Derm vs IM: still debating!!

iluvskin said:

If you do internal medicine, the city will not matter so much --- you will not have time to enjoy it because you will be in the hospital all the time.

Actually, any residency, even dermatology, is going to be very busy. I would go anywhere to get to do dermatology. I'd just fly out often to visit friends in larger cities. You will be studying a lot in dermatology, so the city should not matter as much. Go do your dermatology residency and after you are done, find a job in the city you like.

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Word

ShaveBiopsy said:

Hi Everyone,
so rank order submission time is nearing, and i'm still a bit torn up about what I want to do and need some advice: so all of my derm interviews (which are very few) are at middle tier programs in small cities, but i have prelim medicine interviews at great programs in awesome places...i am torn on if i should just not do derm because of the location issue...i am young and single don't want to be stuck in a bad location for 3 or 4 years (some programs are categorical)...i think i can do medicine and then a fellowship, but i hate medicine residency. any advice?

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don't waste your interviews!

rank the derm places and then just put the prelims after that. No matter what, you'll be spending at least one year at the prelim location of your choice anyway

although all that being said, i've had a couple of derm interviews at some real backwards places so I can commiserate. really hard to compare after doing some prelim interviews in glorious cities like nyc, boston, sf, etc.....

iluvskin said:

I am VERY CURIOUS to find out what cities with a dermatology residency program people consider "backwards."

Danville, PA?
Lubbock, TX?

Are the above cities really that bad that one would not do a dermatology residency in them?

I was going over the list in my head and could not think of others...

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I would hate to call out a program (and on something as fickle as location) so I'm going to keep my lips sealed. If it helps, I sadly was not invited to programs in the aforementioned places 🙁

I was torn about dermatology and IM as well. I still love IM.

First, understand that the SUPER competitive prelims are QUITE competitive. Even if you get phone calls from multiple A+ programs them saying they've ranked you to match, you may not match.

It happened to me.

So as a reality check, don't assume you'll be able to waltz into an A+ prelim. If you can... sure, then you stand a good chance converting them into categoricals.

HOWEVER...

Brutal realization: No matter where it is located, a derm residency gives you opportunities in practice opportunities, compensation and lifestyle that IM will ***NEVER*** offer. I don't care if you go into cards or GI--as an attending in those fields, you will still be paged overnight, you still work damn hard hours, even after sweating blood for 3 IM years + 2 to 3 fellowship years. And there's a natural cap to your earning potential in those IM specialities as compared to derm, where you have a scalable elective procedure aspect that cards/GI don't replicate (at least to my knowledge). You have patients flocking to see a dermatologist; they aren't necessarily running to get their colonoscopies.

Going into IM, you have little chance of converting your profession into a family-friendly, lifestyle-friendly, compensation-friendly, plus interesting one like derm is.

So unless you are a Gold Star Applicant--I mean connected, MD/PhD, Rhoades, Marshall scholar, blahblahblah--I would NEVER take the chance of passing up derm now to do IM, to then return to try to match into derm. I used to think I would, and then I came to my senses. You shrink your available pool of derm residencies significantly.

If you really love IM and derm, and can't imagine not being boarded in both, I'd do derm first. I predict that later, many IM residencies will fall all over themselves to take you as a categorical.

Go for derm first. Anyone can get into an IM program. Derm is severely limited. Don't pass up this opportunity for derm, because it won't come around again.

DermMatch said:

I don't care if you go into cards or GI--as an attending in those fields, you will still be paged overnight, you still work damn hard hours, even after sweating blood for 3 IM years + 2 to 3 fellowship years. And there's a natural cap to your earning potential in those IM specialities as compared to derm, where you have a scalable elective procedure aspect that cards/GI don't replicate (at least to my knowledge). .

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I dont mean to troll here, but as an IM resident I am very amused by the discussion going on here.
the first bit is certainly correct about IM specialists getting paged at home.
But not so sure about the "natural cap" to incomes esp if you become a proceduralist esp in cardiology- but it takes a minimum of 3+4 years now, unlike the magical world of dermatology, and can have a horriebl lifestyle.
The only int med speciality with true elective procedures would be allergy.

Agreed re: allergy. They have a great lifestyle but they do not have the same earning potential compared to derm, I don't think. Not that earning potential is the be all and end all, but I'd be a liar if I said that it doesn't factor into the equation.

From what I understand, allergy is not as competitive as cards or GI because of its low compensation.

if you're not sure about derm, you might as well do IM because there are a lot of us out there who ARE sure and would gladly take your spot.