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Internists don't know enough about skin
- Thread starter Dr McSteamy
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You're right. There should be more derm training or didactics in internal medicine. So many internists, pediatricians, and primary care providers call everything "maculopapular". However, if y'all are at all interested in derm, y'all should consider the med/derm programs...
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I think OP's point was that in most cases, IM/family docs are the ones to see the skin lesions first (before referral) and should have a basic knowledge of derm path to some extent. I think it is similar to being on consult service: when someone asks you a vague question and you are scratching your head trying to make sense out of the consult, think how much better you could provide service to the team consulting you if they gave you a clear question they want answered and defined the patient/HPI in a clear succinct way. Also, even though IMs do tend to give stroids for everything, as would the derm ppl but that can be harmful sometimes and we should know when to refer, which comes from better knowledge about the field. I don't think that we as internist need that indepth of knowledge so as to pursue med/derm pathway...but that is my personal opinion. Hence, I would vote for more didactics on derm issues sometimes during the residency (maybe 3rd year..when we are getting ready to handle outpatient world full time). Just my 2 cents. (well that is already $0.04 for today in 2 threads...darn it...I must stop replying 🙂)
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A derm rotation can be invaluable. In the primary care outpatient setting, you'll see a huge amount of derm, so be prepared.
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Skin is merely the shiny wrapping paper beneath which all the cool christmas presents are found...
Besides, isn't part of the beauty of I'M being able to refer kids, rashes, and vaginas?
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If only IM could refer all the rectums.
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OP, I agree, but that ain't going to happen, unless perhaps you go to a primary care focused program. The hospital needs residents to work on the wards, and therefore they are going to minimize the outpatient rotations, including derm. You're not making any money for the hospital by following a bunch of dermatologists around their clinic and/or seeing patients and presenting to them.
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umm, It's called internal medicine 😛
completely agree with the OP, my derm skills are non-existent.
completely agree with the OP, my derm skills are non-existent.
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IM programs don't pay much attention to gyn, ortho and derm and yet, they will make up a much bigger percentage of the typical practice than calculating a Fick equation.
Just as an aside, being competent at derm is financially rewarding. If you can snip stuff off and throw in a stitch or two, you get to bill for the procedure.
