Surgery for skin cancer is a major part of clinical dermatology, and the largest single component of dermatologic surgery practice. In general, residency training in dermatology provides comprehensive training in the theory and practice of skin cancer surgery. Practicing dermatologists are similarly expert in this area, and frequently assist other medical and surgical services by managing and coordinating the care of patients with skin cancer. However, there are minor gaps in training and practice that bear scrutiny and are amenable to rectification. This article defines the current practice in surgical treatment of skin cancers by dermatologists, gaps in practice, and mechanisms to improve current surgical practice.