August Career Corner

 

WDS Career Corner: Mohs Fellowship Feature

Special thanks to our authors, Dr. Porter, Assistant Professor in the Department of Dermatology at the University of Nebraska Medical Center, and Dr. Vanessa Voss, Assistant Professor in the Department of Dermatology at the University of Nebraska Medical Center, Assistant Mohs Fellowship Program Director, and Director of the High-Risk and Post-Transplant Skin Cancer Clinic, for sharing their expertise.

1. What are the top three factors that make for a strong application?

Strong letters of recommendation — It's a small field, so having a respected Mohs surgeon vouch for you carries significant weight in receiving interviews. Ideally, this letter comes from your home fellowship program director (if you have a fellowship), or your home institution’s Mohs surgeon since they've observed your clinical skills, judgment, and character over an extended period. If you don't have a home program with a Mohs surgeon, make it a priority to spend at least a week — ideally longer — working alongside one so they can speak to your abilities firsthand. A generic or secondhand letter simply doesn't carry the same weight in a field this small, where most program directors know each other personally. A strong letter from your residency program director is also a must. They often know you well and can highlight your strengths throughout residency.

Dedication to the field — This can be demonstrated through research, away rotations, educational initiatives, Mohs-related committee membership, or collaborative projects with other programs. Programs want to see that your interest in Mohs surgery is genuine and sustained, not a last-minute decision. Joining the Mohs community is a privilege, and the field depends on bringing in surgeons who are truly committed to advancing patient care and the specialty itself. Applicants who can point to a track record — publications, presentations, sustained involvement in Mohs-related projects — stand out because that history is hard to fake.

Work ethic and being a team player — Mohs surgery is inherently collaborative. The ability to work well with staff, residents, and multidisciplinary teams isn't a bonus quality — it's a basic requirement. This comes through in multiple ways: your letters of recommendation, informal calls between program directors and your letter writers, in-person visits to a program, and your day-to-day conduct as a dermatology resident.

 

2. What is the single most important piece of advice you would give a prospective Mohs applicant?

Spend time with programs in person if possible, so they can get a genuine sense of you and you can get a genuine sense of them. Being physically present in a clinic lets a program see how you handle real cases, interact with patients and staff, and think on your feet, while giving you a much clearer picture of the program's culture and whether you'd actually be happy there. If an away rotation or in-person visit isn't feasible, the next best option is pursuing a research project with the program — it shows initiative and gives them a tangible body of work to evaluate. Fit is especially important in this field because most programs are small, meaning you'll spend a lot of concentrated one-on-one time with your attendings. A mismatch in working style or personality is much more noticeable in a fellowship of this size than in a larger residency program. Also, make sure to attend — or watch the recording of — the annual MSDO Fellowship Application Forum. There's a lot of good advice shared there.

 

3. What are one or two common mistakes you see applicants make?

Not having a backup plan. Given how competitive and small this field is, applicants sometimes treat Mohs fellowship as their only path forward without seriously considering what they'll do if they don't match. Having a realistic backup — whether that's general dermatology practice, reapplying with a stronger application the following cycle, or pursuing a cutaneous oncology fellowship to strengthen a reapplication — is important both for peace of mind and for making sound career decisions under pressure. This backup plan doesn't need to be finalized, but thinking through your options ahead of time allows you to pivot quickly if you go unmatched.

Over or under-engaging. There’s a balance to strike when interacting with program directors. It’s important to reach out if you have interest in a program and it can help you secure options for greater involvement including away rotations, research projects, or demonstrating interest after an interview, but there are pitfalls too. Don’t be too aggressive or self-promoting, always respect that the PD is very busy, and try to offer something to them rather than asking something of them. Look for genuine ways to engage in person, like asking about their research or a talk they gave. Those conversations tend to feel more authentic, and they leave a much better impression. Also having your mentors reach out to them with your interest carries more weight than you reaching out yourself.

4. What is one thing that might surprise applicants about the fellowship application process?

Programs have different goals for who they want to match, and that isn't always obvious from the outside. One program might be looking for someone who will focus heavily on research, another might prioritize clinical volume and efficiency, and another might be looking for a specific practice type career goal (academic vs. private practice, for example). Applicants sometimes assume all programs are evaluating candidates against the same ideal, when in reality what makes you a top candidate at one program might make you a less obvious fit at another. Understanding a program's specific priorities — through research, conversations, or time spent there — can help you tailor your approach and manage expectations.

5. Do you have any advice on how applicants can best use application signals?

Programs vary in how much they value application signals. Since it’s a relatively new feature in the MSDO match, there is limited data on how these affect match outcomes. If you are doing an away rotation, find out if the program also expects a signal from you.  Also find out if your home program expects you to signal. Our advice is to use them for the programs where you are most interested in interviewing unless that program has specifically stated they aren’t using them this year. There will likely be more guidance to come in the next few years on optimal use of signaling.