City of Hope currently does not have a Mohs Micrographic Surgeon on staff at our center, with many skin cancers sent to other surgical subspecialties. Mohs Micrographic Surgery (MMS) is a surgical technique that can only be performed by a dermatologist who has done a MMS fellowship.  MMS is performed on larger, high-risk cancers as well as those in cosmetically sensitive areas. MMS is the only surgical technique that examines 100% of the margin of tumor, is 99% effective (the high cure rate), and removes skin cancer with the smallest scar possible, sparing healthy tissue. Ideal practice is the referral of most high-risk, cosmetically sensitive skin cancers to a Mohs surgeon. Typically, skin cancers are referred to dermatology for biopsy for diagnosis.  From there, the definitive therapy is determined by a dermatologist (radiation vs. type surgery vs. skin-directed chemotherapy).  At our institution, we frequently have skin cancers referred from oncology or hematology to a surgical subspecialty.  In doing this, we are not considering all therapies.  In particular MMS gets overlooked, more so, because we do not have a MMS trained surgeon at our institution.  Our physicians and Advance Practice Providers should be aware that this technique exists due to the high skin cancer burden among our patient population, particularly in those who have undergone transplant.