To the Editor.—
The editorial by Edward A. Krull, MD, in the November 1990 issue of the Archives on the current status of dermatologic surgery1 did an excellent job of outlining the increasing role of surgery training in dermatology residency programs. The Accreditation Council for Graduate Medical Education (ACGME) was justified in adding requirements for dermatology residency training in various surgical techniques, including laser surgery and small flaps and grafts. It is unfortunate that Mohs surgery, which has been predominantly performed by dermatologists, was omitted from the requirements. In my opinion, this method should be learned by all dermatology residents to assure clear margins of difficult skin cancers long before these residents learn flaps and grafts. What good is a flap or graft if a tumor still persists? Although the Mohs technique requires careful attention to detail, and the oblique frozen sections can be difficult to interpret,2,3 it
Rapini RP. Mohs Surgery: Qualifications and Certification. Arch Dermatol. 1991;127(3):421–422. doi:10.1001/archderm.1991.01680030147024
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