Mohs Surgeon Job Market

[bad_bunny]

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Any recent fellowship graduates who have tested the job market have any input? I'd imagine finding a full-time Mohs job in a city would be hard, rural would be easier. Just looking for anecdotal evidence of the difficulty of securing full-time mohs, and salary

 

[MOHS_01]

Any recent fellowship graduates who have tested the job market have any input? I'd imagine finding a full-time Mohs job in a city would be hard, rural would be easier. Just looking for anecdotal evidence of the difficulty of securing full-time mohs, and salary

Huh -- what would make you think that finding a full time subspecialty job that requires a sizable population to be busy, a sizable referring population to be busy, etc, would be easy to find in a rural setting?

Try this: full time subspecialty MMS does not really exist in rural settings. Mixed / dig out your own? Yeah, doable. You'll never be "busy". "Busy" requires a busy referral network, referral networks require many providers, many providers require a big population. Why do docs seem to locate primarily in the cities? Because that's where the people live. #SuttonsCorollary

 

[asmallchild]

I would add that if full-time Mohs is non-negotiable, I'd think long and hard before committing to another year of training as you'll likely end up disappointed.

I interviewed with numerous practice owners who were insulted at the thought when I brought it up

"I've been in practice for 10 years and I'm not full-time Mohs. What would make you think that I would start you out of the gate full-time Mohs with a full case load?"

PE groups are always quick to offer full-time Mohs citing their armies of midlevels waiting to feed you cases. Having worked at one for <1 year, it's yet another promise that is not fulfilled.

 

[MOHS_01]

I would add that if full-time Mohs is non-negotiable, I'd think long and hard before committing to another year of training as you'll likely end up disappointed.

I interviewed with numerous practice owners who were insulted at the thought when I brought it up

"I've been in practice for 10 years and I'm not full-time Mohs. What would make you think that I would start you out of the gate full-time Mohs with a full case load?"

PE groups are always quick to offer full-time Mohs citing their armies of midlevels waiting to feed you cases. Having worked at one for <1 year, it's yet another promise that is not fulfilled.

Hear, hear. It's a fool's errand to believe you will naturally land a full time job in your chosen field in either dermpath or MMS -- at least "busy" as we would want to be. It's been that way for 15 years now; I mean, I know we can be slow to catch on, but damn....

I remember a few years back at the Mohs college meeting they did an informal survey with the little handheld ballot device (think trivia night at the bar - ha). They asked how many were full time defined as 4 full patient days per week. They then asked how many were full time MMS. They then asked annual volume. A relatively high percentage claimed full time work, a smaller but still significant majority claimed full time MMS, but -- and by no small margin -- the median and most frequent case load was 500-750 cases annually. Sorry, but that math does not compute, someone was not being honest (either with self or group, who knows). Only a small minority, mostly old guys, admitted to routinely performing more than 1000 cases annually. Granted, this was immediately following a keynote speaker decrying the increased utilization... and someone who won't be named getting up and saying that the grand increase was largely by college folks, not the society -- so I'm not sure of the validity of the polling -- but one thing that I am quite sure of: complaints of simply being overcome and looking to add an associate (Mohs) provider were scarce. As in, non-existent.

I'd have a job lined up before agreeing to the fellowship.

 

[ymeacisrej]

Hear, hear. It's a fool's errand to believe you will naturally land a full time job in your chosen field in either dermpath or MMS -- at least "busy" as we would want to be. It's been that way for 15 years now; I mean, I know we can be slow to catch on, but damn....

I remember a few years back at the Mohs college meeting they did an informal survey with the little handheld ballot device (think trivia night at the bar - ha). They asked how many were full time defined as 4 full patient days per week. They then asked how many were full time MMS. They then asked annual volume. A relatively high percentage claimed full time work, a smaller but still significant majority claimed full time MMS, but -- and by no small margin -- the median and most frequent case load was 500-750 cases annually. Sorry, but that math does not compute, someone was not being honest (either with self or group, who knows). Only a small minority, mostly old guys, admitted to routinely performing more than 1000 cases annually. Granted, this was immediately following a keynote speaker decrying the increased utilization... and someone who won't be named getting up and saying that the grand increase was largely by college folks, not the society -- so I'm not sure of the validity of the polling -- but one thing that I am quite sure of: complaints of simply being overcome and looking to add an associate (Mohs) provider were scarce. As in, non-existent.

I'd have a job lined up before agreeing to the fellowship.

What do you mean by having a job lined up before agreeing to the fellowship? Is it typical to already have a job w/ Mohs etc before starting the fellowship? Also isn't it a match process?

 

[MOHS_01]

What do you mean by having a job lined up before agreeing to the fellowship? Is it typical to already have a job w/ Mohs etc before starting the fellowship? Also isn't it a match process?

It‘s not written in code.

 

[tigers96]

I think a lot of it is regional. I believe you can still find busy mohs practices. I was considering doing a fellowship but elected not to due to moving family twice and some other factors. My practice I joined has a mohs surgeon that does over 1k cases/year and booking out 3+ months, not a huge city (around 130k). He wanted me to join given my background and offered to train me. I’m doing mostly general but should have about 300-400 cases this year. We co-read all path together and in general discuss all the cases but I have a lot more independence. I guess it is a fellowship without moving family 2x, not a significant pay cut and continuing in the same job.

 

[MOHS_01]

I think a lot of it is regional. I believe you can still find busy mohs practices. I was considering doing a fellowship but elected not to due to moving family twice and some other factors. My practice I joined has a mohs surgeon that does over 1k cases/year and booking out 3+ months, not a huge city (around 130k). He wanted me to join given my background and offered to train me. I’m doing mostly general but should have about 300-400 cases this year. We co-read all path together and in general discuss all the cases but I have a lot more independence. I guess it is a fellowship without moving family 2x, not a significant pay cut and continuing in the same job.

I would say that represents a very unique and somewhat odd setup, but I'm glad it works for you both. Reminds me of the old story about why should one buy the cow.....