As the medicare reimbursement for primary care physicians (GP) get smaller, a lot of GP are forced to work longer hours with smaller paychecks. This trend will eventually lead to a bigger shortage of GP in U.S. I hear that there are a increasing number of GP who learn to practice lucrative derm and cosmetic procedures and do extremely well financially. Many of them are learning these cosmetics (botox, laser, collagen) and derm procedures (like skin bx) from conferences and courses. Can IM residencies train IM residents more in dermatology? Are there any IM residencies doing that?