Why derm?

[cobaltgreen]

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so--i reluctantly admitted to myself i am interesting in derm...derm, and heme/onc, and family practice. so the question is...why derm?

don't get me wrong--i am sure of my reasons to be interested--but those same reasons could be applicable to heme onc. i like procedures, i love research, i love following the patients....i am interested in melanoma research.

but i also like cancer research relating to hematological diseases.

hmmm....i am trying to decide what to do here.

anyone want to share their reasons for choosing derm? or perhaps challenge me to figure out my specific interest in the field?

 

[CigarTragic]

Why derm?

Why not?

 

[cobaltgreen]

i did ask for that one, no?

 

[crys20]

Haha, did you see my lifestyle/picking what you love thread? I give an extensive description of what I like about derm and love about heme-onc. We should move this party over there. 🙂

 

[PeepshowJohnny]

Why do people pick derm? Probably a combination of these reasons.

A) They're interested in the skin and it's pathology.
B) They're interested in a field with everything: office consultation and prescribing, procedures, seeing people of all ages, cosmetic problems all the way to life threatening conditions.
C) They want to make a lot of money with relatively little work.

How much you each plays in varies from person to person.

Anyway, in your original post I think it's interesting (because intentionally or not) your three interests span the competitiveness of residency programs. Dermatology is arguably the hardest to get residency (if not number one, it's two, definitely the hardest nonsurgical). Internal medicine + Fellowship is what most people would consider moderate difficulty, and matching in family practice is not difficult at all.

 

[Reimat]

so--i reluctantly admitted to myself i am interesting in derm...derm, and heme/onc, and family practice. so the question is...why derm?

don't get me wrong--i am sure of my reasons to be interested--but those same reasons could be applicable to heme onc. i like procedures, i love research, i love following the patients....i am interested in melanoma research.

but i also like cancer research relating to hematological diseases.

hmmm....i am trying to decide what to do here.

anyone want to share their reasons for choosing derm? or perhaps challenge me to figure out my specific interest in the field?

I was talking to a senior derm doc in private practice and he said if you mostly just like the derm procedures (particularly cosmetic ones) go into FP. Far easier to be an FP than a derm if you want to inject botox and remove moles. Obviously, if you want to do melanoma research at a big medical center, you're gonna need to be a dermatologist.

 

[discontinuebed]

I was talking to a senior derm doc in private practice and he said if you mostly just like the derm procedures (particularly cosmetic ones) go into FP. Far easier to be an FP than a derm if you want to inject botox and remove moles. Obviously, if you want to do melanoma research at a big medical center, you're gonna need to be a dermatologist.

Yes, but I'd rather have a dermatologist perform these procedures on me than a FP doc.

And while I don't speak for everyone, I'd bet good money that a significant portion of the patient population has the same preference.

 

[DrDude]

I'm going to go out on a limb and say rarely, if ever, does a person go to med school wanting to be a dermatologist. Now I know somebody's going to refute that by claiming they've always wanted to be a dermatologist since preschool...but you know what I mean. You never hear any premeds saying they want to be a dermatologist, but you hear plenty say they want to be pediatricians, family physicians, surgeons, etc. Rather derm is one of those fields where people with high grades and scores gravitate to when they've had enough of traditional medicine. Usually sometime during 3rd year they decide they've had enough and they'll take their high scores and go for a specialty where they can have a relaxed lifestyle and make tons of money. Nothing wrong with that, but I think that's the real honest reason why most go into derm.

 

[QuantumMechanic]

I'm going to go out on a limb and say rarely, if ever, does a person go to med school wanting to be a dermatologist. Now I know somebody's going to refute that by claiming they've always wanted to be a dermatologist since preschool...but you know what I mean. You never hear any premeds saying they want to be a dermatologist, but you hear plenty say they want to be pediatricians, family physicians, surgeons, etc. Rather derm is one of those fields where people with high grades and scores gravitate to when they've had enough of traditional medicine. Usually sometime during 3rd year they decide they've had enough and they'll take their high scores and go for a specialty where they can have a relaxed lifestyle and make tons of money. Nothing wrong with that, but I think that's the real honest reason why most go into derm.

I think students in general don't know what they want to do before med school. Its really hard to have an idea of what you are going to pursue until you get knee-deep into your rotations and really see what fields are like rather than getting superficial ideas from shadowing and reading about various fields. You could probably say the same thing about derm about several other small, yet competitive specialties out there.

At the same time, there are probably alot more students who are near the top of their classes who aren't even considering derm since they don't have an interest in the subject matter despite the alluring nature of the specialty.

 

[PeepshowJohnny]

Actually, I knew at least five people who really interested in dermatology prior to entering medical school, I think a lot of them had a history/family member with skin condtions. None of them are going to BE a dermatologist. Even though they got good grades/steps, they're scared of hoping for a field where even the best of the best aren't guaranteed a spot.

 

[-Goose-]

Because of all the skin afflictions I had/have; I wanted to be a dermatologist when I was younger. People make fun of them, but they can really help people a lot.

 

[TheMightyAngus]

Yes, but I'd rather have a dermatologist perform these procedures on me than a FP doc.

And while I don't speak for everyone, I'd bet good money that a significant portion of the patient population has the same preference.

No way that a dermatologist is better suited at performing Botox injections and removing a common mole than a FP.
Any FP can probably do both of these with very little training.

What adverse outcomes do you avoid by having a cosmetic dermatologist doing this?

We're not talking about Mohs surgery here. We're talking about a clamp and snip that might not even require local anesthesia.

 

[discontinuebed]

No way that a dermatologist is better suited at performing Botox injections and removing a common mole than a FP.

I'm not even sure I'm reading this right.....

Any FP can probably do both of these with very little training.

You aren't by any chance headed towards FP are you?

What adverse outcomes do you avoid by having a cosmetic dermatologist doing this?

I'd rather not find out the hard way.

 

[TheMightyAngus]

I mean that any FP can learn to do Botox and mole removal to the same extent that a dermatologist can. Let's be realistic here. These are basic low risk procedures that most doctors and even nurse practitioners could perform.

http://www.ultrasmoothskin.com/med_officer_lisa_williams.htm

 

[discontinuebed]

I mean that any FP can learn to do Botox and mole removal to the same extent that a dermatologist can. Let's be realistic here. These are basic low risk procedures that most doctors and even nurse practitioners could perform.

http://www.ultrasmoothskin.com/med_officer_lisa_williams.htm

I think you're absolutely right. It's basic and low risk but to say a dermatologist can't do it as well as an FP is probably going a bit too far.

And if you're going to have that kind of procedure done (or at least, if I am going to have that kind of procedure done), it's going to be at the dermatologist's office unless the FP offers me a significant difference in price.

 

[crys20]

I know several who came to school wanting to be derms due to their hx of skin issues and the positive influence a kind dermatologist had on their lives. But yes, of course a derm could do surgical mole removal procedures and botox better than an FP bc most likely they are doing it more frequently. I have had moles removed by a derm and have no scar at all....vs, when my FP wanted to take them off, she said maybe better wait til 'after your wedding' due to the scar it would leave (then proceeded to show off her scars)

 

[NonTradMed]

I'm going to go out on a limb and say rarely, if ever, does a person go to med school wanting to be a dermatologist. Now I know somebody's going to refute that by claiming they've always wanted to be a dermatologist since preschool...but you know what I mean. You never hear any premeds saying they want to be a dermatologist, but you hear plenty say they want to be pediatricians, family physicians, surgeons, etc. Rather derm is one of those fields where people with high grades and scores gravitate to when they've had enough of traditional medicine. Usually sometime during 3rd year they decide they've had enough and they'll take their high scores and go for a specialty where they can have a relaxed lifestyle and make tons of money. Nothing wrong with that, but I think that's the real honest reason why most go into derm.

I agree. I knew a girl who wanted to be a surgeon. She was a top notch student in college (prestigious college, engineering major w/4.0 ect). But then she shadowed a doctor and learned that a surgeon had a really hard lifestyle. So now, she said she is trying for derm since it is high pay and good hours. Conducive to having a family. I thought it was kind of sad that that was the only reason she is picking the job but I guess the nice lifestyle will make up if she has a lack of interest in that area.

 

[omgwtfbbq?]

Think, you can go to work wearing kitchy t-shirts like "your epidermis is showing"

I want to go into derm despite the high competitiveness because i like path, surgery (want to do mohs), the idea of having my own practice and the entrepreneurship factor, the opportunity to affect the lives of a wide swath of patients, and the fact that it's not ONLY cosmetic like many people tend to think, or at least they talk like it is. I grew up in AZ, 2nd highest rate of melanoma in the world... and i'll tell you what, a good mohs surgeon can save somebody's life if they're good. I'll apply to every single program in the country come residency app. time if I have to.

So if you like derm... go for it. Just don't apply to the residencies I want 😉 hehe

 

[DrGregoryHouse]

My dermatologist is cool as ice. If I smoke the boards, dermatology will be at the top of the list. If I don't, I'll kill myself. Anyone know what a lethal dosage of accutane is?

 

[howelljolly]

I know of somebody who did that

 

[DrGregoryHouse]

I know of somebody who did that

With accutane? For real?

 

[Long Dong]

With accutane? For real?

I think he is talking about somebody who didn't get into derm.

 

[howelljolly]

Yeah, not the accutane part... someone who checked out early because they didnt match into Derm.

 

[Re3iRtH]

I agree. I knew a girl who wanted to be a surgeon. She was a top notch student in college (prestigious college, engineering major w/4.0 ect). But then she shadowed a doctor and learned that a surgeon had a really hard lifestyle. So now, she said she is trying for derm since it is high pay and good hours. Conducive to having a family. I thought it was kind of sad that that was the only reason she is picking the job but I guess the nice lifestyle will make up if she has a lack of interest in that area.

Honestly, did that really surprise you? It seems like stories
like that are a dime a dozen these days.

 

[Ashers]

Actually, I knew at least five people who really interested in dermatology prior to entering medical school, I think a lot of them had a history/family member with skin condtions. None of them are going to BE a dermatologist. Even though they got good grades/steps, they're scared of hoping for a field where even the best of the best aren't guaranteed a spot.

I started out med school with derm being one of my top interests (along with ortho, cardiology, and EM), but it quickly fell off the list when I found out what's really involved in it. My dermatologist I saw in high school was one of the best doctors I had; she just had to move to PA. I've had a fair amount of experience with dermatologists, which is a reason I thought I wanted to do derm. The only way I would do a derm rotation is if I were to go home and do an away where one of our friends has a leprosy patient. And I'm also convinced I'm going to die of some sort of skin cancer.

Pathology convinced me that derm's not for me.

 

[TRAMD]

The main reasons people pick derm is high salary, few hours, no nights, no weekends, no call, your patients rarely die and the field is in high demand.

Remember to tell your interviewers that you are actually interested in skin, however. It seems like you already have that bit down so you are all good!

 

[TRAMD]

Yeah, not the accutane part... someone who checked out early because they didnt match into Derm.

Suicide is quite possibly the most selfish thing a person can do. How could we expect someone to really care for strangers when they don't even realize the worth of their life to those that love them?

Then to kill yourself over something like this? The world of medicine came out ahead here. Maybe I am just in a pissy mood tonight . . .