Plastics vs. Dermatology

[YupGypsy]

I've seen more match into Plastics than Dermatology on some match list. Which one is easier to match into? In terms of income, which one takes the lead?

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[dilated]

Overall pay, plastic wins, on a per hour basis derm wins (handily). Derm is (IMO) a little harder to match because programs seem to mostly fill with their own candidates whereas at least plastics is open to people from other schools. In any case they're not really very similar so it's pretty unusual that those are going to be the final two you're picking from.

 

[colbgw02]

A straight through plastics residency has been the single hardest match in recent years. The caveat is that most plastic surgeons don't go that route; they do a 5-year general surgery residency and then a plastics fellowship.

Dermatology is a close second to plastics though, IMHO. It's either at the top or very near the top of competitiveness.

A cosmetic plastic surgeon, which is what people often (mistakenly) think of as plastics, will beat out a dermatologist regarding salary. That goes for even a cosmetic dermatologist. I bet a reconstructive plastic surgeon might lose out to a cosmetic dermatologist, or even a general dermatologist that does things like Botox.

Dilated hit the nail on the head though; dermatologists come out ahead on money making efficiency. There also don't tend to be very many dermatologic emergencies at 2am, whereas any surgeon has to worry about wound infections, dehiscence, etc. at all hours of the day. Also, if you're dealing with any type of cosmetic medicine, be prepared to deal with a patient population that is absolutely crazy.

 

[deuist]

What match list are you referring to? There were 276 derm positions available last year, while plastics only had 88. Given that 75% of med school applicants matched into derm---compared to 46% for plastics---I'd say that derm is the easier route.

 

[dilated]

What match list are you referring to? There were 276 derm positions available last year, while plastics only had 88. Given that 75% of med school applicants matched into derm---compared to 46% for plastics---I'd say that derm is the easier route.

I wouldn't take percentage as being indicative of much. You can take a prayer shot at integrated plastics while ranking gen surg and if you don't match integrated, just do a plastics fellowship later, it's not hugely different from integrated. If you're going derm and you don't get derm, it's game over and you're scrambling into something you really don't want (IM?).

If you look at match lists for derm programs you'll see a really high percentage of people taken by their home programs. That's what really makes derm hard IMO, that so few of the available slots are actually "available".

 

[Long Dong]

Go here, see the stats from 2005 yourself:

http://www.nrmp.org/matchoutcomes.pdf

Plastics:
Match rate for U.S. seniors ranking plastics first ~48%
Median step 1 for those matched ~243
Mean step 1 for those applied 231
# of those with 260+ not matching 0
% aoa applying ~33%
% with publications applying ~75%
Spots available 82

Derm:
Match rate for U.S. seniors ranking derm first ~65%
Median step 1 for those matched ~238
Mean step 1 for those applied 233
# of those with 260+ not matching 2
% aoa applying ~50%
% with publications applying ~87%
Spots available 316

The matching rate for seniors by the nrmp doesn't reflect all those who applied and didn't get an interview, I think eras gives the total who applied. From what I've heard ~900 total (including those w/o interviews) applied for the ~300 derm spots. As for plastics you might have to ask those on plasticseducation.com if they know the total who applied including those who didn't get interviews, but I've heard ~350 for the ~80 spots. But if you don't match derm there are research fellowships that you can do after internship year that can help you get in.

 

[Law2Doc]

I've seen more match into Plastics than Dermatology on some match list. Which one is easier to match into? In terms of income, which one takes the lead?

It's sort of irrelevant -- you don't just go into the most competitive field you can get into, or the easiest, or the highest paid, you go into the one you actually want to do. They are drastically different jobs. In fact, it's pretty common for the top student at a given school to choose neither of those.

 

[DoctorAck]

But what if you don't get into the field that you want to go into? Or does it usually work out that if there is a field you desire the most, you usually do what is necessary to get into it?

 

[Critical Mass]

But what if you don't get into the field that you want to go into? Or does it usually work out that if there is a field you desire the most, you usually do what is necessary to get into it?

At the onset of medical school, my experience tells me that there is a widespread fear of working your butt off only to be "forced" to do an unwanted specialty. This causes people to stray from the fluffy essays that got them into med schol and turn into competative asses.

The evidence suggests that most people do in fact get to do what they want to do even if it isn't at the program they wanted to match at. There are exceptions to this (derm for instance), but I think that it is possible to reach the surgical specialties via gen surg plus fellowship if you can't match them outright.

Just don't let your thirst for a specialty make you forget why you wanted to become a doctor in the first place.

 

[Bertelman]

It's sort of irrelevant -- you don't just go into the most competitive field you can get into, or the easiest, or the highest paid, you go into the one you actually want to do. They are drastically different jobs. In fact, it's pretty common for the top student at a given school to choose neither of those.

Sounds to me like the one Gypsy most wants to do is the best-paid. Oh how I wish pre-meds would be more honest with their personal statements.

"My goal is to become a Plastic Surgeon or a Dermatologist, but that depends on which is easier to match. Of course, money will always play a role. And I'd prefer to have some free time to spend my money. To be honest, I can't really tell you why I chose medicine, but I'm really looking forward to becoming a Plastic-Dermatology-Radiologist."

 

[dilated]

Sounds to me like the one Gypsy most wants to do is the best-paid. Oh how I wish pre-meds would be more honest with their personal statements.

Maybe if medical school admissions focused less on social engineering attempts and more on merit then people could be more honest. As it is, you either toe the academia PC line or you have no chance. The entrance gates to medicine are guarded by people that are out of whack with the rest of the field.

 

[Bertelman]

Maybe if medical school admissions focused less on social engineering attempts and more on merit then people could be more honest. As it is, you either toe the academia PC line or you have no chance. The entrance gates to medicine are guarded by people that are out of whack with the rest of the field.

I'd prefer my doctor have some social responsibility and not just stellar board scores. The world is full of industries with greed as their focus. I don't think doctors should ascribe to that. It's a field centered around helping others.

Academia may be out of whack, but I believe they are making a conscious effort to ensure future physicians are well-selected. It's not about being PC. It's about compassion. You can choke on that word and vomit if you like, but I promise if you are ever in a tragic situation where you or your loved one is critically ill, you will pray that the physician has some compassion, and isn't in it to grab a quick buck before his tee time.

 

[soeagerun2or]

I'd rather play with tits than pop zits any day..

 

[Sophie]

I'd prefer my doctor have some social responsibility and not just stellar board scores. The world is full of industries with greed as their focus. I don't think doctors should ascribe to that. It's a field centered around helping others.

Academia may be out of whack, but I believe they are making a conscious effort to ensure future physicians are well-selected. It's not about being PC. It's about compassion. You can choke on that word and vomit if you like, but I promise if you are ever in a tragic situation where you or your loved one is critically ill, you will pray that the physician has some compassion, and isn't in it to grab a quick buck before his tee time.

It's totally possible to have compassion and still be interested in giving yourself a semblance of a life. The way the admissions system functions currently, you can't admit that you're interested in being relatively well-off, having some time for your family, AND helping people. The more self-sacrificing the better. I think this makes most of us into liars, because honestly, even though I really do want to help people, and one of my primary reasons for going into medicine is to make a difference, I'm not willing to give up my own life in the process.

 

[Droopy Snoopy]

My wouldn't this be a nice predicament to be in? They're pretty much in the same league, with lots of overlap in competitiveness, salary, and working hours. And really, your lifestyle isn't going to be much different earning $400K vs. $450K, working 55 hours a week or 60. It's like asking which is the better gig, quarterback for the Broncos or wide receiver for the Jets.

 

[colbgw02]

Clearly QB for the Broncos.

 

[dilated]

I'd prefer my doctor have some social responsibility and not just stellar board scores. The world is full of industries with greed as their focus. I don't think doctors should ascribe to that. It's a field centered around helping others.

"Social responsibility" does not equal compassion. Regardless, the debate over what your ideal physician does and why he does it is irrelevant to the fact that as long as medical schools insist on demanding applicants fit their very narrowly defined set of values and beliefs -- and those beliefs can and do deviate from those actually held by most practicing physicians -- you can't blame applicants for mouthing the platitudes the adcoms want to hear.

 

[45408]

But what if you don't get into the field that you want to go into? Or does it usually work out that if there is a field you desire the most, you usually do what is necessary to get into it?

Just keep a range of interests. Don't put all your eggs into the dermatology basket. Want a relaxed lifestyle? Keep an interest in psychiatry. 😉

 

[Bertelman]

It's totally possible to have compassion and still be interested in giving yourself a semblance of a life. The way the admissions system functions currently, you can't admit that you're interested in being relatively well-off, having some time for your family, AND helping people. The more self-sacrificing the better. I think this makes most of us into liars, because honestly, even though I really do want to help people, and one of my primary reasons for going into medicine is to make a difference, I'm not willing to give up my own life in the process.

I was working under my impression that the OP cared primarily for $$$. He wasn't looking for a "semblance of a life"...

I've seen more match into Plastics than Dermatology on some match list. Which one is easier to match into? In terms of income, which one takes the lead?

I understand the adcoms don't want us to mention the fact that we want a life out of this. It's a little game to play. I'm not trying to crucify everyone who wants to share some time with their family. I'm just saying, it's not like we have to play this charade for 4 years, or even the rest of our lives. All you have to do is fake it for a few essays and a few hours of interviews. If you can't muster up the determination to act as though you care more about humanity than dollar bills for a few silly interviews, then I really question your motives.

Besides, it's no different than any other facade. We all do it every single day. "Oh yeah, you look great in that." At the very least, the people charged with selecting those honored to attend medical school have a sincere motivation to only accept the best. I don't see what's so bad about that. And it is very likely that

 

[Bertelman]

"Social responsibility" does not equal compassion. Regardless, the debate over what your ideal physician does and why he does it is irrelevant to the fact that as long as medical schools insist on demanding applicants fit their very narrowly defined set of values and beliefs -- and those beliefs can and do deviate from those actually held by most practicing physicians -- you can't blame applicants for mouthing the platitudes the adcoms want to hear.

I agree. I don't blame applicants for mouthing the words. My original comment was just that I wish the OP would have included this in his essay.

 

[Droopy Snoopy]

I agree. I don't blame applicants for mouthing the words. My original comment was just that I wish the OP would have included this in his essay.

I really would like to see some ERAS statements by folks applying to a specialty so obviously driven by the lifestyle like derm. "My desire to treat acne began at an early age..."

 

[deleted77919]

I really would like to see some ERAS statements by folks applying to a specialty so obviously driven by the lifestyle like derm. "My desire to treat acne began at an early age..."

I imagine you discuss treating skin cancers and blistering disorders. Have you ever seen someone with the gravis varient of dystrophic EB? I salute people who perform research in this field and provide what little care is currently available for these patients.

Yes, I realize most people going into derm probably aren't thinking about treating these types of disease, but some are. Heck, I've met one physician personally who specializes in this and doesn't really see much else.

 

[dilated]

I imagine you discuss treating skin cancers and blistering disorders. Have you ever seen someone with the gravis varient of dystrophic EB? I salute people who perform research in this field and provide what little care is currently available for these patients.

Yes, I realize most people going into derm probably aren't thinking about treating these types of disease, but some are. Heck, I've met one physician personally who specializes in this and doesn't really see much else.

I don't see why derm gets slagged so hard except for jealousy. If helping patients is measured in patient satisfaction then derms are doing better than a lot of doctors that are just torturing senile gomers who have no idea wtf century it is with yet more invasive procedures.

 

[Pinkertinkle]

I don't see why derm gets slagged so hard except for jealousy. If helping patients is measured in patient satisfaction then derms are doing better than a lot of doctors that are just torturing senile gomers who have no idea wtf century it is with yet more invasive procedures.

Agreed. Sounds like a lotta sour grapes around here.

 

[deuist]

I don't see why derm gets slagged so hard except for jealousy. If helping patients is measured in patient satisfaction then derms are doing better than a lot of doctors that are just torturing senile gomers who have no idea wtf century it is with yet more invasive procedures.

While there are some nasty skin diseases out there, the bulk of dermatology revolves around cosmetic procedures. Hence, why dermatologists get slammed like plastic surgeons.

Second, getting a derm residency is incredibly difficult. A student will have to be at the top of his class, have outstanding rec letters, and possibly be published and in AOA. After all of this hard work to be one of the top docs around, the dermatologist then goes into one of the easiest specialties---with little call and easy money to be made over people's lack of self-esteem.

 

[Critical Mass]

I really would like to see some ERAS statements by folks applying to a specialty so obviously driven by the lifestyle like derm. "My desire to treat acne began at an early age..."

I think that you'll get a 😉 😉 from PD's if you say this because they wrote it themselves one day.

I've seen the sentiment around that says derm is the reward for hard work during med school rather than a lifelong dream come true.

 

[Sophie]

While there are some nasty skin diseases out there, the bulk of dermatology revolves around cosmetic procedures. Hence, why dermatologists get slammed like plastic surgeons.

I'd rather go through life with hypertension than a big unsightly red rash on my face. Why is it so much more noble to treat "a real medical problem" rather than a cosmetic one, if the cosmetic problem is making the patient have low self-esteem, depression about their appearance, and keeping them from fully living their life?

To go with the stereotypical example, I'm betting the majority of us had acne as teenagers. Didn't it make you want to be invisible sometimes, lower your self-esteem, and decrease your confidence? Can you imagine going throughout your whole life like that, rather than just a few years? Personally, I came to adore my dermatologist, because she made my whole life better, not just one small aspect of it. I've wanted to be a dermatologist ever since - and Tic, if you're still around here in 3 years, I'll let you read my PS. 😛

 

[Towelie]

I'd rather go through life with hypertension than a big unsightly red rash on my face. Why is it so much more noble to treat "a real medical problem" rather than a cosmetic one, if the cosmetic problem is making the patient have low self-esteem, depression about their appearance, and keeping them from fully living their life?

To go with the stereotypical example, I'm betting the majority of us had acne as teenagers. Didn't it make you want to be invisible sometimes, lower your self-esteem, and decrease your confidence? Can you imagine going throughout your whole life like that, rather than just a few years? Personally, I came to adore my dermatologist, because she made my whole life better, not just one small aspect of it. I've wanted to be a dermatologist ever since - and Tic, if you're still around here in 3 years, I'll let you read my PS. 😛

The difference is that the "real" problems can kill you. Acne can't.

And in derm/plastics, you're almost exclusively serving the upper class.

I guess a lot of people don't really view it as "real" medicine when the bulk of what you do is botox and the prescription of acne meds.

 

[Droopy Snoopy]

I'd rather go through life with hypertension than a big unsightly red rash on my face. Why is it so much more noble to treat "a real medical problem" rather than a cosmetic one, if the cosmetic problem is making the patient have low self-esteem, depression about their appearance, and keeping them from fully living their life?

To go with the stereotypical example, I'm betting the majority of us had acne as teenagers. Didn't it make you want to be invisible sometimes, lower your self-esteem, and decrease your confidence? Can you imagine going throughout your whole life like that, rather than just a few years? Personally, I came to adore my dermatologist, because she made my whole life better, not just one small aspect of it. I've wanted to be a dermatologist ever since - and Tic, if you're still around here in 3 years, I'll let you read my PS. 😛

If you have the stats to go into derm and the genuine personal motivation to do so I say well done and good luck. But I believe the majority of the brilliant and accomplished folks crowding out a good proportion of the residency spots are there simply because it's a nice gig. Fine, it's how the market works and more power to 'em. But let's not kid ourselves. If psychiatrists and pediatricians made 500K for a 40 hour week, the 270/99's of the world would apply there and learn to love the crazies and the stinky children as much as they presently learn to love the zits and moles.

 

[deuist]

Depending on your practice area, you can make a lot of money doing peds or psych. My school's psych professor does not accept insurance and charges $400 an hour. I think she told us once that she takes home around $400,000 a year. Likewise, pediatricians with lots of experience can join MD/VIP practices and pull in loads of money with few patient encounters each day.

 

[TheMightyAngus]

The difference is that the "real" problems can kill you. Acne can't.

And in derm/plastics, you're almost exclusively serving the upper class.

I guess a lot of people don't really view it as "real" medicine when the bulk of what you do is botox and the prescription of acne meds.

Dude, get a clue.

 

[Biscuit799]

If you have the stats to go into derm and the genuine personal motivation to do so I say well done and good luck. But I believe the majority of the brilliant and accomplished folks crowding out a good proportion of the residency spots are there simply because it's a nice gig. Fine, it's how the market works and more power to 'em. But let's not kid ourselves. If psychiatrists and pediatricians made 500K for a 40 hour week, the 270/99's of the world would apply there and learn to love the crazies and the stinky children as much as they presently learn to love the zits and moles.

Were I to be more eloquent in the use of colloquialisms, or my verbosity were in a range far superior than the current, Neanderthal-esque mumblings with which I regularly go about incorporating into daily conversation, I would still lack the capacity or profundity necessary to punctuate this point in a more sage manner.

 

[Towelie]

Dude, get a clue.

OK Angusman.

Maybe you could let me know what you're referring to?

 

[dilated]

OK Angusman.

Maybe you could let me know what you're referring to?

The idea that the bulk of what derm does is botox and that they're almost exclusively serving the upper class. That's pretty ridiculous, have you ever even seen a derm practice?

 

[Towelie]

The idea that the bulk of what derm does is botox and that they're almost exclusively serving the upper class. That's pretty ridiculous, have you ever even seen a derm practice?

I've been working in one part time for the past year. In an inner city. And yet, I would bet that 90% of the patients here are in the upper middle class or the upper class. The practice that I work for is part of an academic center, and thus does very little cosmetics. I can't even imagine how skewed it is at private practices.

What I wrote about botox and prescribing acne meds was referring to other physicians' perspective of derm, and why many look down on dermies.

Have you ever seen a derm practice?

 

[dilated]

I've been working in one part time for the past year. In an inner city. And yet, I would bet that 90% of the patients here are in the upper middle class or the upper class. The practice that I work for is part of an academic center, and thus does very little cosmetics. I can't even imagine how skewed it is at private practices.

What I wrote about botox and prescribing acne meds was referring to other physicians' perspective of derm, and why many look down on dermies.

Have you ever seen a derm practice?

Yes, I have. And I wouldn't say anything near 90% of the patients are upper class. You realize that you're suggesting that in a clinic that does "very little cosmetics", 90% of the patients are upper class? So 90% of the people with non-cosmetic skin problems who get treatment are upper class? What are the other 75% of the people in the country with serious skin problems doing, dying? It's a patently ridiculous statement on its face. Insurance is insurance, and most of the people with health insurance in the US are middle class, which isn't even TOUCHING the massive number of people on Medicare who can go see most derms.

 

[YupGypsy]

I agree. I don't blame applicants for mouthing the words. My original comment was just that I wish the OP would have included this in his essay.

Who said I didn't include $$$ in my essay. For $2.99, you can see it yourself.

 

[Bertelman]

Who said I didn't include $$$ in my essay. For $2.99, you can see it yourself.

 

[Doctor Bagel]

The difference is that the "real" problems can kill you. Acne can't.

And in derm/plastics, you're almost exclusively serving the upper class.

I guess a lot of people don't really view it as "real" medicine when the bulk of what you do is botox and the prescription of acne meds.

Well, melanoma can kill 'ya. My MIL just died of skin cancer last year. Fun stuff. 🙄 She was poor, too.

 

[Dr. C. Troy]

Plastics and Derm are legitimate medical fields, and it's high-time that the stigma created by the cosmetic aspects of those two fields is removed. My only issue with the OP would be that since he is interested in two totally different fields linked together only by teh cosmetic/lifestyle aspects, then yeah, it is pretty obvious what he's interested in. It's not ridiculous to assume that someone may just be legitimately interested in one or the other because of the nature of the cases that they would be taking on.

But at any rate, if you are ever burned, you'll thank god Plastics exists. Likewise, if you develop skin-cancer, you'll be happy derm exists.

I've worked a lot in ortho, and those guys talk about money far more often than they do about patients, yet they don't have the stigma derm and plastics do. The only reason that I can see for this is that they don't do cosmetic procedures. I've had friends in Rads-Onc say the same thing about the people they were around - it was non-stop talk about money.

 

[Biscuit799]

Yes, I have. And I wouldn't say anything near 90% of the patients are upper class. You realize that you're suggesting that in a clinic that does "very little cosmetics", 90% of the patients are upper class? So 90% of the people with non-cosmetic skin problems who get treatment are upper class? What are the other 75% of the people in the country with serious skin problems doing, dying? It's a patently ridiculous statement on its face. Insurance is insurance, and most of the people with health insurance in the US are middle class, which isn't even TOUCHING the massive number of people on Medicare who can go see most derms.

Break out the phone book and call every derm clinic in town, and tell them that you plan on paying with Medicare. See how many appointments you can get.

 

[Towelie]

Yes, I have. And I wouldn't say anything near 90% of the patients are upper class. You realize that you're suggesting that in a clinic that does "very little cosmetics", 90% of the patients are upper class? So 90% of the people with non-cosmetic skin problems who get treatment are upper class? What are the other 75% of the people in the country with serious skin problems doing, dying? It's a patently ridiculous statement on its face. Insurance is insurance, and most of the people with health insurance in the US are middle class, which isn't even TOUCHING the massive number of people on Medicare who can go see most derms.

You have no clue what you're talking about. With an average HMO, or with medicare, it's nearly impossible to get most derm visits covered.

To say "insurance is insurance" is pretty ridiculous.

As for the other poster who referred to skin cancer, skin cancer patients are primarily treated by oncologists. Not dermatologists.

 

[TheMightyAngus]

You have no clue what you're talking about. With an average HMO, or with medicare, it's nearly impossible to get most derm visits covered.

To say "insurance is insurance" is pretty ridiculous.

As for the other poster who referred to skin cancer, skin cancer patients are primarily treated by oncologists. Not dermatologists.

Dude, get a clue.

 

[Towelie]

Dude, get a clue.

OK buddy.

 

[Doctor Bagel]

As for the other poster who referred to skin cancer, skin cancer patients are primarily treated by oncologists. Not dermatologists.

I think dermatologists are the docs who generally do the primary diagnosis for things like melanoma. I've known plenty of people who've been referred to dermatologists for suspicious moles, so obviously they're doing something other than prescribing accutane. My dad has precancerous skin lesions that he regularly sees a dermatologist for.

As for the insurance statement, have you ever dealt with your own medical insurance issues? With most ppo plans (which are what most plans are), you can see any specialist necessary in your network. Some plans require a referral and some don't. Either way, the insurance will cover your visit to a dermatologist for treatment for medical conditions like suspicious moles, eczema, rashes, etc. Plenty of ordinary people have access to dermatological treatment through their insurance.

 

[dilated]

You have no clue what you're talking about. With an average HMO, or with medicare, it's nearly impossible to get most derm visits covered.

"A recent survey conducted by the American Academy of Dermatology (AAD) showed that beneficiaries of Medicare make up 38% of current patients...
CONCLUSION: overall access to dermatologists appears comparable for patients with Medicare and private insurance"
J Am Acad Dermatol. 2004 Jan;50(1):85-92.

Ooh, smells like fresh pwnage. Almost 40% of derm visits are medicare. Boy, those derms sure are livin it up on those big reimbursement medicare patients. After all, 90% of the visits to derms are upper class, right?

 

[TheMightyAngus]

You have no clue what you're talking about. With an average HMO, or with medicare, it's nearly impossible to get most derm visits covered.

You would be surprised about how many "cosmetic" procedures would be technically reimbursable by insurance and Medicaid. It all depends on how the dermatologist codes the procedure.

 

[Towelie]

"A recent survey conducted by the American Academy of Dermatology (AAD) showed that beneficiaries of Medicare make up 38% of current patients...
CONCLUSION: overall access to dermatologists appears comparable for patients with Medicare and private insurance"
J Am Acad Dermatol. 2004 Jan;50(1):85-92.

Ooh, smells like fresh pwnage. Almost 40% of derm visits are medicare. Boy, those derms sure are livin it up on those big reimbursement medicare patients. After all, 90% of the visits to derms are upper class, right?

Did you seriously write "ooh, smells like fresh pwnage"? All I can say is: wow.

You selectively quote from that article like I've never seen, removing the word "although" and then all of the rest of the conclusion. I'll post it here: "There was dramatic geographic variation. In areas where Medicare payments are low relative to commercial payors, there were increases in Medicare rejection rates and wait times. In communities with relatively low Medicaid payment rates, patients with Medicaid faced higher rejection rates and longer wait times."

The 90% was in the practice that I work in. Clearly you are right, and this number isn't nationally representative. My original statement was just meant to point out that as a dermatologist, particularly one in cosmetics, you will be serving a higher proportion of affluent patients than you would in any other medical field that I can think of (other than Plastics). I don't think you can dispute that.

I'm done wasting my time with this. Peace.

 

[VCMM414]

As for the other poster who referred to skin cancer, skin cancer patients are primarily treated by oncologists. Not dermatologists.

This cannot be further from the truth. Dermatologists diagnose and treat primary basal cells, squamous cells, cutaneous T cells, precancerous lesions (actinic keratosis), among other things. The above disease entities compose the VAST majority of skin cancers. Dermatologists also diagnose melanomas (only 5% of total cutaneous malignancies, albeit the most invasive). Typically a primary dermatologist will punch biopsy a suspicious nevus, and refer to medical/surgical oncology as needed (typically if the melanoma is >1mm deep, and thus requiring sentinel node biopsy).

 

[deuist]

In addition, derm sub-specialists called Mohs surgeons specifically remove skin lesions. They don't do skin creams, acne treatments, and laser therapy.