The Real Deal on Derm

[DrRedMan]

I'm a MS3 who's been reading this forum for a while now, and I really appreciate all the good advice (and entertainment) on these posts. I think everyone knows that derm has great hours, pay, etc. However, there aren't too many posts about the actual merits of the field itself. Heres some of the reasons why I'm thinking about derm:

Outpatient pace
Minor procedures
Visible pathology
Tangible results
Work with both adults and children
Continuity with a subset of your patients
Relatively healthy patients who appreciate your help
Variety - clinical vs procedural vs cosmetic

Am I way off base here? Are these realistic expectations?

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[DCDERM]

With certain rare exceptions, all of your answers do come to fruition in the real world. In addition, there's no overnight call!

 

[03Doc]

Derm has about all of those things, though it should be "fast" outpatient pace. How much money you make is directly related to how many people you see and procedures, since in derm it's VERY hard to get reimbursed for "high-complexity" office visits.

 

[tdittyx2x3]

Ok so big bump from a kid starting in August..

1. Do you guys agree with the above?

2. How complex is dermatology in terms of coming up with a diagnosis and the relevant pathology compared to other specialties?

3. How much money will I make after residency? (joking.. please)

 

[asmallchild]

Ok so big bump from a kid starting in August..

1. Do you guys agree with the above?

2. How complex is dermatology in terms of coming up with a diagnosis and the relevant pathology compared to other specialties?

3. How much money will I make after residency? (joking.. please)

1. Absolutely.

2. It depends. There's a range here. There are some things mean-spirited middle schoolers could point out (acne) and there are others that you could submit for Grand Rounds and get 10 different answers from 10 different experts.

3. It also depends.

 

[tdittyx2x3]

4. Do any of you experience downsides to dermatology? Why does this appear to be a dream field in medicine to my feeble pre-med brain?

I feel like I'm being fooled or something.

 

[asmallchild]

4. The downside is that you're signing up for 3 years of MS3 all over again, albeit now you're doing something you enjoy

The working part is a given: you're expected to do a good job during the day just like a 3rd year student. But because of the nature of dermatology, there's a lot of didactic time built in. Which means you should be going home each night to study. And even when you want to take a day off, you have this nagging voice in the back of your brain telling you should be studying a la the shelf exams at the end of each 3rd year rotation.

Part of this is to look competent during the daily didactics, which is trickier than it seems considering the caliber of students derm programs are taking. And part of this is to cram in the insane minutiae that is asked of you during the boards.

It's a small disadvantage but it is a disadvantage. You can compare this to your intern year, or even now as a 4th year, where I may put in a rigorous day of work but the moment I sign out, I hang up the white coat and can relax with whatever I want until the following morning.

So as great as derm is, it can be a less than enthralling residency experience if you pick it for the wrong reasons. 3 years of reading about something you have little-to-no interest in can get real tiring real quickly.

 

[tdittyx2x3]

What exactly is the "nature of derm?"

What is the typical day like in training? in private practice?

Aside from the obvious pre-requisite of having an interest in skin pathology, what are good reasons to choose derm? the OP's list?

Check this reasoning? --> I'm looking more at what life will be like as an attending for narrowing my options for a specialty. I figure that practically all residencies are long hard roads, so I should look past it to the 20+ years in field. Do this make sense?

 

[asmallchild]

What exactly is the "nature of derm?"

What is the typical day like in training? in private practice?

Aside from the obvious pre-requisite of having an interest in skin pathology, what are good reasons to choose derm? the OP's list?

Check this reasoning? --> I'm looking more at what life will be like as an attending for narrowing my options for a specialty. I figure that practically all residencies are long hard roads, so I should look past it to the 20+ years in field. Do this make sense?

Shadowing is a good way to see what the nature of derm is like.

With regards to your reasoning, I think you are on the right track. What makes it so tricky is that what we are exposed to as medical students and even residents is often times very different from what being an attending is like.

I've met general surgeons who have better work hours than my personal dermatologist (one made a conscious decision to work less, join a large group, and dilute the call. the other made a conscious decision to set up her own practice and work herself to the bone)

So it's definitely wise to look past a residency when considering a career options as well as realizing there's quite a bit of flexibility in terms of molding your life post-residency (in frequenting the neurosurgery forums, it seems like a manageable lifestyle is even possible in that field)

 

[tdittyx2x3]

Thanks for the help asmallchild. Definitely looking into more shadowing experiences once I'm in school and will be able to participate a bit more. Besides I only have 110 days and 12 hours of freedom left.

For the attendings/residents out there... Could you share your own schedule in an average week? Really any information about the day-to-day experience would give us a better grip on this specialty. Maybe mentioning the negatives would be more informative than the overstated positives here in SDN land..