-Identify patients with advanced or high-risk cutaneous malignancies within the academic dermatology setting who warrant multidisciplinary evaluation, systemic therapy consideration, or referral beyond the dermatology office. -Analyze real-world barriers to optimal care delivery in academic institutions—including formulary approval processes, institutional decision-making dynamics, and operational hurdles—that impact timely adoption of appropriate treatment strategies. -Apply strategies to strengthen referral pathways and collaborative care models among dermatologists, Mohs surgeons, medical oncologists, radiation oncologists, and hospital-based care teams to optimize patient outcomes and streamline continuity of care.