan-A) immunostaining uses antibodies that specifically bind to melanoma cells, making them glow distinctly under the microscope. This dramatically improves the accuracy of margin assessment for melanoma cases. Surgeons who incorporate MART-1 into their Mohs practice are performing a more technically demanding version of the procedure that requires additional laboratory equipment, histotechnician training, and pathologic interpretation expertise.

If you have been diagnosed with melanoma in situ or early-stage melanoma, asking whether the Mohs surgeon uses MART-1 immunostaining is one of the most important questions you can ask. Not all Mohs surgeons are equipped or trained to perform this technique.


Frequently asked questions

1. What is the most important credential to look for in a Mohs surgeon?

Completion of an ACMS-accredited Mohs surgery fellowship. This is the single most reliable indicator of training quality, surgical volume during training, and reconstructive capability. You can verify this in under 30 seconds by searching the ACMS "Find a Surgeon" directory at mohs.org.

2. What is the difference between a dermatologist who does Mohs and a fellowship-trained Mohs surgeon?

Medicare data shows that non-fellowship physicians who bill for Mohs surgery perform a median of 138 cases per year, compared with 370 cases per year for fellowship-trained Mohs surgeons — a nearly threefold volume gap (Walocko et al., 2022). Fellowship-trained surgeons also complete one to two years of additional dedicated training in Mohs surgery and reconstruction beyond their dermatology residency.

3. Should my Mohs surgeon perform the reconstruction, or should I see a plastic surgeon?

Your Mohs surgeon should perform the reconstruction in the vast majority of cases. National Medicare data shows Mohs surgeons perform 75.3% of all cutaneous reconstructions in cosmetically sensitive areas — more than plastic surgeons, ENT surgeons, and general surgeons combined (Tan et al., 2023). Same-surgeon reconstruction preserves critical information about the defect that is lost in a handoff.

4. How can I verify a surgeon's fellowship training?

Visit the ACMS website at mohs.org and use the "Find a Surgeon" directory. Only fellowship-trained ACMS members appear in this directory. You can also verify board certification in Micrographic Surgery and Dermatologic Oncology through the ABMS at certificationmatters.org.

5. What infection rate is normal for Mohs surgery?

Published Mohs surgery infection rates range from 0.4% to 2.0% across large case series (Maragh & Brown, 2008; Alam et al., 2013). For comparison, hospital-based surgical infection rates range from 2.5% to 8.7%. A surgeon who tracks their own infection rate and can share it with you is demonstrating a level of quality assurance that patients should expect.

6. What recurrence rate should I expect after Mohs surgery?

For primary basal cell carcinoma, recurrence rates are approximately 3–4%, translating to 5-year cure rates of 96–97%. For primary squamous cell carcinoma, approximately 97% cure rate. For recurrent cancers, 91–94% cure rate. These rates make Mohs surgery the highest-cure-rate treatment available for appropriate skin cancers (Lacerda et al., 2024; Wehner et al., 2025).

7. Is it worth traveling to see a fellowship-trained Mohs surgeon?

For cases where Mohs surgery is clearly indicated — cancers on the face, recurrent cancers, aggressive subtypes, or large tumors requiring complex reconstruction — traveling to a fellowship-trained specialist is almost always worthwhile. The difference in training volume, reconstructive capability, and tracked outcomes can meaningfully affect your surgical result. Many Mohs surgeons offer telemedicine consultations to help you evaluate whether the trip is necessary.

8. What is MART-1 immunostaining, and does my surgeon need it?

MART-1 immunostaining is a laboratory technique that uses antibodies to highlight melanoma cells during Mohs surgery, dramatically improving margin accuracy for melanoma cases. If you have been diagnosed with melanoma in situ or early-stage melanoma, this capability is critical. Not all Mohs surgeons offer MART-1, so asking about it directly is one of the most important questions for melanoma patients.

9. What does "board-certified dermatopathologist" mean for a Mohs surgeon?

Board certification in dermatopathology (a separate ABMS certification) means the surgeon holds formal credentials to render pathologic diagnoses on skin specimens. When a Mohs surgeon also holds dermatopathology certification, they can interpret frozen sections during surgery and permanent sections after surgery at the highest level of expertise. This combination indicates advanced training integration.

10. What are the red flags when evaluating a Mohs surgeon?

Key warning signs include: no ACMS fellowship training (or inability to name their fellowship institution), routine referral of reconstruction to another surgeon, inability to provide infection or recurrence rate data, very low case volume (Mohs as a small part of a general dermatology practice), and credentials that cannot be verified through ACMS or ABMS directories. Marketing claims that do not match verifiable credentials should be treated with particular skepticism.


The bottom line

Choosing a Mohs surgeon is one of the most consequential healthcare decisions a skin cancer patient will make. The evidence is clear: fellowship training, surgical volume, same-surgeon reconstruction, and pathology interpretation capability all directly affect outcomes. The good news is that every one of these factors can be independently verified by patients before committing to surgery.

Start with the ACMS directory. Verify board certification through ABMS. Ask the questions in this guide. And remember that the best Mohs surgeons are not just skilled technicians — they are integrated cancer surgeons, pathologists, and reconstructive specialists who handle every step of your care in a single visit.


References

Ahn P, et al. Fellowship training in Mohs micrographic surgery. American Board of Dermatology. 2025.

Alam M, et al. Adverse events associated with Mohs micrographic surgery: multicenter prospective cohort study of 20,821 cases at 23 centers. JAMA Dermatol. 2013;149(12):1378-1385. PMID: 24080866

Andersen JS, et al. Five-year recurrence rates and risk factors for skin cancer treated with Mohs micrographic surgery: A Danish nationwide cohort study. Acta Derm Venereol. 2025;105:adv41118. PMID: 41385634

Kesty E, et al. Concordance between Mohs surgeons and dermatopathologists in assessment of surgical margins. J Am Acad Dermatol. 2023;88(1):118-122.

Lacerda E, et al. Mohs micrographic surgery versus conventional excision for skin cancer: A systematic review and meta-analysis. J Eur Acad Dermatol Venereol. 2024;38(6):1058-1069.

Maragh SL, Brown MD. Mohs micrographic surgery: infection rate and antibiotic use. J Am Acad Dermatol. 2008;59(2):275-278. PMID: 18571773

National Comprehensive Cancer Network (NCCN). Basal Cell and Squamous Cell Cancers (Cutaneous). NCCN Guidelines. Version 1.2025.

National Comprehensive Cancer Network (NCCN). Squamous Cell Carcinoma of the Skin. NCCN Guidelines. Version 1.2025.

Olsen TL, et al. Geographic distribution of Mohs surgeons in the United States: An updated analysis of access disparities. Dermatol Surg. 2025;51(2):88-95.

Tan MD, et al. Mohs surgeons perform the majority of complex facial reconstructions: A 2023 Medicare claims analysis. J Am Acad Dermatol. 2023;89(5):1045-1052.

Walocko FM, et al. Mohs surgery surgical volume and training: A Medicare analysis of fellowship-trained versus non-fellowship Mohs providers. Dermatol Surg. 2022;48(7):847-855.

Wehner MR, et al. Recurrence rates for basal cell carcinoma treated with Mohs micrographic surgery: A systematic review. JAMA. 2025:2840731.


About This Site

Skin Trust is a free educational website created by Dr. Thomas L.H. Hocker, M.D., M.Phil. to make dermatologic knowledge accessible to patients and healthcare professionals. All content is provided for educational and informational purposes only and does not constitute medical advice, diagnosis, or treatment recommendations. Skin Trust is Dr. Hocker's independent educational work, completely unaffiliated with any medical practice, healthcare system, hospital, university, or organization. Using this website does not create a doctor-patient relationship. If you have or suspect you have a medical condition, consult a qualified healthcare provider. Never delay seeking professional care based on information from this site.

Portrait of Dr. Thomas L.H. Hocker

About the author

Dr. Thomas L.H. Hocker is a Harvard- and Mayo Clinic-trained, triple board-certified dermatologist, Mohs surgeon, and dermatopathologist. He is the Founding Director of Dermatologic Surgery at the UMKC School of Medicine and University Health and an Iron Surgeon lecturer at the American Society for Dermatologic Surgery. His work focuses on Mohs surgery for melanoma, complex and rare skin tumors, and aesthetic reconstruction after skin-cancer treatment. He co-authored the best-selling textbook Review of Dermatology and created Skin Trust to give patients and clinicians free access to clear, current, evidence-based education.

Read Dr. Hocker's background and mission

Dr. Hocker earned his bachelor's degree with honors from Yale University, where he was inducted into Phi Beta Kappa. As a Winston Churchill Scholar, he then studied at the University of Cambridge and earned an M.Phil. in Organic Chemistry. He received his M.D. with honors from Harvard Medical School, where his research focused on melanoma genetics. He completed dermatology residency at Mayo Clinic, a dermatopathology fellowship at the University of Michigan, and a Mohs micrographic and reconstructive surgery fellowship at Mayo Clinic. He is board-certified in Dermatology, Dermatopathology, and Mohs Micrographic Surgery.

Dr. Hocker serves as the Founding Director of Dermatologic Surgery at the UMKC School of Medicine and University Health. He is an internationally invited lecturer and speaker who teaches about Mohs surgery for melanoma, complex and rare tumors, dermatopathology, and aesthetic reconstruction after skin-cancer treatment. He has also been selected as an Iron Surgeon lecturer by the American Society for Dermatologic Surgery. He is the co-author of Review of Dermatology, a best-selling dermatology review textbook, and he continues to teach and mentor medical students, residents, and physicians.

Skin Trust exists because Dr. Hocker believes access to excellent medical knowledge should not depend on geography, wealth, or proximity to a major academic center. After training at several of the world's leading institutions, he sees that education as both a gift and a responsibility: to translate current evidence, expert judgment, and hard-won clinical experience into guidance that patients, families, and clinicians can actually use.

The mission is to increase awareness, reduce avoidable suffering, and give every person equal access to trustworthy, up-to-date information that can help them make the best decisions for their life. Skin Trust also extends Dr. Hocker's lifelong commitment to teaching, writing, and mentoring medical students and residents as they build lives and careers of purpose and service.

For Dr. Hocker, this work is also an expression of faith. He regards the opportunities to learn at Yale, Cambridge, Harvard, Mayo Clinic, and the University of Michigan as blessings from God. Teaching, writing, mentoring, and building Skin Trust are ways to pay those blessings forward in service to patients, learners, and the broader community. His faith is the personal motivation to do this work carefully, generously, and with integrity; it is not a condition of using or benefiting from this free resource.