Derm residency after Path?

[Grace82]

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I was wondering how feasible it is to enter a dermatology residency after pathology particularly after completing a dermpath fellowship? Does anyone here know someone who has done this? Thanks!

 

[Substance]

LOL

 

[path19]

yes, i know of one person who did this just like you said. path -> dermpath -> derm

 

[cmz]

There was a recent resident at UTSW who went this pathway, so it's not impossible.

 

[icpshootyz]

There's a derm resident at Tufts that did the same thing. It happens, often because that person falls in love with clinical derm while doing dermpath. Not very common, though.

 

[kruppe]

Thre was a guy at the Mayo Clinic who did this.... he was a derm resident there when I was interviewing for the dermpath fellowship. He did path>dermpath>derm all at the Mayo clinic.

 

[malchik]

There's a derm resident at Tufts that did the same thing. It happens, often because that person falls in love with clinical derm while doing dermpath. Not very common, though.

You sure there's not another reason?

 

[icpshootyz]

Certainly money comes into play, and derm is a much more lucrative and lifestyle-friendly field these days. But dermpath by itself can be very comfortable, so it can't be just the money. Derm does offer one the ability to open and run your own practice, which is basically non-existent in path now. So yes, there's other reasons. That particular path-dermpath-derm resident has a wife who is a dermatologist, so basically they're setting themselves up to have a husband/wife full service derm/dermpath practice.

 

[turtle1966]

Certainly money comes into play, and derm is a much more lucrative and lifestyle-friendly field these days. But dermpath by itself can be very comfortable, so it can't be just the money. Derm does offer one the ability to open and run your own practice, which is basically non-existent in path now. So yes, there's other reasons. That particular path-dermpath-derm resident has a wife who is a dermatologist, so basically they're setting themselves up to have a husband/wife full service derm/dermpath practice.

A trend in dermatopathology is in-housing of pathology service, either PC only or global, by dermatology practices. This favors VERY greatly derm-dermatopathologists over pathology trained dp, unless the dermatology group wants to exploit their dermatopathologist. Just ask around if there are any unemployed derm-dps, after their (first) fellowship. I think this is the reason why there has been a precipitous drop in path-dp jobs in recent years.

Only way to slow this would be a total exclusion of in-house AP service (TC and PC) from Stark safe harbor provision, which is not likely. Even if such an exclusion were to come to pass, the derm-dps would still have a natural advantage over path-dps.

 

[turtle1966]

I was wondering how feasible it is to enter a dermatology residency after pathology particularly after completing a dermpath fellowship? Does anyone here know someone who has done this? Thanks!

Over two decades ago, when dermatology was not as hot as it is now, I heard directly from the mouth of then secretary of American B of Dermatology, that former pathologists was the largest contingent of dermatologists with 2nd specialty certification.

If you can get into a dermatology residency, by all means you should, and were to get it, must thank your God for your fortune.

 

[dr4n6]

I have a relative that functioned as a Residency Program Director for a large Dermatology Department, and I vaguely recall being told that changes in ACGME funding capped the number of years that a resident could receive funding and effectively precluded selecting individuals for a second residency after completion of a primary residency unless the resident was able to fund their own position.

 

[turtle1966]

I have a relative that functioned as a Residency Program Director for a large Dermatology Department, and I vaguely recall being told that changes in ACGME funding capped the number of years that a resident could receive funding and effectively precluded selecting individuals for a second residency after completion of a primary residency unless the resident was able to fund their own position.

That is correct.

Over 5 years ago, a private group (I think was pharmaceutical companies or something similar) had volunteered to fund additional residency spots and it was then accepted by AAD. The proposed additional spots were only a few spots, a truly negligible number as I recall.

You know what then happened? Board certified dermatologists complained so loudly that AAD cancelled the program. Now, in certain areas of country, the recruiters are courting matched MS even before they start their residency. It is very reminiscent of our leadership (sic), isn't it? Pathology is the only specialty that practices apoptosis (aka, hara-kiri)!

 

[dr4n6]

Turtle-So are these individuals that are doing derm as a second residency then funding their own positions? My relative gave me the impression that his department under mandate of the hospital would not take a self-funded resident.

 

[turtle1966]

Turtle-So are these individuals that are doing derm as a second residency then funding their own positions? My relative gave me the impression that his department under mandate of the hospital would not take a self-funded resident.

Unfortunately, I do not know. I have known many many who did derm as 2n specialty, but that was a long time ago, over 10 and 20 years ago. But again, I suspect this ACGME funding rule is of rather recent (means last few years) origin. If you can, go for derm by all means, even if you have self fund it.

 

[2121115]

This is not as uncommon as you might think. I personally know people who did residencies in pathology and then, due to the suboptimal job market, did second residencies in dermatology, family practice, and radiology.

 

[Dr.Tao]

I work with a Dermatopathologist double boarded in Pathology and Dermatology at a major medical/academic center.

 

[Tamahawk]

Turtle-So are these individuals that are doing derm as a second residency then funding their own positions? My relative gave me the impression that his department under mandate of the hospital would not take a self-funded resident.

The funding issue does make it harder to get any second residency after competing your first. As far as I know, the dept essentially eats the cost of training that person since Medicare won't fund their training AFTER having exhausted their allotted # of training years (which varies depending on what you initially match into: more years of training are covered for ppl who match into surgery from the outset than internal medicine for example). I know of a few people who have done a prior residency before going into Derm; they do NOT generally fund their own position; the program just eats that cost, which is why a larger dept is more able to absorb the cost (especially if they view that applicant and their past experience as an asset to the dept). As far as I know, this is why larger Derm Depts are often willing (more so than small depts at least) to take a great applicant who is applying for a second residency. Also, if the program doesn't rely on Medicare funding for their trainees (not naming names), then this is a non-issue and explains why such a place would be willing to take ppl who have already completed training in another field.