Mohs surgery is performed by thousands of dermatologists across the country. However, only a very small group of dermatologists complete a 1- to 2-year long fellowship accredited by the American College Mohs Surgery (ACMS). During this time, ACMS members dedicate their training purely to Mohs micrographic surgery and reconstruction. They must complete a minimum of 500 cases, often for skin cancers in difficult anatomic locations, and are exposed to rare tumors of the skin. Only ACMS accredited fellowships provide Mohs surgeons with formal training in performing complex wound reconstruction. This ensures the highest cure rate and most cost-effective skin cancer treatment available. To be accredited by the ACMS, a fellowship training program must undergo a rigorous and peer-reviewed process by the Accreditation Council for graduate Medical Education (ACGME).