I was wondering how long it would take for someone other than the OP to finally answer. lol. It's been a while since I've worn those rose-colored glasses, good times.
Yeah, I think you do have rose-tinted glasses,
@PatsyStone. As an academic professor going up the time-limited tenure ladder, you're going to have a lot more responsibility on your plate, than just teaching residents and medical students (which probably doesn't even carry the greatest weight for tenure), depending on what specific track you are on, and you'll be expected to publish in journals and participate in other extra academic/med school ****, as you will go up yearly? for tenure review with the medical school, when you move up from Instructor -> Assistant Professor -> Associate Professor -> Professor, as well as the daily clinical responsibility you already have.
The reason derm residents don't stay in academia is because for 3 years you're exposed to the daily BS of academic medicine: faculty that are hard ***es some of whom are miserable to residents and can't stand eachother, politics pervading nearly everything of significance that affects the residency - funding, choosing residents, etc., meetings meetings meetings, setting up for conferences, etc. After doing nearly 8 years of doing what other people want us to do (med school & residency), once we finally get to the point where we can make our own decisions, most would choose the path of making nearly 50% more in private practice with a better work-life balance. I don't know one person who went into private practice who regrets it, and you can always go back into academics if you truly don't like it.
I think whether you choose academics has a lot to do with your specific residency program. If you have teaching faculty who actively and positively mentor you to pursue it, you'll see much more of the positives and might stay in academics. I've also seen people who finish derm residency plus a fellowship, and then work in academics but bail after a few years or even after a decade or two. The temptation of being your own boss and making your own decisions, making much more money than you would ever make in academics, etc. is just too great, and it's going to be even more the case with the amount of debt we all have. Unless you're a glutton for punishment, and in Dermatology there are many (not just derm research fellows) eventually you want to get off the hamster wheel and actually start enjoying life.
