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Micrographic Dermatologic Surgery (MDS) Board Certification – Why Every ACMS Member Should Get Certified

by Sherrif F. Ibrahim, MD, PhD, FACMS

In October 2018, the American Board of Medical Specialties approved the application by the American Board of Dermatology to create the Micrographic Dermatologic Surgery (MDS) subspecialty.  The first administration of the exam will be held this October nationwide. Many ACMS members have been confused as to what this means to our specialty and our organization.

Per the ABD’s website the following criteria must be met in order to sit for the certification examination:

Candidates for the MDS subspecialty must:

  1. Possess a current, valid, full, and unrestricted license to practice medicine  or osteopathy in at least one state or province within the United States or Canada;
  2. Hold primary certification in general dermatology from ABD;
  3. Be up-to-date in Maintenance of Certification (MOC) if certification by ABD is time-limited;
  4. Demonstrate experience in the subspecialty by:
    successfully completing the ACGME-accredited MSDO fellowship
    attesting to active practice of micrographic surgery as part of one's patient care activiites*
    *during an initial five-year practice pathway eligibility period only
  5. Pass the MDS certification exam

Unlike ACMS membership, which is contingent upon completing a rigorous fellowship, any board-certified dermatologist who attests to practicing Mohs surgery will be able to sit for the exam during its first 5 years of administration (2021 – 2025). Starting in 2026, any dermatologist who wishes to become board certified in MDS must first complete an ACGME-accredited fellowship in Micrographic Surgery and Dermatologic Oncology (MSDO). The test carries a fee of $1800, consists of 200 multiple choice questions, and will be administered once annually.

It is recommended by the ACMS that all members who will continue to practice beyond five years pursue board certification in MDS. Although CMS will not require board certification,  private insurers and managed medicare insurers may over the next years begin to distinguish surgeons by board certification status and may eventually require board certification. Other factors that may be impacted by MDS certification include malpractice insurance rates and employment eligibility.

Frequently asked questions regarding the board examination can be found here, and the ABD has put forth a general study guide and list of topics that will be included in the examination here.

The ACMS has gone to great lengths to ensure that its members are all well prepared to sit for and pass the MDS examination.  These resources include the ACMS MDS Board Examination Study Guide, regular online study sessions available on the ACMS website.  An ACMS committee dedicated to MDS certification expects that familiarity with contents of these member-only benefits will adequately prepare candidates for passing the exam.

As leaders of the field in Mohs surgery and cutaneous oncology, it behooves us all to become board certified in MDS.  Although we can not prevent non-ACMS dermatologists from stating that they are now ‘Board Certified’ in Mohs surgery, ACMS membership will still be viewed as the gold standard for quality in performing Mohs surgery and managing skin cancer.  It is feasible that insurance reimbursement may be affected by board certification status and many patients may inquire as to board certification status.  The window for non-fellowship trained dermatologists to sit for the MDS examination will soon be closed and it is up to the ACMS and its members to decide on the impact of this designation and the future of our specialty.

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