One in every three diagnosed cancer is a skin cancer; therefore, dermatologists should be at the forefront of leading techniques for the care of skin cancer patients. One such technique is Mohs Micrographic surgery (MMS) also known as margin-controlled excision; a specialised surgical technique that aims to completely remove the skin cancer and leave as much healthy skin tissue as possible.
In contrast to the US and Australia, the availability of MMS in Europe is very limited. The EADV aims to expand the number of European Mohs surgeons and offer the best possible care for skin cancer patients.
Applications for a fellowship starting in 2023 are open until 31 May 2022.
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The General and Oncologic Dermatology Department Ambroise Paré University Hospital
Expert center in dermato-oncology. The department was a pioneer in France in the implementation of the Mohs technique in 1999.
REQUIREMENTS
- EADV European specialist member
- Must have completed their residency in dermatology and provide a medical diploma recognised in Europe
- Must be HBV and Covid vaccinated
- Must have an insurance (professional liability)
PROGRAMME DESCRIPTION
Several practitioners are trained in the Mohs (cryopreservation) or slow Mohs (paraffin) technique in our department.
The fellow will benefit from an initial theoretical training (1h of course) to explain the different techniques of micrographic surgeries and the indications.
The fellow during his 6 months of training will:
- Participate in multidisciplinary consultation meetings with patients coming for the initial management of their skin cancer These meetings take place on Friday mornings.
- Operate on patients, under the supervision of dermatologist surgeons trained in these techniques, after having attended a few procedures in order to put into practice the advice learned during an initial period of 2 sessions.
Mohs (cryo-freezing) surgeries are performed once a week on Thursdays. Slow Mohs surgeries are spread throughout the week (Monday to Friday), between standard and Mohs surgeries (Thursdays). We have two operating rooms.
The Dermatology Department Valencian Institute of Oncology IVO
Monographic skin cancer unit with more than 30 years’ experience on Mohs surgery and dermatologic oncology.
They perform approximately 600 Mohs micrographic surgery procedures annually and have a formal training program for Mohs micrographic surgery (MMS).
www.ivo.es/tratamientos/cirugia/
www.ivo.es/profesionales/dermatologia/
REQUIREMENTS
- EADV European specialist member
- Must have completed their residency in dermatology and must be board-certified dermatologists in a European country
- Sufficient knowledge and skills in surgery
PROGRAMME DESCRIPTION
IVO Fellowship program in Micrographic Surgery and Dermatologic Oncology offers 6 months of education and experience.
The IVO Mohs Surgery fellowship program is primarily aimed at learning in:
1. Cutaneous oncologic surgery with special focus on Mohs micrographic surgery and slow Mohs technique
2. Cutaneous reconstructive surgery
3. Education in clinical dermatology and dermatopathology of cutaneous malignancies
4. Dermatologic oncology, which incorporates knowledge of the clinical and pathologic diagnosis, staging, and treatment options for patients with cutaneous malignancies.
Fellowship training takes place at Valencian Institute of Oncology Hospital. During training, there is an emphasis on Mohs Micrographic surgery and complex reconstruction with the opportunity to work with 6 experienced Mohs surgeons in diverse setting.
During the 6 months training program, fellows complete a minimum of 300 cases of Mohs surgery on different skin tumors. Both Mohs techniques, frozen and paraffin fixed tissue, are used. At least there are four work days weekly in surgery room.
In addition, fellows have the opportunity to work with other oncologic and surgical specialties at FIVO, including ENT, plastic surgery and radiation oncology.
Dermatologic Surgery University Hospital Zurich
dermazentrumzuerich.ch
derma.usz.ch
REQUIREMENTS
- Must have completed their residency in dermatology and must be board-certified dermatologists in a European country
- At least 2 years experience in dermatosurgery is required
- Must have the oportunity to practice Mohs surgery or build up a new Mohs surgery unit after the fellowship upon their return to their home country
- ESMS associate membership
- Fluency in English language. Only applicants who are also fluent in German (level B1) will also be able to treat patients without direct supervision.
- EU / EFTA citicenship, proof of no criminal record
PROGRAMME DESCRIPTION
The duration of the fellowship is 6 months and must be completed in one consecutive period. Fellows will be given the opportunity to participate in a high volume of frozen section Mohs procedures, including the lab procedures, as well as assist in some slow Mohs and other dermatosurgical procedures.
The fellowship will take place in 2 centers: Outpatient clinic „Circle“ (Uninversity Hospital, Zurich Airport) and Dermatologisches Zentrum Zürich AG. The fellow will be able to participate in > 200 Mohs cases under supervision of the program director or another ESMS-certified surgeon. A majority of the cases will include flap or graft reconstruction. > 50 complex cases can be expected. Furthermore, > 20 cases of slow Mohs will be performed. The fellow will be involved in reading of pathology slides of all cases of frozen section Mohs surgery.
Infrastructure: In both venues there is a dedicated Lab within easy walking distance in the same building complex as the operating rooms, with lab technicians trained in Mohs surgery. In both venues there are > 2 operating rooms fulfilling local requirements for dermatosurgical procedures, including flap and graft reconstructions. Some hospitalized patients at the University Hospital, Zurich will be operated and there is a documented collaboration with other specialities as well as the possibility to discuss patients at a tumor board (University Hospital).
The Erasmus University Medical Center
The Erasmus University Medical Center (Rotterdam, The Netherlands) is among the largest MMS centres in Europe. They perform approximately 1700 MMS procedures annually and have a formal training program for MMS.
https://www.erasmusmc.nl/en/education/education-opportunities/mohs-fellowship
REQUIREMENTS
- EADV European specialist member
- Sufficient knowledge and skills in surgery
- The awardee must have the possibility to put MMS into practice after finishing the fellowship either by opening a Mohs unit or by contributing to an existing unit in an academic hospital-based department of dermatology within Europe
- Must be HBV and Covid vaccinated
PROGRAMME DESCRIPTION
- 6 months duration.
- Mohs procedures 5 days per week, with 5 different supervisors and a dedicated team of nurses and lab technicians.
- We ususally perform 6 Mohs procedures a day (75% BCC, 25% SCC and occasionally rare tumors). Two Mohs fellows are supervised by one Mohs surgeon, each fellow performs 3 Mohs procedures a day. We review the slides together (with a dual head microscope). You will learn performing Mohs in all its aspects including different types of reconstructions and you will get an extensive training in histology.
- We also perform Mohs for rare tumors such as Merkelcell carcinoma, sebaceous carcinoma, dermatofibrosarcoma protuberans.
- We have specially trained Mohs supervisors and an ophthalmologist who operate tumors on the eyelids.
- The minimal amount of cases that a Mohs fellow should perform is 200, you will have 2 exams: one half way and one at the end of the training. The first exam consists of assessing the slides of 10 Mohs cases and the final exam consists of 20 cases. The Mohs fellow should pass the final exam in order to get the Mohs certificate.