Viewpoints
A History of the ACMS Annual Meeting
By Ashley Wysong, MD
As we approach the 50th Anniversary of the Mohs College Annual Meeting, it is a wonderful time to reflect on who we are and from where we have come. Dr. Frederic E. Mohs (1910-2002) the originator of chemosurgery and namesake of our College, treated his first patient with a squamous cell carcinoma of the lip on June 30, 1936 and the field has advanced by leaps and bounds since that time.
The American College of Chemosurgery (ACC) was established on December 5, 1967 at a dinner meeting in Chicago attended by Dr. Mohs and 22 other individuals. According to Dr. Perry Robins, ACMS President from 1976-78 and a founding member of the College, “we actually initially thought about forming the College while at a meeting at the Four Seasons Hotel in Munich with the World Congress of the Cancers of Skin the year prior. There were 8 to 10 of us who had discussions that led to the first meeting held at the Palmer House in Chicago coinciding with the AAD.”
Founding officers elected at the first meeting were Dr. Mohs as President, Dr. Ray Allington as Vice President and Dr. Perry Robins as Secretary-Treasurer. Dr. Robins recalls, “the first meeting of The American College of Chemosurgery was held in 1968. The first meeting was very interesting with a bunch of ‘misfits’ – it was really a show and tell of our interesting cases. We always met in the #10 Wabash room at the Palmer House in Chicago for the first 10-15 years. In the early days, 70% of the attendees were dermatologists and around 30% were a mixed bag of GPs, surgeons, and other physicians. I remember Al Kopf, one of our honorary members, gave a talk saying ‘I can visualize that over the years you will have a Mohs surgeon on the faculty in every academic department in the country.’ Boy, was he right.”
The Annual Meetings continued to build in terms of attendance and content. Dr. Rex Amonette, ACMS President from 1980-1982 recalls, “My wife, Johnnie, and I have wonderful memories of our many ACMS meetings over the years. We began attending meetings at The Palmer House in the early 1970’s, and it was always a special event. While we enjoyed learning about the progress being made in Mohs surgery, we enjoyed even more seeing our fellow Mohs surgeons and their family members. It started out being a small group of people, and we knew every single person there. It was truly like a family reunion. The numbers have increased dramatically today, but it is still a wonderful group of people at the meetings, and it still feels to us like a warm, large family. Mohs totally turned around the care and treatment of skin cancers and has given dermatologists an ever-increasing recognition as skin surgeons and dermatopathologists. When I saw what a game-changer Mohs was, I knew I had to share. So I began offering fellowships. For many years, I trained fellows, and I cannot tell you how proud that makes me. Johnnie and I are so grateful to Dr. Mohs, to Dr. Perry Robins, and to all who made great strides to bring the ACMS where it is today as we celebrate our 50th anniversary.”
Dr. John Zitelli, ACMS President from 1996-1998, also remembers the evolution of the ACMS Annual Meetings fondly and said “my memories of the early meetings revolve around a small group of 50 or less, and significant discussion after each presentation. Each presenter was eager to share the biggest and worst cases, and it was quite a show! I think that is why for a long while, Mohs surgeons had a bad reputation for creating huge holes, when in fact we were showing how subtle some tumors can be, and how much subclinical extension can exist. I don't think that was appreciated in the 70's and 80's by most physicians other than Mohs surgeons. Only later did we begin to emphasize the key factor that we examine 100% of the margin while routine pathology examines less than 1%.”
Dr. Robins also recalls several big transitions in the field of Mohs surgery that were disseminated through the meetings over time, “In the 1970s a big change came–Ted Tromovitch presented a paper of 102 cases with the fresh tissue technique. He is really the father of modern Mohs micrographic surgery. I remember Rex Amonette and I had previously done a few cases with the fresh tissue technique around the globe where the (zinc chloride) paste would have damaged the eye. After the meeting that year, I started doing more of the fresh tissue technique and after three years, we were all doing fresh tissue technique.” He also remembers a similar evolution in reconstruction revolving around the meetings: “In the early 90s, [Sam] Stegman and Tromovitch wrote an article about reconstruction and that’s when we started teaching how to do repairs at the meetings. I filmed a series of 24 videos on procedural dermatology and repairs over a six-year period. Dermik, a large dermatology company at the time, gave me a grant to create a flaps and grafts course where I traveled around the country with 1800 Kodachromes. To keep people awake, I would tell a joke once an hour.”
Dr. Zitelli also recalls the transition toward teaching reconstruction and other topics at the Annual Meeting,:“in the late 80's and 90's there became an emphasis on reconstruction. As our skills improved, we collectively developed our talents beyond those of general plastic surgeons. Now we also include basic science and have an entire specialty based on a large fund of knowledge.”
As we look back to celebrate 50 years of the Annual Meeting, it is important to remember where our field started and how far we have come. As Dr. Robins put it, “I have not trained anyone that is not ecstatic or thrilled to be a Mohs surgeon. However, there are several of us who, if we had taken no for an answer, none of you would be here today.” He hopes to share more of his memories at at the upcoming 50th Anniversary Celebration Reception at 6 pm on Saturday May 5 during the Annual Meeting in Chicago. The reception will be held at the Palmer House Hilton where the first and many other meetings of the American College of Chemosurgery was held.
In addition to the special celebrations at the upcoming meeting, the ACMS has created a commemorative book entitled “ACMS: The Margin of Victory for 50 years (1968-2018)” to celebrate the 50th anniversary of the College. Dr. Natalie Curcio, who contributed to the book, describes it thusly: “this book chronicles the history of the ACMS, as the American College of Chemosurgery (ACC), in its inception in 1968, through its transition to the American College of Mohs Micrographic Surgery and Cutaneous Oncology (ACMMSC) in 1986, to its modern day identity as the American College of Mohs Surgery, since 2007. It highlights the pivotal influence of the founding doctors such as Frederic Mohs and Perry Robins in their establishment of chemosurgery or the fixed tissue technique and Theodore Tromovitch and Samuel Stegman as pioneers of the fresh tissue technique now known as Mohs surgery. It is an intriguing history of many physicians in their tireless pursuit of curing skin cancer, matched by an unrivaled passion for innovation.” The book will be available for sale on site in Chicago and online after the meeting.
As we gather for the 50th Annual Meeting of the American College of Mohs Surgery let us all consider with gratitude the words of Dr. Deborah Sarnoff as shared by Dr. Robins: “for those of you doing Mohs, you are fortunate that you work with your hands, fortunate that you work with your head, and fortunate that you work with your heart – you have it all.”