why arent there any im fellowships in skin care etc. what allows derms to control this market so tightly? couldnt this be feasible for the future?

i don't think there's a specific fellowship per se. however, i think allergy/immunology comes closests to derm. i've heard u end up seeing a lot of skin problems in the form of rashes. u could probably contact various companies like allergan to learn botox, buy urself a smoothbeam laser for 50 grand (not sure price) to tx acne, by another laser for like 20k to remove hair, do skin biopsies, remove moles/warts w/ liquid nitrogen, tx eczema, etc.