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Vermont’s First Mohs Surgeon, Mary Maloney

August 8, 2023 by Janet Essman Franz

The Division of Dermatology welcomed Mary Maloney, M.D., to the faculty this spring, for the second time. A medical alum from the University of Vermont class of 1977, Maloney is an expert Mohs surgeon. This procedure, which was relatively new when Maloney began her career as a physician, involves removing skin cancer in layers, looking at the skin under a microscope while the patient waits, then removing more layers as necessary. Maloney was Vermont's first and only Mohs surgeon when she served on the UVM faculty from 1983-88, and the second female Mohs surgeon in the U.S.

Mary Malone, M.D., medical alum from the Class of 1977, was Vermont's first Moh's surgeon and the nation's second female Mohs surgeon.

When Mary Maloney, M.D., graduated from the University of Vermont College of Medicine in 1977, treatments were rapidly advancing for skin cancer, the most common cancer in the United States. A procedure called Mohs micrographic surgery, named after its originator, Frederic E. Mohs, M.D., had emerged as the most accurate method for removing cancer from the skin. Dr. Mohs first used the procedure on a patient in 1936, on an individual with a squamous cell cancer of the lower lip., but the procedure was not common practice until the 1970s.

Maloney became Vermont's first Mohs surgeon when she joined the UVM Division of Dermatology in 1983. She practiced at the medical center and mentored emerging dermatologic surgeons for five years before leaving in 1988 to join Penn State College of Medicine. In 1999 she moved to UMass Memorial, becoming division chief and then founding chair of dermatology, leadership positions she held for 21 years.

Maloney re-joined UVM’s dermatology division as a clinical professor of medicine in February 2023. She currently sees patients at UVM Medical Center and mentors medical students, dermatology residents and fellows in surgical dermatology.

Mohs surgery involves cutting out a visible cancer tumor and then shaving a thin layer of the surrounding skin, with the patient awake under local anesthesia. The layer of skin is frozen and cut into very thin horizontal slices. The slices are placed on microscope slides and stained. While the patient waits, the Mohs surgeon examines all the edges and underside of the tissue under a microscope to look for cancer cells. If cancer cells are found, another layer of skin is removed and examined.

This process of removing a thin layer of skin and looking at it under a microscope continues until the surgeon no longer sees cancer cells. If multiple rounds are needed, the process can take several hours. The ability to see where the cancer stops allows patients to keep as much healthy skin as possible because the surgeon only removes the skin with cancer cells. This is especially important when skin cancer develops in an area with little excess tissue, such as the eyelid, nose, ear, or hand. The procedure allows removal of all cancerous cells for the highest cure rate while sparing healthy tissue and leaving the smallest possible scar, Maloney said.

“It’s 99.9 percent effective for curing a primary tumor,” Maloney said. “It saves a lot of tissue compared to traditional surgery.”

Maloney learned about Mohs surgery during her dermatology residency at Hitchcock Clinic in Hanover, N.H. She participated in a fellowship in Mohs surgery and cutaneous oncology at University of California–San Francisco. At that time, she was one of only two female Mohs surgeons in the United States. In a 2018 article about female Mohs surgeons published in the International Journal of Women’s Dermatology, Maloney explained that gender disparity was significant in almost every field of medicine, and she did not expect to have many female colleagues regardless of the path she chose. When Maloney attended medical school at UVM, there were only 13 female students in her class, seven in the preceding class, and only three in the class preceding that. By contrast, 76 students (60 percent) in the Larner class of 2026 identify as female.

Last winter, when Joseph Pierson, M.D., professor and chair of dermatology at the Larner College of Medicine, offered Maloney a position at UVM, she was delighted to return to her alma mater.

“I wasn’t ready to retire,” said Maloney. “At 70 years old, I wanted to step down as [department] chair, but I wanted to continue to practice. Vermont is where my roots are, so I said, ‘Why not go home?’”

Maloney’s Vermont roots run deep: Her ancestors settled in Salisbury in the 1700s, and her grandfather founded Basin Harbor, a resort hotel in Vergennes, in 1909. She was born at the University of Vermont Medical Center — then called Mary Fletcher Hospital — and grew up working in her grandfather’s hotel, where she still keeps a house on the grounds. Maloney’s daughter, Katherine Anderson, M.D.’14, is assistant professor of pediatrics at Larner College of Medicine and chief of the Clinical Genetics Division at UVM Medical Center.

Today in Vermont, there are numerous Mohs surgeons, some of whom trained under Maloney. As both a surgeon and clinical instructor, Maloney enjoys the opportunity to connect with patients, rising physicians, and medical students in a personal way.

“I have the best job in the world, because I get to know people, not just for an instant. While I remove and examine their tumor, we talk and form a bond,” she said, adding that, while performing surgery with dermatology fellows, residents, and medical students, “I develop a bond with them because we’re doing something together. I have trained a lot of people, and I’ve been passionate about academic medicine and the career development of physicians.”

Maloney’s service and dedication to the field was recognized when she received the Frederic E. Mohs Award for Career Achievement at the American College of Mohs Surgery 2018 annual meeting. Over the course of her career, she has held numerous leadership positions, including serving on the boards of directors for the American Academy of Dermatology, the American College of Mohs Micrographic Surgery and Cutaneous Oncology, the American Society for Dermatology Surgery, the Association of Professors of Dermatology, and the Association of Academic Dermatologic Surgeons. She was the U.S. representative to the International League of Dermatologic societies. She has held the position of president of the Association of Academic Dermatologic Surgeons and the Women’s Dermatologic Society, and she served as the secretary-treasurer for the American Academy of Dermatology.

Reflecting on her journey as the first Mohs surgeon in Vermont, one of the first females in the field, a teacher, and a mentor, Maloney said, “We all need to elevate the people coming behind us so they will take what we have done to new heights. It’s a debt we owe to the people who taught us. The people I have trained have become excellent surgeons, well-known in the field, sought-after speakers, and I’m proud of them all.”

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