Surgeon Experience Level and Number of Mohs Stages: A Prospective Observational Study of In-training Surgeons

Abstract

Background
 Comparisons of Mohs surgeons by experience level (early-, mid-, late-career) and their respective number of stages taken during Mohs have not detected any difference. However, data comparing the number of stages for attending Mohs surgeons to Mohs fellows is non-existent.
 Objective
 To prospectively observe and compare the mean number of Mohs stages taken for attending Mohs surgeons and fellows.
 Methods/Materials
 Procedural data from 2,140 Mohs cases over 24 months was collected and divided into an attending or fellow surgeon cohort.
 Results
 The attending cohort had a higher mean number of stages for all nonmelanoma skin cancer when compared to the fellow cohort (p=0.005). The attending cohort demonstrated a higher mean number of stages for non-aggressive, non-superficial basal cell carcinoma (p<0.001), but no difference was found for other cancer subtypes. No difference was detected when comparing the two cohorts’ performance at high, medium, and low risk surgical areas.
 Conclusion
 The attending cohort had a higher mean number of stages overall for combined types of skin cancer and for non-aggressive, non-superficial basal cell carcinoma specifically when stratified by diagnosis as compared to the fellow cohort. No difference existed in the mean number of stages between the cohorts based on surgical area.