What's the point of going into derm if......

Probably the most important thing is having enough knowledge so you don't end up harming your patients. You may not see very many moles in IM (certainly not as much as Derm), so you might only catch the "typically bad" ones. It doesn't help anyone very much if you take off a mole thinking it's benign and it turns out to be a weird presentation of melanoma that ends up spreading. Plus, you can't take the Derm boards, so that may have implications as far as reimbursements from insurances. Finally, you really can't "advertise" yourself as a skin specialist -- you just have to take whatever comes your way.

Just a few thoughts from someone who's nowhere near there yet.

 

You can advertise your self as doing cosmetic procedures. I know a few IM generalists that do many derm procedures even without adverstising themselves.

 

I agree with this .. Although Internists and FPs and others will do some derm related procedures they will generally be small part of their practice. Their level of expertise for diagnosis and treatment of skin related problems will be far below that of someone who did a residency and deals with these kinds of problems all day.The main benefit of being a Dermatologist is that you will be considered an expert and will get referrals from other physicians,HMOs etc.You will be busy right away doing derm and only that.Primary care docs will do some derm but it will generally be from patients already in their primary care practice.

 

True

 

I agree that thats how it usually starts, your will be doing primary care for a few years until you master your procedures but if you do a search online there are many primary docs have given up primary med practice and only do cosmetics. It depends what area you're working at and once you build your practice and are known to do a good job people will line up to see you. After all medicine is a business and if you have the skills you can do better financially than many dermatologists who have no business sense. Both Derm and FP, IM are similar in a way that there are outpatient medicine and its all about how you run your business/clinic. So if you dont get in the derm residency its not the end of the world, its a tough match for everyone.

 

Yea exactly, if you really want to do derm its not the end of the world if you dont get a derm residency.

I dont know if this happens, but is it possible to do a residency with out getting paid? Lets say you really want to do the residency could you offer to go unpaid? Will that help you get some more competitive residencies?

 

i havnt heard of any..it would be nice to get the experience

 

The answer is you can not do it unless they let you. They wont let you as there are insurance/reimbursement issues. It would cause chaos. Dumb rich kids could go and train in neurosurg or anything else they wanted.

 

Thats what I meant, with the permission of the PD. I know PDs have restrictions on how much money they can allocate, so if you were to offer to go unpaid for a year or two (considering you were qualified to enter the field, but for whatever reason werent able to) could this help?

Just wondering, I m still far from even really thinking of what type of residency that I may want. But I know people who did this in undergrad to get some really good interships, basically offered to go unstipend.