In this interview, Dr Ramone F. Williams discusses the Mohs Surgeons Leading the Future program and highlights the program's objectives, the specific projects undertaken, and the valuable lessons learned by participants in enhancing their leadership skills and advancing the field of Mohs surgery.

Ramone F. Williams, MD, MPhil, is a mohs surgeon at Massachusetts General Hospital and an instructor at Harvard Medical School, in Boston, MA.

Transcript:

The Dermatologist: Can you provide an overview of the Mohs Surgeons Leading the Future program and its objectives?

Dr Williams: The Mohs Surgeons Leading the Future program is a competitive award program that is sponsored generously by the American College of Moh Surgery Foundation and this program focuses on leadership and career development. The program selects up to eight participants that are all Moh surgeons from around the country. So it was really an honor and a privilege to have the opportunity to participate this year.

The Dermatologist: What were the specific projects undertaken by each group of four individuals during the program?

Dr Williams: There were two projects this year. We were each divided into groups of four that focused on separate projects. So my project focus was the frozen section, tissue processing, flipbook, which is an online resource that I will talk more about. And then the second project was regarding mohs surgery workforce adequacy.

The Dermatologist: How were the projects selected, and what criteria were considered in their development?

Dr Williams: There are so many options for projects. So project selection is always challenging.

Project selection is undertaken by the leadership of the American College of Mohs surgery, which our membership includes many of the mohs surgeons across the country. And essentially projects that are given priority are projects that are thought to be of high importance to both our mohs college members, our mohs surgeons around the country, as well as patients, of course, that suffer with skin cancer and projects that will focus on advancing development and treatments for skin cancer, as well as improving the quality of life for these patients.

The Dermatologist: Can you discuss the goals and outcomes achieved by each group through their respective projects?

Dr Williams: The goal of the mohs workforce adequacy was essentially to look overall broadly at what will happen to our mohs workforce as time goes on.

There are changes to board certification and of course changes to the pipeline of young surgeons that are pursuing the field of mohs surgery. So this is a very important project. The project that I focused on was equally as important, focusing on frozen section tissue processing.

And essentially, this project helps to tackle and troubleshoot issues that may arise during frozen section tissue processing during a busy day in mohs surgery. I would say that overall, we were fortunate that the year went very smoothly.

The Dermatologist: What challenges did the participants encounter during the project implementation, and how were they addressed?

Dr Williams: I would say the greatest challenge was determining the scope of the project.

You know, we're given kind of a project goal and overall mandate, and then it comes down to fine tuning. How broad will our project be? We don't want to make it too broad such that we would not be able to accomplish our goals in the 12 month period, but we also at the same time did not want to make it so narrow that we wouldn't be able to efficiently address the goals that we wanted to achieve. Luckily, I think we found the perfect balance and we were able to get the project done in an appropriate scope.

The Dermatologist: How did the leadership skills of the participants evolve throughout the duration of the program and the project execution?

Dr Williams: I would say the greatest challenge was determining the scope of the project.

You know, we're given kind of a project goal and overall mandate, and then it comes down to fine tuning. How broad will our project be? We don't want to make it too broad such that we would not be able to accomplish our goals in the 12 month period, but we also at the same time did not want to make it so narrow that we wouldn't be able to efficiently address the goals that we wanted to achieve. Luckily, I think we found the perfect balance and we were able to get the project done in an appropriate scope.

One of the major goals of the Mohs Surgeons Leading the Future program is to develop and foster future leaders in mohs surgery. So throughout the program, we gained exposure to the leadership of the ACMS as well as the strategic goals of the ACMS, the American College of mohs surgery. So these included dynamic group sessions, one-on-one sessions with leaders in the college.

We each got assigned a mentor that has demonstrated significant leadership for many decades in the mohs college, and we also had access to the executive board of directors of the American College of Mohs Surgery, which was a wonderful opportunity.

The Dermatologist: What lessons did the participants learn from their projects, and how do they plan to apply these lessons in their professional practice?

Dr Williams: So many great lessons learned throughout the program, definitely the importance of teamwork. We were all tasked with working together with our teams, which was integral to the completion of our projects.

Lots of lessons regarding the importance of mentorship. I would say the mentorship program is particularly strong. I was lucky enough to be matched with a mentor and really got to experience wonderful mentorship throughout the program.

And I would say the third thing would be just the importance and value of collaboration. We could not complete our projects in a vacuum and we relied on guidance and contributions from just amazing leaders in our fields and surgeons in our field who are generous enough to contribute to our projects.

The Dermatologist: Can you describe the findings of the Mohs Workforce Adequacy Project and the Mohs Histopathology Flipbook Project?

Dr Williams: For the Frozen Section Tissue Processing Flipbook, before we started our flipbook, we surveyed the college in an attempt to determine what topics our mohs surgeons wanted to see represented in our flipbook.

So three areas of interest emerged. So we learned that mohs surgeons around the country were most interested in learning about troubleshooting slides and artifacts that may appear on our glass slides, harvesting difficult layers during mohs surgery, as well as processing layers at different sites, sites in particular that are considered more challenging, for example, the eyelid or the ear, cartilage bearing areas are typically considered challenging. So we really were able to hone in and focus on these topics in our flipbook.

For the Mohs Workforce Adequacy Project, this is not my area of focus, but briefly, our colleagues in this group found out that there is a maldistribution of mohs surgeries across the country. Essentially there are areas with very high concentrations of mohs surgeons which is great, but more concerning is that there are many areas across the country with very few mohs surgeons and we need to work to ensure that patients in these parts of the country have adequate access to care.

The Dermatologist: How do you envision the projects contributing to the advancement of mohs surgery and dermatology as a whole?

Dr Williams: Our frozen section processing flipbook in particular, we are very excited about. This is an online resource, an online textbook that the members of the American College of Mohs Surgery, as well as the ASMH, our histotech colleagues, will both have access to. It contains high quality photographs, high quality videos of guidance and opinions from leaders in our field and just lots of high yield information that will greatly enrich members of our college and histotechs alike. It will be particularly important in troubleshooting issues during a mohs day to ensure just the highest quality of care for our patients.

I do anticipate that this will be a great addition to all the members of our field. In terms of the mohs workforce adequacy project, just highlighting areas of mohs need where mohs surgeons are needed the most around the country, I think we'll encourage future efforts to really look at how do we recruit surgeons to areas of most need and again, improve access of care and access to care and quality of care for our patients with skin cancer.