So how hard is it to get a Mohs fellowship? Is it impossible if you come from a mediocre program? Just curious....
How hard is it to get a MOHS fellowship?
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It's a huge game. So it's mostly a matter of politics, who you know, how well people like you, etc.
In my experience, it has relatively little to do with merit (i.e. quality of your training program, mock boards, pubs, etc.)
In my experience, it has relatively little to do with merit (i.e. quality of your training program, mock boards, pubs, etc.)
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Every (non-toolbag) that I know who has applied has had zero problem landing a fellowship. The real question to ask yourself is this -- why do you want to do one and will it be worth it? I would recommend securing your practice opportunity prior to committing yourself to the fellowship, then go for it. Best of luck with it.
Not hard. I can't think of anyone that wanted to do one that didn't ultimately get a spot.
It is much, much easier than getting a derm residency spot.
The funny thing about residents who want to do a Mohs fellowship is that they are often inspired by someone who has been doing Mohs for 10+ years and seems really happy. When you're around such a person, it's certainly natural to want to be like them.
The problem is that if you're looking to do a Mohs fellowship now, there is virtually no chance that you're going to be able to have the same type of practice as someone who got into the field 10-20 years ago. Those opportunities, for the most part, no longer exist.
This advice is good if you can pull it off, but it is almost impossible to actually put into practice. It's hard to secure a practice opportunity suitable for a Mohs surgeon that far in advance of actually being qualified to do Mohs (if it's before you go through the Mohs match, then it's over 1.5 years).
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Amen, and I wish that this was common knowledge. We have overtrained as is evidenced by the number of colleagues I am familiar with who have had significant difficulty finding a "desirable" job. Sure, there are a ton of "one to two day a week" Mohs jobs -- but you can do that if you throw up a solo practice shingle. This is why I would strive to secure a decent position prior to dedicating to the extra training.
Neither is hard. But if I take your question literally, then getting a job in a saturated city would be easier. If you're willing to accept any job, you could always start your own practice or take an academic position in any city if you couldn't find anything else.
Getting a general derm job in a saturated city is pretty much 100%. Getting a Mohs fellowship is a little bit less than that.
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Agreed; could not tell if the question was serious or not.
Go to a city with a growing population, though....
Yes, the question was serious, but I guess it lacked specificity. I'm thinking about relocating to new york city (or just outside the city) after residency. I'm trying to get a sense of how difficult it is to get a job there, since I don't know any dermatologists in the area. I've also considered doing a mohs fellowship. So, having heard that both are "competitive," I was trying to get a sense of how much so, and thought I could at least get a relative sense. Let's say I'm interested in finding a full time practice job with at least the median derm income, 250-300k; not just any job where I could be making 150k or a part time job. How hard is that in comparison to a mohs fellowship (decent program, any location). Does that clarify the question? Thanks!
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MOHS_01,
What precisely happened to practicing MOHS? I remember reading something about Medicare not allowing proper billing for the removal and the reconstruction (essentially cutting reimbursement in half) during the same visit??? Sorry for the confusion, but just curious.
What precisely happened to practicing MOHS? I remember reading something about Medicare not allowing proper billing for the removal and the reconstruction (essentially cutting reimbursement in half) during the same visit??? Sorry for the confusion, but just curious.
Answer is pretty much still the same. Neither is hard.
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Well, in Jan '08 we lost the multiple procedure reduction exemption (inappropriate application of the MPR rule -- and the specifics of how it happened is...ummmm.... suspect at best -- but that's another story for another time). When viewed in a vacuum, this loss resulted in a revenue loss of approximately 30-40% for like work -- which would translate into a much larger % drop in profit/income . In reality, for most, the loss was mitigated by a number of factors: mixed nature of most practices, alterations in the number of cases performed per day, alterations in the number of tumors treated per session, and, probably most importantly, we were in the middle of a RVU upward valuation for several dermatology codes (including reconstructions) that helped offset the other losses.
I did not change the way that I practiced at all and my revenue dropped by somewhere between 15 and 20%, but this drop includes an increase in the amount of cases I performed, number of patients seen, and dropping most of the cosmetic side of my practice. In short, there were too many variables involved for me to have a solid handle on the specific effect -- but I will tell you that Feb/March collections of 2008 (which reflected the reimbursement change but prior to a shift in the number of cases / day and additional general derm aspect) was brutally ugly.
I hope that addresses what you were looking for.
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Definitely. Thank you!
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So, what you are saying is that it is possible to get a mohs fellowship if you work hard and don't have a horrible personality. The next question is, "how do you know which programs are good???" There are no rankings (unless someone knows of one). I suspect that any proposition for ranking of Mohs Fellowships would be totally subjective.
Obviously since some of these fellowships are private and some academic, they each have goods and bads associated with them. Could someone also respond to goods/bads of academics vs private fellowship programs???
Thanks
Obviously since some of these fellowships are private and some academic, they each have goods and bads associated with them. Could someone also respond to goods/bads of academics vs private fellowship programs???
Thanks
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I would like to find out the answer for this one as well, please...
