title: Career trajectory and job satisfaction trends in Mohs micrographic surgeons.
abstract: BACKGROUND
  Although many residents and fellows in Mohs surgery express an interest in academics, departure from academics occurs for many trainees or junior faculty.
  
  
  OBJECTIVE
  We designed a survey, issued to all American College of Mohs Surgeons (ACMS) members in 2009, to assess reasons for practice selection.
  
  
  RESULTS
  A response rate of 65.0% (n=455) was obtained. Of all ACMS members, 33.9% started in academic positions, and 66.1% started in private practice. Retention rates in private practice (61.2%) were significantly higher than in academics (28.0%) (p<.001). The rationale for selection of an academic career included referral base and teaching and research opportunities. Reasons for selection of a private practice career were higher salary, autonomy over resources, and geographic flexibility. There were high rates of departure from academics early on; reasons for departure included lack of support from the academic chair and lack of autonomy over resources. Surgeons leaving academia were able to perform Mohs surgery and continue interests in research and teaching with benefits of greater autonomy over resources in private practice.
  
  
  CONCLUSIONS
  Novel efforts to retain academic Mohs surgeons are needed to ensure continued success and evolution of the specialty.
authors.affiliation: Department of Dermatology, School of Medicine, Tufts University, Boston, Massachusetts, USA.
authors.forename: Emily P
authors.initials: EP
authors.lastname: Tierney
authors.forename: C William
authors.initials: CW
authors.lastname: Hanke
authors.forename: Alexa Boer
authors.initials: AB
authors.lastname: Kimball
mesh_terms: D000328:Adult; D002321:Career Choice; D002322:Career Mobility; D005260:Female; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D015580:Mohs Surgery / Q000193:education*; D012878:Skin Neoplasms / Q000601:surgery*; D011795:Surveys and Questionnaires