How many hours do derm residents work?

[yalla22]

What does a derm residents schedule look like through the three years in terms of hours, night shift (?), calls, etc...?

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[dutchman]

about 36, but the competition to land derm is insane.

 

[MonkeyNuts!]

Can't be that bad. I imagine you would rarely get 3AM calls for acne or a rash...

 

[MonkeyNuts!]

about 36, but the competition to land derm is insane.

ah the ROAD to success

 

[szhao]

i wake up 3am, i have a skin rash, let me get out of my bed and go to the emergency.

 

[Law2Doc]

about 36, but the competition to land derm is insane.

According to the AMA Frieda website the average hours for a derm resident are 45.

But as this poster stated, competition is insane and it's not one of those specialties you can bank on. When all is said and done, only a small handful of any given med school class even have that door open to them, should they be interested.

 

[yalla22]

According to the AMA Frieda website the average hours for a derm resident are 45.

But as this poster stated, competition is insane and it's not one of those specialties you can bank on. When all is said and done, only a small handful of any given med school class even have that door open to them, should they be interested.

I'm not in medical school yet so i dont have a good feel for this but when they say "competition is insane" what do they mean exactly? what does this entail?

 

[dutchman]

I'm not in medical school yet so i dont have a good feel for this but when they say "competition is insane" what do they mean exactly? what does this entail?

It means the people applying have near perfect medschool grades and USMLE scores, and there are fewer spots than applicants. Derm has broken a lot of hearts so be carefull.

 

[Law2Doc]

I'm not in medical school yet so i dont have a good feel for this but when they say "competition is insane" what do they mean exactly? what does this entail?

It means in a class of 150 students at a given allo school, less than 10% will legitimately get to consider it, and fewer still will get it.

 

[Sol Rosenberg]

It means the people applying have near perfect medschool grades and USMLE scores, and there are fewer spots than applicants. Derm has broken a lot of hearts so be carefull.

The term "near-perfect" is a bit of an exaggeration. While excellent board scores are a prerequisite, it is possible to land a Derm residency while not being a member of AOA. If you (OP) are really, truly interested, in Derm (as I am) I'd suggest you visit the Derm. Residency forum here, as the people there give excellent advice about getting into Derm.

 

[Captain Fantastic]

Derm requires a prelim year in internal medicine. If you're lucky you'll find a program that will intergrate your IM year over your entire Derm residency. Then you can spread out the pain. If you're not so lucky you'll have to do a straight-up IM intern year before starting Derm. That year will suck, but once it's over you'll be so happy with 50 hour weeks as a Derm resident you'll be giddy as a school girl.

 

[Captain Fantastic]

Double post.

 

[Pinkertinkle]

Derm requires a prelim year in internal medicine. If you're lucky you'll find a program that will intergrate your IM year over your entire Derm residency. Then you can spread out the pain. If you're not so lucky you'll have to do a straight-up IM intern year before starting Derm. That year will suck, but once it's over you'll be so happy with 50 hour weeks as a Derm resident you'll be giddy as a school girl.

Pretty sure you can do a transition year which can be a lot less work than a prelim medicine or surgery year.

 

[Captain Fantastic]

Pretty sure you can do a transition year which can be a lot less work than a prelim medicine or surgery year.

Ah, I forgot about transitional. Here we only have preliminary and categorical residents (except for Rads, which has an integrated program -- no need for a transitional or prelim year). All the people I know going into Derm (that would be two) were prelim IM residents.

 

[staticsoliloquy]

why do you guys want to do derm?

 

[JadedSurgeon]

Lol....respect for that one...

 

[leviathan]

It means the people applying have near perfect medschool grades and USMLE scores, and there are fewer spots than applicants. Derm has broken a lot of hearts so be carefull.

Broken a lot of hearts, but made the rest of us laugh at them.

 

[JadedSurgeon]

Broken a lot of hearts, but made the rest of us laugh at them.

Hey dude, respect those who are less fortunate than you. That attitude is embarrassing for future doctors.

 

[leviathan]

Hey dude, respect those who are less fortunate than you. That attitude is embarrassing for future doctors.

No, most derm applicants are embarassing for future doctors. Cut the pay of that specialty in half and see how many future applicants derm gets. 🙄 Well, except for jota and other people who are genuinely interested in it.

 

[porokeratosis]

Ah, I forgot about transitional. Here we only have preliminary and categorical residents (except for Rads, which has an integrated program -- no need for a transitional or prelim year). All the people I know going into Derm (that would be two) were prelim IM residents.

Here's the internship year requirements (directly from the American Board of Dermatology)
http://www.abderm.org/residency.html

To summarize, you can get into Derm residency with an internship year in the following: Transitional Year (which I did and highly recommend), Internal Medicine, Pediatrics, Family practice, and/or General surgery. You may also do a 1st year in emergency medicine, general surgery, and obstetrics & gynecology (but why torture yourself?!)

In general, most programs prefer you do your internship in internal medicine, pediatrics, or transitional year. There are a few strict programs that want you to only do an internal medicine internship.

 

[porokeratosis]

Broken a lot of hearts, but made the rest of us laugh at them.

Yes, but we're laughing all the way to the bank!

No, most derm applicants are embarassing for future doctors. Cut the pay of that specialty in half and see how many future applicants derm gets. Well, except for jota and other people who are genuinely interested in it.

Say what you will. I'm very happy and satisfied with my specialty. What makes this specialty unique is that it's one of the few fields where you're trained to do clinical medicine, skin surgical procedures, laser surgery, read dermatopathology slides, and perform cosmetic procedures. With so much diversity, the field is very fun and interesting.

As for those naysayers that believe derm is a piece of cake. Consider this...Put a patient with a pigmented lesion in front of some of them and they immediately think it's a melanoma. When in reality it may be a pigmented seborrheic keratosis or dermatofibroma (both benign conditions) or just a benign nevus (mole). And even if they could figure out the difference between these entities, most would not have the training to independently read the dermatopathology slide to confirm the diagnosis.

Consider this...most other specialties freak out immediately when they encounter a patient with 70% of his body covered with extremely pruritic psoriasic plaques and psoriatic arthritis...they immediately refer to dermatology. Most other specialties refer to dermatology the patient with severe hand dermatitis where large blisters form and she's failed multiple therapies and she cannot perform her job as a secretary.

What I'm saying is...don't be so quick to judge. Every medical specialty has its place and usefulness.

 

[PathOne]

Would have to concur with porokeratosis. If Derm was really truly that easy, then FP's would of course love to do it, but consider that histopathologically, you have 1800 (!!) different diagnoses, far and away more than in any other disease group.

Yes, it is true that most Derms can se a very large number of patients daily, and that treatment options are somewhat limited. And yes, the current competitiveness of Derm is very much due to the combination of high pay and a relatively easy lifestyle. But it's simply not true that it's easy - although it's obviously true that a lot of those who apply but don't get a residency of course would be able to become excellent Dermatologists.
However, the field is small, and it would be nonsensical to increase residency slots simply because of the high number of qualified applicants.

To the OP, I would guess that most residents work in the clinic 45-50 hrs/week, but some of course burn the midnight oil doing research-oriented projects.

 

[MOHS_01]

All of this "compensation is out of line" talk regarding dermatology is baseless -- perhaps everyone should spend a little more time learning how the compensation system of medicine works, how the structure is derived, etc, before suffering from a case of "diarrhea of the mouth" about it.

Below are a couple of surveys -- there are many more out there if you are willing to do just the tiniest bit of google legwork -- that all fall into a range whose trend is common amongst respective specialties.

If anyone wants to throw stones at current compensation trends, stick to things that can be backed up with reason and numbers (i.e. all E&M codes relatively undervalued, 88305 way overvalued, etc).

http://www.allied-physicians.com/salary_surveys/physician-salaries.htm

http://www.memag.com/memag/article/articleDetail.jsp?id=379594

 

[cdql]

No, most derm applicants are embarassing for future doctors. Cut the pay of that specialty in half and see how many future applicants derm gets. 🙄 Well, except for jota and other people who are genuinely interested in it.

A rather stupid (okay, there are no stupid arguments. Let me amend that to illogical) argument as I'm pretty sure it applies to every other job on God's green Earth. 👎

 

[MDstudent79]

However, the field is small, and it would be nonsensical to increase residency slots simply because of the high number of qualified applicants.

Yeah, but what about the general public seems to regularly complain about 3-8-week waiting lists to even see a derm in town? Seems they could increase spots and still have enough business--though of course the $$ would go down I guess.

 

[MOHS_01]

Yeah, but what about the general public seems to regularly complain about 3-8-week waiting lists to even see a derm in town? Seems they could increase spots and still have enough business--though of course the $$ would go down I guess.

Unfortunately, that would not work. There are two separate issues here, neither of which would change much with a simple increase in the number of slots.

First -- wait times. Several factors come into play, but it boils down to a distribution problem. This may be either geographic maldistribution or patient/disease mix maldistribution, or even a hours worked , same end result either way. If you simply throw more MD's into the mix, the distribution issues do not go away. This has been proven time and again with rural medicine and primary care pushes.

Second -- pay. We all need to realize that, until free market supply/demand forces really come into play (which is slowly happening with the abandonment of traditional, low deductible health plans in favor of HSA's and high deductible plans), we are dealing with a case of unlimited demand, which cannot be satiated with a simple increase in the number of providers. Pay would go down to some degree, but not for the reasons that you suggest. Pay would go down as a result of the subsequent erosion of provider negotiating strength with payors as the direct result of an increased fragmented work force.

 

[MDstudent79]

Perhaps then derms really could be working more hours than their reputed normal cush 45 a week or so? Maybe this is limited to my part of the country--or the fact that derm is one of the few specialists people consult with on their own without being referred--but it just seems people are always griping about how long it takes to see a derm.

After all, many people don't automatically get paid for lost work due to doctor's visits, so perhaps throwing some night hours into the mix for office wouldn't be the end of the world and would draw a lot of business?

And of course, adding more derms each year wouldn't be the magic bullet. But wouldn't it by necessity give more coverage (though not necessarily adequate by public standards) in currently underrepresented areas--perhaps at the cost of a slight decrease in salary in places like NY and the CA and the other typically over-doctored areas of the country? Surely the overabundance vs. lack of MDs in other fields is why most MDs get paid more in ND or OK than MA or FL, right--though other factors are at play as well?

But hey, I'm not complaining. If the supply of medicine in the country weren't so regulated, it'd be nearly impossible to get anyone to commit to the lengthy training with such uncertain futures.

(Disclaimer: I know hardly anything about the business of derm...just seeing what the responses are out of curiosity.)

 

[cdql]

But you already said it yourself: derms draw more than enough business already. They can tell their customers to wait for 3-8 weeks at a time. I don't think they need to add night hours into the mix to draw even more business.

 

[helpfuldoc2b]

why do you guys want to do derm?

Do you really HAVE to have your entire resume as your signiture to your posts?

 

[flowerss]

I love to just come on here and read the threads from time to time for a good laugh. I imagine you guys and gals thinking how smart and perfect you are but when you get outside your circle, you would realize nobody likes you. Take your money to the bank, by yourself in your closed empty world. Keep talking though cause it is just plain entertainment.

 

[r7p3]

Perhaps then derms really could be working more hours than their reputed normal cush 45 a week or so? Maybe this is limited to my part of the country--or the fact that derm is one of the few specialists people consult with on their own without being referred--but it just seems people are always griping about how long it takes to see a derm.

After all, many people don't automatically get paid for lost work due to doctor's visits, so perhaps throwing some night hours into the mix for office wouldn't be the end of the world and would draw a lot of business?

And of course, adding more derms each year wouldn't be the magic bullet. But wouldn't it by necessity give more coverage (though not necessarily adequate by public standards) in currently underrepresented areas--perhaps at the cost of a slight decrease in salary in places like NY and the CA and the other typically over-doctored areas of the country? Surely the overabundance vs. lack of MDs in other fields is why most MDs get paid more in ND or OK than MA or FL, right--though other factors are at play as well?

But hey, I'm not complaining. If the supply of medicine in the country weren't so regulated, it'd be nearly impossible to get anyone to commit to the lengthy training with such uncertain futures.

(Disclaimer: I know hardly anything about the business of derm...just seeing what the responses are out of curiosity.)

I know this will sound silly, but is it possible for dermatologists to do 60 to 80 hour weeks if they really want to?

 

[Balderdash]

I know this will sound silly, but is it possible for dermatologists to do 60 to 80 hour weeks if they really want to?

See patients 8-5 M-F

45 hours

Charting: add 5 hours

50 hours

Read your own path: add 5-10 hours

55-60 hours

Now add Saturday's. Could be another 8 hours

63-68 hours

I also know some mohs folks who will have cases go into the evening. So the answer is yes, dermatologists can work >60 hours. There's a high demand for dermatologists.

Despite what some in this old thread like to think, the value added by dermatologist and the cost savings (e.g. Outpatient excision versus OR excision, not biopsing benign lesions) make the work both fulfilling and challenging.

 

[r7p3]

See patients 8-5 M-F

45 hours

Charting: add 5 hours

50 hours

Read your own path: add 5-10 hours

55-60 hours

Now add Saturday's. Could be another 8 hours

63-68 hours

I also know some mohs folks who will have cases go into the evening. So the answer is yes, dermatologists can work >60 hours. There's a high demand for dermatologists.

Despite what some in this old thread like to think, the value added by dermatologist and the cost savings (e.g. Outpatient excision versus OR excision, not biopsing benign lesions) make the work both fulfilling and challenging.

And could someone make sudden shifts in their type of practice i.e. 2 weeks of Mohs surgery followed by 2 weeks of pathology?
Or I suppose all parts of pt care are interlinked so one cannot do just one type of care in derm and nothing else for a long time?

 

[asmallchild]

And could someone make sudden shifts in their type of practice i.e. 2 weeks of Mohs surgery followed by 2 weeks of pathology?
Or I suppose all parts of pt care are interlinked so one cannot do just one type of care in derm and nothing else for a long time?

It's possible not probable. Most people are not practicing both Mohs and dermpath given the amount of energy required to build up either practice.

 

[Balderdash]

And could someone make sudden shifts in their type of practice i.e. 2 weeks of Mohs surgery followed by 2 weeks of pathology?
Or I suppose all parts of pt care are interlinked so one cannot do just one type of care in derm and nothing else for a long time?

You would have to find a group practice that would be amenable to such a setup. The path and mohs job markets are hard enough as is so the chances of that are quite low.

 

[doctalaughs]

And could someone make sudden shifts in their type of practice i.e. 2 weeks of Mohs surgery followed by 2 weeks of pathology?
Or I suppose all parts of pt care are interlinked so one cannot do just one type of care in derm and nothing else for a long time?

There are some older dermatologists that do mohs and also read their own slides but are fellowship-trained in neither. Its probably not a good idea, since in all likelihood they are doing a poor job at both. But it does happen.


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[kettle12]

I don't know about all derm residency programs but at least at my program I am working on average 55-60 hours a week not counting call time. We work from 8-5:30 every day of the week and then after 5:30 first year's do call backs which take about 1.5 hours so that's 11 hours a day 5 days a week. I'm also on call one week every 3 and depending on how many calls you get on nights and weekends you add a few hours.

Not to mention the fact that most derm residents probably read outside of clinic on average an additional 15 hours a week you're looking at easily 70-80 hours a week.

 

[username456789]

I don't know about all derm residency programs but at least at my program I am working on average 55-60 hours a week not counting call time. We work from 8-5:30 every day of the week and then after 5:30 first year's do call backs which take about 1.5 hours so that's 11 hours a day 5 days a week. I'm also on call one week every 3 and depending on how many calls you get on nights and weekends you add a few hours.

Not to mention the fact that most derm residents probably read outside of clinic on average an additional 15 hours a week you're looking at easily 70-80 hours a week.

First years do all the call backs? Ouch.

 

[FIREitUP]

I don't know about all derm residency programs but at least at my program I am working on average 55-60 hours a week not counting call time. We work from 8-5:30 every day of the week and then after 5:30 first year's do call backs which take about 1.5 hours so that's 11 hours a day 5 days a week. I'm also on call one week every 3 and depending on how many calls you get on nights and weekends you add a few hours.

Not to mention the fact that most derm residents probably read outside of clinic on average an additional 15 hours a week you're looking at easily 70-80 hours a week.

wow that sucks. my future program has two half days a week off and staff that does the call backs. i'm guessing you're in a program that has one resident per year if you're on call every 3rd week?

 

[kettle12]

wow that sucks. my future program has two half days a week off and staff that does the call backs. i'm guessing you're in a program that has one resident per year if you're on call every 3rd week?

I thought it was norm for residents to do call backs? Also, the two half days you get off are you just off to do whatever you want or do you have scheduled lectures/didactics on those days?

 

[username456789]

I thought it was norm for residents to do call backs? Also, the two half days you get off are you just off to do whatever you want or do you have scheduled lectures/didactics on those days?

It tends to be the norm to do call backs as a resident. But we all did our own callbacks for our own patients, throughout all 3 years. I guess if you have attending clinics, you don't really have ma y of your own patients.

 

[FIREitUP]

I thought it was norm for residents to do call backs? Also, the two half days you get off are you just off to do whatever you want or do you have scheduled lectures/didactics on those days?

from my understanding it's "academic time", so you can do what you want with it. there are morning lectures throughout the week.

 

[werd]

when i was a resident i worked in the office about 45 hours per week, plus 10-20 per week studying, depending on how close to in-service we were.

 

[dermie1985]

I think generally we're doing about 36 hours/week in clinic, 8 hours/week lectures (2x 1/2 days), and about 8 hours/week studying at home. So that's about 52 hours/week? Definitely better than intern year. There's still those random afternoons when you're in some crazy bullous disease, rheum-derm or CTCL clinic and end up staying late (my latest night so far was 7:30 trying to figure out which MRI to order to evaluate for a colonic fistula in a HS patient). We only do call-backs on our continuity clinic patients and occasionally for an attending who doesn't know who to use Epic very well. It will also depend slightly on how many sites your program has (our hours/patient load at the county hospital are better with less call patients, while the VA hours are also sweeter but you'll be doing most of the call backs for the bajillion skin cancers you're biopsy-ing.)

 

[username456789]

When I was in residency, it was mostly continuity clinic with a few attending specialty clinics thrown in. VA clinic was continuity as well. Most weeks we had 8 clinic half days and 2 half days of academic/reading time. Didactics every morning for 1 hour.

We did 100% of our call backs and answered all messages on patients (even the ridiculous BS ones that could've and should've been directed to an MA, LPN/RN, or scheduler/front desk). Some of that was real annoying, but you learn to handle your ****, and makes it infinitely easier to transition to real practice.