Dermatologist Characteristics

[youngin]

How would you describe what dermatologists are like (please spare the BS stereotypes we all know)? What do you think makes a good dermatologist?

Also, from those who are actually doing derm, do you feel it's just a lot of memorization vs critical thinking? I'm finishing my sub-i now in medicine and the one thing I have liked about it is the critical thinking or logical manner of approaching patient care (e.g. cards ) that I sometimes wonder if I'll miss by doing derm. Thinking recently if I "fit" in with the field although everyone in the field is awesome.

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[sore eye asses]

Dermatologists are universally good kissers.

As part of the initiation process at my program, each new resident had to make out with all the staff members.

This was erotic, and I only got a mild case of herpes, so it was worth it.

as for the day to day stuff, i think it's much more about pattern recognition than anything else. once you've seen something a few times you'll never miss it again. it's just that there's 2400 pages of bolognia worth of stuff to know.

also, you have to be a really really really really really big fan of the eponym to truly flourish in derm.

but it's cool when you gain the skill of using eponyms as insults. just the other day I punched a guy with psoriasis and proclaimed "you just got Koebnerized, son!"

 

[SkinNerd]

I was also someone who enjoyed the critical thinking in Internal Medicine. You do get to utilize critical thinking in dermatology, but not in the same ways as in Medicine.

There are times when a disease presentation is so classic, you can diagnose and treat the patient from the doorway in under a minute.

However there are many patients that will have atypical presentations of common things, or non-classic presentations of rare things, or a rash that no one can figure out, that doesn't respond to treatment and no one knows what it is.

If you enjoy treating the whole patient; tying in each medical issue and coming up with a plan for dealing with all of their health issues, then derm may not be for you. If what you enjoy is the critical thinking, then you can certainly do that as a medical dermatologist.

Yes, we do a lot of reading textbooks and rote memorization of eponyms and subtypes or variants of diseases. But I do think that a large part of dermatology is learning how to methodically work through a patient's skin problem, using problem solving and critical thinking skills. You just will be doing it in a more focused fashion than in medicine.

At the end of the day, you simply need to be interested in skin disease, and enjoy the process of examining the skin, describing skin lesions, and trying to match up what you see visually with your knowledge base. Clinics are generally fast-paced; you need to be able to set aside the rest of their medical issues and pick out what information you need to make your derm diagnosis.

Just like with any field of medicine, you can tailor your career to your interests within the field. You can certainly focus on medical dermatology (which there is a need for!). At my institution we have an attending who focuses on skin disease in transplant patients, chemo patients, etc. Basically trying to do dermatology hospitalist work. It is very internal medicine heavy.

Hope that helps.

You may consider a med-derm combined program, which is 5 years total. i think there are 6 or 7 programs in the US.