Attendings keep telling me “you will be miserable if you go into derm”

[FancyFeast]

Hey, everyone, I’m trying to figure out if I want to do derm, and although I feel like a jerk posting this, I was hoping one or more of you could give me advice.

Since my first semester of med school, I have been very active in an internal medicine sub-specialty. While working with several physicians in the department, I have had excellent clinical and research mentoring, and I’ve also gotten a few papers, too. I’ve been on the fence as to whether or not I want to go into IM with the intention of going into this sub-specialty, or if I want to go into derm. Recently, I started telling these attending that I was considering derm, and they’ve all told me the same thing: I will be miserable in derm because it’s too superficial. Not superficial in the vain sense, but superficial because derm doesn’t deal with curing any major diseases, like MIs or cancer or diabetes. I also talked to one of the deans at my school, and he told me the exact same thing. I’ve tried talking to the derm chair at my school, but he really wasn’t helpful and couldn’t give me any advice or clarity.

I’ve shadowed in derm, and I love it! If I went into derm, I’d want to go in academics, and I’d want to do clinical medicine and research (translational/clinical). Out of everything I have seen in clinic, I've loved working with patients with autoimmune and malignant skin conditions, in particular, I have been fascinated by psoriatic arthritis, scleroderma, GVHD, bullous diseases, and CTCL. Although I find cosmetics interesting (and I understand they are a major revenue source), I’m primarily attracted to derm because of the grossness (I know that sounds weird). I know derm has great hours, but for me, it’s more important to feel challenged and excited about my career than to have a 40 hour work week.

Besides thinking about the advice from attendings, I'm also aware that I I could write a ticket to almost any IM program, but there’s a fair chance I might not even match into derm. I scored between 247 and 253 on Step 1, and I have 8 pubs (3 first authored, 5 basic, 1 public health, 2 clinical, none are in derm). I’m an M3, and so far, I have honored medicine, psych, and OB/GYN. I did research during college, fulltime after college, and currently during med school.

So, did any of you have attendings you respected/trusted tell you to not go into derm? If so, are you happy that you chose derm?

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[username456789]

So, did any of you have attendings you respected/trusted tell you to not go into derm?

On a very regular basis.

If so, are you happy that you chose derm?

I'm still doing my intern year and haven't started the Derm part of residency yet, but I can still say emphatically YES. Hopefully that will never change, and I don't really expect it to.

Much of what you're hearing is sour grapes. Especially in an academic setting, people in other fields are part of the whole "you have to save the world one clogged artery at a time" philosophy, cut from the same cloth as the "you have to devote 150 hours/week in the hospital to carry any worth as a physician" philosophers.

Internal medicine specialists don't cure MIs, don't cure diabetes, and don't cure cancer. They manage the symptoms, risk factors, and aftermath. This is what Dermatologists do for dermatological diseases. Most of what the majority of doctors do cannot be categorized as "curing", although surgical specialties fall in line more closely with that idea.

Anyway, to get back to your main point, I guarantee at least some of the snide remarks you hear are due to a strong sense of jealousy - whether overt or subconscious - mixed in with varying degrees of their own job dissatisfaction.

With your scores and research and grades, you are painting the picture of a very competitive derm applicant. Keep up the clinical excellence, try to get at least a case report or two in derm if you can (although this won't make or break you at this point, it can at least help tip the scales in your favor despite your already strong research background), and try to get to know your home program and faculty very well. Continue to attempt to reaffirm your interest in dermatology; if you do that, you may reach a point where asking whether or not to apply for derm isn't even a question anymore, but simply the only obvious plan for you. Do a couple away rotations early in 4th year if you can as well.

Don't listen to the negativity from other physicians. Medicine (in the broadest sense) is full of people sh*tting on everyone else's specialty. Once you realize that's just a game everyone seems to play and can move past it, life is good.

 

[dermathalon]

So, did any of you have attendings you respected/trusted tell you to not go into derm? If so, are you happy that you chose derm?

You seem to have thought this through well so let me ask you a question? Do you think we actually cure anything in medicine? MIs are not cured, they are acted upon. Diabetes is not cured but it is controlled, Cancer can be cured but it's uncommon for chemotherapy to truly cure cancer without some surgical input. Everyone can toot their horn about how great their specialty is but you have to do what interests you.

To answer your question, yes, several attendings did tell me that. I typically lost a notch of respect of them afterwards unless they took time to understand what drove me to derm. They rarely ask and care about the answer (typical medicine culture where they assume they already know the answer). They prolly see their patients the same way. Funny thing is one of the most brilliant IM docs that I met (I mean absolutely superb) asked me why and then was so excited that I was going into derm. See, if your "respected" attending actually cares they should find out what makes you so interested. Otherwise, and I hate to be mean, but their opinion is not worth a damn. If they actually listen, then hear them out but you still have to do what is in your heart.

I've had nephrologists, peds, IM, you name it, tell me that I was going to be wasting my time and such garbage...I couldn't have been happier in my life with the choice to go derm. It's amazing and that's a massive understatement. I feel sorry for future medical students that will actually take advice from these people in the future.

On a side note, you would laugh if you knew how many times we have bailed inpatient teams out when we show up at the bedside to figure out the diagnosis...

 

[hawk126]

I wouldn't worry about what attendings in other fields say in regards to your career plans. After finding out that I'm a prelim medicine intern going into derm, attendings invariably say: "I wish I would have chosen derm", "smart man" or some variant; or "what a waste", "you'll never be happy just treating acne", blah, blah, blah. Every med student who has chosen derm encounters this stuff and, as was mentioned previously, most of that sentiment arises from envy, either on a conscious or subconscious level.

It sounds ridiculous, but choosing a field in medicine is about following your gut... if you feel like you will be happiest as a medicine sub specialist, then go for it! After 4 months of medicine internship, the thought of an entire career of this makes me want to claw my eyes out. Derm is such a wonderful field! If you want lifestyle, you can have it. If you want intellectually challenging bench work, you can have that too. If you want to work 60 hours a week like the subspecialists, it's there. In dermatology, there's a niche for everyone. If you're seriously considering it at this point, my guess is that you'll live to regret not choosing dermatology. Good luck, and regardless of what you choose, don't let envious attendings dictate your path.

 

[pupster]

Hey, everyone, I’m trying to figure out if I want to do derm, and although I feel like a jerk posting this, I was hoping one or more of you could give me advice.

Since my first semester of med school, I have been very active in an internal medicine sub-specialty. While working with several physicians in the department, I have had excellent clinical and research mentoring, and I’ve also gotten a few papers, too. I’ve been on the fence as to whether or not I want to go into IM with the intention of going into this sub-specialty, or if I want to go into derm. Recently, I started telling these attending that I was considering derm, and they’ve all told me the same thing: I will be miserable in derm because it’s too superficial. Not superficial in the vain sense, but superficial because derm doesn’t deal with curing any major diseases, like MIs or cancer or diabetes. I also talked to one of the deans at my school, and he told me the exact same thing. I’ve tried talking to the derm chair at my school, but he really wasn’t helpful and couldn’t give me any advice or clarity.

I’ve shadowed in derm, and I love it! If I went into derm, I’d want to go in academics, and I’d want to do clinical medicine and research (translational/clinical). Out of everything I have seen in clinic, I've loved working with patients with autoimmune and malignant skin conditions, in particular, I have been fascinated by psoriatic arthritis, scleroderma, GVHD, bullous diseases, and CTCL. Although I find cosmetics interesting (and I understand they are a major revenue source), I’m primarily attracted to derm because of the grossness (I know that sounds weird). I know derm has great hours, but for me, it’s more important to feel challenged and excited about my career than to have a 40 hour work week.

Besides thinking about the advice from attendings, I'm also aware that I I could write a ticket to almost any IM program, but there’s a fair chance I might not even match into derm. I scored between 247 and 253 on Step 1, and I have 8 pubs (3 first authored, 5 basic, 1 public health, 2 clinical, none are in derm). I’m an M3, and so far, I have honored medicine, psych, and OB/GYN. I did research during college, fulltime after college, and currently during med school.

So, did any of you have attendings you respected/trusted tell you to not go into derm? If so, are you happy that you chose derm?

Sigh...Please do not feed the trolls.....

 

[FancyFeast]

Sigh...Please do not feed the trolls.....

?


To those of you who responded, all I can say is thank you. You've given me clarity, and I truly appreciate the time you took to respond to my post and to share your stories with me

 

[diagonal]

Hey, everyone, I'm trying to figure out if I want to do derm, and although I feel like a jerk posting this, I was hoping one or more of you could give me advice.

Since my first semester of med school, I have been very active in an internal medicine sub-specialty. While working with several physicians in the department, I have had excellent clinical and research mentoring, and I've also gotten a few papers, too. I've been on the fence as to whether or not I want to go into IM with the intention of going into this sub-specialty, or if I want to go into derm. Recently, I started telling these attending that I was considering derm, and they've all told me the same thing: I will be miserable in derm because it's too superficial. Not superficial in the vain sense, but superficial because derm doesn't deal with curing any major diseases, like MIs or cancer or diabetes. I also talked to one of the deans at my school, and he told me the exact same thing. I've tried talking to the derm chair at my school, but he really wasn't helpful and couldn't give me any advice or clarity.

I've shadowed in derm, and I love it! If I went into derm, I'd want to go in academics, and I'd want to do clinical medicine and research (translational/clinical). Out of everything I have seen in clinic, I've loved working with patients with autoimmune and malignant skin conditions, in particular, I have been fascinated by psoriatic arthritis, scleroderma, GVHD, bullous diseases, and CTCL. Although I find cosmetics interesting (and I understand they are a major revenue source), I'm primarily attracted to derm because of the grossness (I know that sounds weird). I know derm has great hours, but for me, it's more important to feel challenged and excited about my career than to have a 40 hour work week.

Besides thinking about the advice from attendings, I'm also aware that I I could write a ticket to almost any IM program, but there's a fair chance I might not even match into derm. I scored between 247 and 253 on Step 1, and I have 8 pubs (3 first authored, 5 basic, 1 public health, 2 clinical, none are in derm). I'm an M3, and so far, I have honored medicine, psych, and OB/GYN. I did research during college, fulltime after college, and currently during med school.

So, did any of you have attendings you respected/trusted tell you to not go into derm? If so, are you happy that you chose derm?

Chase those dreams my friend.

PS: how about you cure wrinkling and balding in your free time. I mean, you want to help people, so why not really go for it?

 

[username456789]

Sigh...Please do not feed the trolls.....

I don't think you understand what a troll is.

 

[pupster]

I don't think you understand what a troll is.

Seriously? First time poster w/ the standard excellent resume (well...w/ the exception of the slightly low Step I...but he DOES have >>EIGHT<< publications) who comes into the DERM forum asking if there are miserable people and then starts off an "innocent discussion" about how other specialties (specifically IM) think that derm is superficial. I mean...good God...he's coming into the DERM forum. What did he expect? For the most part, most people here are already biased into wanting to do derm and are happy w/ the specialty (well...I guess there are the occasional exceptions, MOHS_01, bless your heart, as you have pretty opinionated, but thoughtful posts and I do appreciate the honesty, even if it's not exactly "politically correct" to state your opinions, although I also have issues w/ the use of the term "politically correct," but I'm digressing... )).

Anyway, I stand by my original premise. Urban dictionary link here:

"troll - One who posts a deliberately provocative message to a newsgroup or message board with the intention of causing maximum disruption and argument"

That said, if this ISN'T a troll, then I'd point him to discussions such as below that were found using the SEARCH button in the top right of this page (I guess some people think it's a good use of our time to ask inflammatory questions or ask questions that have already been answered before w/out showing evidence that they have already done the necessary effort/groundwork to find the answers on their own...):

http://forums.studentdoctor.net/showthread.php?t=875704&highlight=why+dermatology
http://forums.studentdoctor.net/showthread.php?t=748107&highlight=why+dermatology

Hey, everyone, I'm trying to figure out if I want to do derm, and although I feel like a jerk posting this, I was hoping one or more of you could give me advice.

Since my first semester of med school, I have been very active in an internal medicine sub-specialty. While working with several physicians in the department, I have had excellent clinical and research mentoring, and I've also gotten a few papers, too. I've been on the fence as to whether or not I want to go into IM with the intention of going into this sub-specialty, or if I want to go into derm. Recently, I started telling these attending that I was considering derm, and they've all told me the same thing: I will be miserable in derm because it's too superficial. Not superficial in the vain sense, but superficial because derm doesn't deal with curing any major diseases, like MIs or cancer or diabetes. I also talked to one of the deans at my school, and he told me the exact same thing. I've tried talking to the derm chair at my school, but he really wasn't helpful and couldn't give me any advice or clarity.

I've shadowed in derm, and I love it! If I went into derm, I'd want to go in academics, and I'd want to do clinical medicine and research (translational/clinical). Out of everything I have seen in clinic, I've loved working with patients with autoimmune and malignant skin conditions, in particular, I have been fascinated by psoriatic arthritis, scleroderma, GVHD, bullous diseases, and CTCL. Although I find cosmetics interesting (and I understand they are a major revenue source), I'm primarily attracted to derm because of the grossness (I know that sounds weird). I know derm has great hours, but for me, it's more important to feel challenged and excited about my career than to have a 40 hour work week.

Besides thinking about the advice from attendings, I'm also aware that I I could write a ticket to almost any IM program, but there's a fair chance I might not even match into derm. I scored between 247 and 253 on Step 1, and I have 8 pubs (3 first authored, 5 basic, 1 public health, 2 clinical, none are in derm). I'm an M3, and so far, I have honored medicine, psych, and OB/GYN. I did research during college, fulltime after college, and currently during med school.

So, did any of you have attendings you respected/trusted tell you to not go into derm? If so, are you happy that you chose derm?

 

[dermathalon]

Pup, I see your perspective but I think this is a legitimate question this time. Neither of the other links have anything that discuss how you deal with attendings that might deprecate your choice of specialty. They talk about why people go into derm and how to deal with people that give you a hard time about derm but this is very different than how to deal with an attending that you respect and is in a position of potential mentorship. It's one thing if it's Joe Blow on the street but entirely different when you are trying to take advice from an attending who has gone through the rigors of med school and has some bearing to give advice in this arena.

I've had many medical students ask me how to take advice that says that it will be boring in derm and this has come up time and time again outside of this forum. I'm sure that for this post, there are many with the same question. So, based on the number of times that I've been asked this question before in person, I'm willing to give the benefit of the doubt in this situation.

Also, a 247-253 score is not a low (or even slightly low) score for derm applications unless you are a crazy program that only looks for 260s...

 

[username456789]

So, based on the number of times that I've been asked this question before in person, I'm willing to give the benefit of the doubt in this situation.

Yeah, my troll radar is usually very sensitive, but not for one second while reading the OP's post did it seem to be trolling.

This board is already a ghost town, we don't need to actively try to quell new posters' discussions.

 

[Hoser]

Yeah, my troll radar is usually very sensitive, but not for one second while reading the OP's post did it seem to be trolling.

This board is already a ghost town, we don't need to actively try to quell new posters' discussions.

Agreed.

 

[pupster]

Yeah, my troll radar is usually very sensitive, but not for one second while reading the OP's post did it seem to be trolling.

This board is already a ghost town, we don't need to actively try to quell new posters' discussions.

Fine.

 

[KeratinPearls]

Seriously, I've seen so many posts that say "My attendings this, my attendings that." Seriously, who tha eff cares? Do what you want.

 

[N-Surge]

Reality check-- We are called on to "cure" TEN. And fortunately sometimes it does indeed happen...

 

[Silent Cool]

Hey, everyone, I’m trying to figure out if I want to do derm, and although I feel like a jerk posting this, I was hoping one or more of you could give me advice.

Since my first semester of med school, I have been very active in an internal medicine sub-specialty. While working with several physicians in the department, I have had excellent clinical and research mentoring, and I’ve also gotten a few papers, too. I’ve been on the fence as to whether or not I want to go into IM with the intention of going into this sub-specialty, or if I want to go into derm. Recently, I started telling these attending that I was considering derm, and they’ve all told me the same thing: I will be miserable in derm because it’s too superficial. Not superficial in the vain sense, but superficial because derm doesn’t deal with curing any major diseases, like MIs or cancer or diabetes. I also talked to one of the deans at my school, and he told me the exact same thing. I’ve tried talking to the derm chair at my school, but he really wasn’t helpful and couldn’t give me any advice or clarity.

I’ve shadowed in derm, and I love it! If I went into derm, I’d want to go in academics, and I’d want to do clinical medicine and research (translational/clinical). Out of everything I have seen in clinic, I've loved working with patients with autoimmune and malignant skin conditions, in particular, I have been fascinated by psoriatic arthritis, scleroderma, GVHD, bullous diseases, and CTCL. Although I find cosmetics interesting (and I understand they are a major revenue source), I’m primarily attracted to derm because of the grossness (I know that sounds weird). I know derm has great hours, but for me, it’s more important to feel challenged and excited about my career than to have a 40 hour work week.

Besides thinking about the advice from attendings, I'm also aware that I I could write a ticket to almost any IM program, but there’s a fair chance I might not even match into derm. I scored between 247 and 253 on Step 1, and I have 8 pubs (3 first authored, 5 basic, 1 public health, 2 clinical, none are in derm). I’m an M3, and so far, I have honored medicine, psych, and OB/GYN. I did research during college, fulltime after college, and currently during med school.

So, did any of you have attendings you respected/trusted tell you to not go into derm? If so, are you happy that you chose derm?

I didn't even read the responses but all I can think is: "They're jealous."

 

[Tamahawk]

This board is really dead these days. Is there somewhere else ppl are going?

 

[pupster]

This board is really dead these days. Is there somewhere else ppl are going?

kinda miss the old dermboard days...had lots more snarkiness and discussion owing to the anonymity of it all...lol

 

[N-Surge]

This board is really dead these days. Is there somewhere else ppl are going?

Not sure... The mall? Sore-eye's mom's house?

 

[asmallchild]

This board is really dead these days. Is there somewhere else ppl are going?

For those who have recently graduated, anywhere one can cram for the certification exam

 

[N-Surge]

For those who have recently graduated, anywhere one can cram for the certification exam

Exactly... I actually forgot what day it was today, until I decided to check this evening, like 20 minutes ago. Times flies when you are having fun studying.

 

[sore eye asses]

Not sure... The mall? Sore-eye's mom's house?

My mom just moved in with your mom, so...

 

[DoctorDermis]

Seriously? First time poster w/ the standard excellent resume (well...w/ the exception of the slightly low Step I...but he DOES have >>EIGHT<< publications) who comes into the DERM forum asking if there are miserable people and then starts off an "innocent discussion" about how other specialties (specifically IM) think that derm is superficial. I mean...good God...he's coming into the DERM forum. What did he expect? For the most part, most people here are already biased into wanting to do derm and are happy w/ the specialty (well...I guess there are the occasional exceptions, MOHS_01, bless your heart, as you have pretty opinionated, but thoughtful posts and I do appreciate the honesty, even if it's not exactly "politically correct" to state your opinions, although I also have issues w/ the use of the term "politically correct," but I'm digressing... )).

Anyway, I stand by my original premise. Urban dictionary link here:

"troll - One who posts a deliberately provocative message to a newsgroup or message board with the intention of causing maximum disruption and argument"

That said, if this ISN'T a troll, then I'd point him to discussions such as below that were found using the SEARCH button in the top right of this page (I guess some people think it's a good use of our time to ask inflammatory questions or ask questions that have already been answered before w/out showing evidence that they have already done the necessary effort/groundwork to find the answers on their own...):

http://forums.studentdoctor.net/showthread.php?t=875704&highlight=why+dermatology
http://forums.studentdoctor.net/showthread.php?t=748107&highlight=why+dermatology

I really appreciate the multiple viewpoints that are present on these forums. Reminds me to take a step back more often and consider alternate perspectives at which to re-evaluate situations.