ABD Mohs Surgery study guide
ABD Mohs Surgery · Work through your exam, one topic at a time.
Mohs micrographic surgery is the subspecialty credential in dermatologic surgery built around a single technical idea: excising a cutaneous tumor, mapping the specimen, and examining essentially 100% of the surgical margin on frozen sections before deciding whether to close. Certification in this area is intended for dermatologists who have completed Mohs fellowship training and who run or intend to run a Mohs laboratory, because the exam tests the whole pipeline rather than just the excision - tumor biology, margin mapping and tissue orientation, frozen-section histology, reconstruction, anesthesia and complication management, head and neck anatomy, and the regulatory and ethical side of running a laboratory. The ABD Mohs Surgery study guide has 8 sections and about 1,982 words.
01Cutaneous Oncology and Tumor Biology
Candidates must know the biology of the tumors Mohs is used for and, equally, the tumors for which it is inappropriate. Basal cell carcinoma subtypes matter: nodular and superficial tumors behave indolently, whereas morpheaform, infiltrative, and basosquamous variants show subclinical extension and higher recurrence after standard excision.
279 words, about 1 min02Mohs Micrographic Surgery Technique and Indications
Mohs achieves complete margin examination by mapping tissue in a contiguous plane. The critical technical steps: scoring and orienting the specimen, taking saucerized stages with a bevel, inking the true margin, relaxing incisions to flatten the tissue, and correlating the map with histology.
296 words, about 1 min03Histopathology and Frozen-Section Interpretation
Candidates must identify BCC (nodular, infiltrative, morpheaform), SCC, and melanoma on frozen sections, and recognize artifacts unique to frozen tissue: freeze artifact, chatter, and cautery distortion. Know that frozen sections are typically stained with hematoxylin and eosin and that melanoma and some adnexal tumors require immunohistochemistry, which may not be available on frozen tissue - a key practical limitation.
252 words, about 1 min04Reconstructive Surgery and Wound Management
Candidates must understand when to allow second-intention healing, when to use primary closure, and when to use grafts or flaps. Site matters: the nose, ear, and eyelid have unique constraints.
267 words, about 1 min05Perioperative Care, Anesthesia, and Complications
Know local anesthetic pharmacology: lidocaine with epinephrine, maximum dosing, and the role of epinephrine for hemostasis and prolonged anesthesia. Understand buffering to reduce injection pain and the recognition of epinephrine sensitivity.
215 words, about 1 min06Surgical Anatomy of the Head and Neck
Candidates must know the anatomic danger zones for Mohs on the face: the temple (frontal branch of the facial nerve), the nasolabial fold and cheek (buccal and zygomatic branches), the periauricular region (great auricular nerve, parotid duct), and the medial canthus (lacrimal apparatus). Understand the course of the facial nerve and the risk of injury during deep dissection.
245 words, about 1 min07Practice Management, Quality, and Patient Safety
Understand the elements of a safe Mohs practice: accurate specimen labeling, map verification, time-out procedures, and documentation. Know the role of frozen-section quality control and turnaround.
212 words, about 1 min08Ethics, Professionalism, and Health Policy
Candidates must understand informed consent, shared decision-making, and conflict-of-interest management. Know the principles of beneficence, nonmaleficence, autonomy, and justice as applied to surgical decisions.
216 words, about 1 min