Derm or IM?

[bob3]

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Here's a question a good friend of mine is grappling over: If given the chance, would you pick a derm residency or an IM residency (at a prestigious place) with the intention of doing Cards, or something like that? Anyone with any input? My take-

Derm-pros:competitive, easy, high pay; cons: no prestige, a very miscellaneous specialty, don't feel like doctor

IM/Cards-rather competitive, higher pay, prestige, not at all miscellaneous, definitely doctor feel

 

[Stormreaver]

I'd take IM every day. But then, that's me-- I care less about lifestyle than others. IM's a passion, Derm (for me) would be simply a job.

 

[ny skindoc]

Unless you are very highly motivated to go into Derm,dont bother with it.One needs to be highly dedicated in terms of research, making contacts etc to match.High grades and boards scores in applicants are virtually taken for granted.Most people who go into Derm cant see doing any thing else and are ready to do research fellowships to have a chance.If you will only feel like a "real doctor" in IM then that should be your route.Lack of enthusiasm will show through on interviews.

 

[bob3]

The question is not whether it's hard-my friend has been offered a derm position. The question for him is the worthiness of a field that some people think should not even exist. It should be merged with general practice.

 

[ny skindoc]

If you friend has been offered a Derm position he is very fortuate- (as these positions are generally offered only through the match).However it sounds from your post that he knows and cares little about the field aside from it having a good lifestyle.He will be unhappy with this choice and is advised pick something he is more excited about and interested in. Dermatologists treat a wide range of malignant,infectious and inflammatory skin problems.Many of these are difficult to handle and require someone with extensive experience to manage properly. Family Practioners are generally capable of handling the most common straight forward cases,beyond that Dermatologists are usually called upon,and are in very short supply.These links are to several Derm Journals and they give some idea of what the scope of Dermatology is....http://archderm.ama-assn.org http://www.eblue.org

 

[AlexanderJ]

c'mon nyskin doc, your average private practice dermie sees acne, warts, psoriasis, dermititis, and some indolent (and largely clinically insignificant) neoplasms (squams and basal cells). Yeah, you will occasionally catch a melanoma but FPs can do that - all you have to do is biopsy any susipicios moles. Most of the other derm stuff, much of which is interesting, occurs so rarely that your average private practice dermie has to refer onto a tertiary academic center anyway.

Hey, I agree, the dermies have a great lifestyle and make good money. But, make no mistake, they do NOT do important work. Bottom line, your patients are generally not sick, and that's why you have such little call. After all, is acne, wrinkles, botox, laser resurfacing, and chemical peels really medicine? Sounds more like advanced cosmetology to me, albeit a lucrative cosmetology practice.

Like any other specialty derm has disadvantages, specifically the benign nature of disease (is acne a disease?) that is treated and the lack of respect from the other medical specialties and the general public (e.g. the very funny "pimple popper MD" Seinfeld episode). But, hey, its got advantages too - its cush. Each to his own I guess.

 

[ny skindoc]

If you had a chronic skin condition you might think otherwise about the importance of dermatologists work.As far as the "lack of respect" for skin problems exhibited by the rest of the medical community..its not a disadvantage at all...its what keeps dermatologists in business!

 

[eddieberetta]

My suggestion below is based on a scenario where the guy really has no idea which specialty he likes bettter, from an interest point of view. If he genuinely likes internal better, he shoud pick it regardless of pay/lifestyle factors or he will be unhappy.

Otherwise...

Pick derm. He is not assurred of getting into cards. If he really hates derm he can always switch into internal but the reverse is hardly true. Prestige? You have to be kidding. The general public doesn't even know that "internal medicine" is a specialty and it really doesn;t matter.

 

[smackdaddy]

what's the big deal? take the derm spot and do a prelim IM year at the prestigious place. if he or she likes IM, he can give up the derm spot. someone would leap into the derm spot before the end of the day.

or

see if they would be interested in letting him do the IM first and then coming to do derm. many dermatologists have done IM residency first. and at that point if he/she knows he/she doesn't want to do derm, easy enough to back out. he/she would apply to cardiology during second year and will know whether or not he/she got it. if he/she likes derm better than primary care, he/she will be a better dermatologist for the extra training.

 

[goto1]

don't take the derm spot. most people think of derms as cop-outs and definitely not medical docs. they can't even admit a patient. why waste 4 yrs of med school and become a dermatologist?? i wouldn't take it if given a million dollars.