The M ohs histotechnician: a review of training and practice within 29 centres in the UK

Summary Background Although various assessments pertaining to the surgical aspect of M ohs micrographic surgery ( MMS ) have been performed, the pivotal role played by the MMS histotechnician ( MH ) has not previously been addressed in the UK . Aim To undertake a review of the training and practice of MH s in all centres performing MMS within the N ational H ealth S ervice ( NHS ) in the UK . Methods NHS dermatology departments performing MMS in the UK were identified and contacted by telephone between N ovember 2011 and January 2012. MMS practice data pertaining to the role of the MH in tissue processing was collected by speaking directly to a histotechnician in each department. Results In total, 29 centres were identified. The number of MH s at each centre varied from 1 to 13 (median 3). All MH s had undergraduate degrees in biomedical science. Most (85%) MH s worked full‐time under the directorate of their local pathology department. In 19 centres (66%), the M ohs surgeon reviewed the slides, and in the remaining 10 centres (34%), a consultant histopathologist reviewed the slides, either alone or in partnership with the M ohs surgeon. There was significant variation in tissue handling and processing techniques across the centres. All centres used MMS to treat primarily high‐risk basal cell carcinomas, with over half (55%) also treating squamous cell carcinomas. MH s from all centres had learned about the specifics of MMS tissue processing ‘on the job’, with a minority having received formal training by attending a larger MMS centre or an MMS course. Conclusions Significant variation in MMS tissue‐processing techniques exists across the UK . A standard of practice should perhaps be considered, as this has risk‐management, quality‐control and possible medicolegal implications.