Why is dermatology such a coveted residency?

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jazzadi

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Why is dermatology such a coveted residency?
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Having around a 40 hour work week along with other Lifestyle factors (along with radiology, and anesthesiology to a degree) that earn the same $$ as a tired, 80 hour work week surgeon make it highly desirable. The risk of getting sued as a dermatologist also seems to be pretty low also. Good luck getting into the field though- its harder to get into derm than it probably is to get into all the top 10 medical schools in the country while being offered a scholarship by all. Put it this way, there are posters in allo that have nothing but high passes and mostly honors- will probably get a 240-250+ on their step 1 and still not get into derm.
 
armybound said:
it is?

I thought people always made fun of dermatologists
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I guess it's because dermatologists are so superficial. But really, dermatologists have, after residency, the cushy 9-5 office job, they don't have to be on call all the time, and they can make a lot of money, especially in certain locations.
 
no phone ringing at 4am. no emergencies really in the specialty.
 
armybound said:
it is?

I thought people always made fun of dermatologists
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Thats mostly because you see them advertising on television for products or for their business. Seldomly you will find a surgeon or PCP advertising through the newspaper or television for their business. Take for example, the hydroxycut guy or any other doctor that advertises for some product on television or even Dr. 90210. THe unspoken rule in medicine seems to be, that if you put yourself in the media like that to make bank, you're going to get ridiculed behind your back.
 
I think it may also be because there are very limited number of residency spots nationwide. My roommate is a M3 and she's looking into derm--she's probably going to have to take a year off to do research because in order to improve her chances
 
Derm is much more of a lifestyle specialty than rads or anesthesiology. There are also so few spots available.
 
jazzadi said:
Why is dermatology such a coveted residency?
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some points:

$200k a year at least for working <60 hrs/wk
rarely anything immediately life-threatening
skin cancer
the pathology is complex and many find it interesting
lots of reading during residency (wide variety of diseases impact the skin)
highly demanded
potential to do your own pathology readings
not heavily tied to medicare reimbursements
you don't have to spend your career in the hospital
 
I really don't see why people ridicule the surgeons on Dr. 90210 so much on this site. "You're young, financially successful, attractive, and have a loving family/spouse. Hahaha, youre such a joke.":thumbdown:

braluk said:
Thats mostly because you see them advertising on television for products or for their business. Seldomly you will find a surgeon or PCP advertising through the newspaper or television for their business. Take for example, the hydroxycut guy or any other doctor that advertises for some product on television or even Dr. 90210. THe unspoken rule in medicine seems to be, that if you put yourself in the media like that to make bank, you're going to get ridiculed behind your back.
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braluk said:
Having around a 40 hour work week along with other Lifestyle factors (along with radiology, and anesthesiology to a degree) that earn the same $$ as a tired, 80 hour work week surgeon make it highly desirable. The risk of getting sued as a dermatologist also seems to be pretty low also. Good luck getting into the field though- its harder to get into derm than it probably is to get into all the top 10 medical schools in the country while being offered a scholarship by all. Put it this way, there are posters in allo that have nothing but high passes and mostly honors- will probably get a 240-250+ on their step 1 and still not get into derm.
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Sounds like an exaggeration to me. I'm sure it is difficult to get but there are probably < 20 people each app cycle that get in to the entire top 10 while being offered anything other than need based scholarships. I totally agree that it is very competitive, but people need to stop holding things up like they're the holy grail. If you want it and work for it you can get it.
 
NovemberWhiskey said:
If you want it and work for it you can get it.
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if you have a low Step 1 score, it is nearly impossible to land derm. remember that Step 1 can't be retaken unless it is failed.
 
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QuantumMechanic said:
if you have a low Step 1 score, it is nearly impossible to land derm. remember that Step 1 can't be retaken unless it is failed.
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Agreed. The number of slots is so limited that folks with fairly high scores still often feel the need to do an extra year of research just to improve the odds.

This is something most wont get just by wanting it enough.
 
Let me put it this way: Derm is so coveted that I am going into derm one way or the other. If I don't match derm, I will still find a way to open a dermatological center. Bottom line, period.:mad:
 
QuantumMechanic said:
if you have a low Step 1 score, it is nearly impossible to land derm. remember that Step 1 can't be retaken unless it is failed.
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Right so work hard BEFORE taking step 1. I didn't say "at any point in your med school career can you decide you want derm and get it". I said if you want it and work hard you can get it. IE if you know you want derm, you're going to have to work hard, do well in classes, boards, etc and you'll get it. I just get irritated when people speak of things as impossibilities.
 
sirus_virus said:
Let me put it this way: Derm is so coveted that I am going into derm one way or the other. If I don't match derm I will still find a way to open a dermatological center. Bottom line, period.:mad:
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you just gotta find a dermatopathologist and a MOHS specialist to work for you :rolleyes:
 
sirus_virus said:
Let me put it this way: Derm is so coveted that I am going into derm one way or the other. If I don't match derm I will still find a way to open a dermatological center. Bottom line, period.:mad:
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Damn, thats commitment!

Ive heard derm has fluctuated alot lately. It used to be fairly unpopular some years ago, but now is one of the most competitive specialties. Personally, Id be bored looking at skin all day, but everyone has their own tastes.
 
NovemberWhiskey said:
Right so work hard BEFORE taking step 1. I didn't say "at any point in your med school career can you decide you want derm and get it". I said if you want it and work hard you can get it. IE if you know you want derm, you're going to have to work hard, do well in classes, boards, etc and you'll get it. I just get irritated when people speak of things as impossibilities.
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the issue is of timing. most people concede that your choice of specialty really isn't confidently set until M3 at earliest. by this point you have already taken Step1...the problem is that if one isn't gunning for a competitive specialty from day one, they might not have this Step 1 score to get into derm.

furthermore, there are lots of med students that just won't score that highly on Step 1, no matter how much they want to get into derm...Step 1 score is not entirely a function of effort and dedication to studying, some people just aren't going to score >230. Like I said before, your Step 1 score can't be improved once you've taken the test, unless you failed it, the NBME won't let you take it again.
 
QuantumMechanic said:
the issue is of timing. most people concede that your choice of specialty really isn't confidently set until M3 at earliest. by this point you have already taken Step1...the problem is that if one isn't gunning for a competitive specialty from day one, they might not have this Step 1 score to get into derm.

furthermore, there are lots of med students that just won't score that highly on Step 1, no matter how much they want to get into derm...Step 1 score is not entirely a function of effort and dedication to studying, some people just aren't going to score >230. Like I said before, your Step 1 score can't be improved once you've taken the test, unless you failed it, the NBME won't let you take it again.
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Right, I was generalizing. There are always exceptions, there will be some people even if they did their absolute best, they still couldn't hack it, but my comment was in response to Braluk's mentality that it is basically impossible for anyone, which is obviously not the case.
 
Nuriko said:
Damn, thats commitment!

Ive heard derm has fluctuated alot lately. It used to be fairly unpopular some years ago, but now is one of the most competitive specialties. Personally, Id be bored looking at skin all day, but everyone has their own tastes.
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Actually it has always been competative. Plus to whoever mentioned it, I don't think that taking a year off for research will help if you don't have the numbers to start with.

You have to keep in mind the number of spots available. It's all about market control. This is a capitalist system, and if one derm has more patients in his/her "motor unit" if you will, the doc can simply innervate the easy cases with midlevels without having to train competition (i.e. recruit other motor units). If you have a skin problem and a derm is not available, you either take the midlevel or wait. If demand for derm serves go up, you just wait longer.

I don't really think that it is about taste. After you've been beaten up mentally for a couple of years, pimped by everybody, taken time away from your family, lost interest in entertainment/leisure, etc., you stop having particular "tastes." You will see so many body cavities, dangling limbs, etc. that the body part you decide to spend the rest of your life working on becomes just another pathological specimen.

Most people don't go into medicine so that they can someday crawl up into peoples' asses on a daily basis, but guess what, GI is one of the most popular IM fellowships and is very competative. Reason? Salary, procedures, baby boom demand.

People who have gone to med school understand what "lifestyle" really means after being run through the system. Last year my school matched 17 gas and 17 family med. That in itself says a lot. This ain't your daddy's healthcare system anymore.
 
sirus_virus said:
Let me put it this way: Derm is so coveted that I am going into derm one way or the other. If I don't match derm I will still find a way to open a dermatological center. Bottom line, period.:mad:
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Sorry, I'm gonna gun you down.
 
NovemberWhiskey said:
Sounds like an exaggeration to me. I'm sure it is difficult to get but there are probably < 20 people each app cycle that get in to the entire top 10 while being offered anything other than need based scholarships. I totally agree that it is very competitive, but people need to stop holding things up like they're the holy grail. If you want it and work for it you can get it.
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With each school having around 5 spots each year for derm, I think it's a stretch to say that anyone can work for it and get it.
 
Med school kills the altruism that brought many students there till they just want what everyone else does. The most money with the most cush lifestyle, derm offers that.
 
Chuckwalla said:
Med school kills the altruism that brought many students there till they just want what everyone else does. The most money with the most cush lifestyle, derm offers that.
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Yeah well dermatologists aren't true doctors -- according to my Columbia interviewer. :rolleyes:
 
Mr. Tee said:
Yeah well dermatologists aren't true doctors -- according to my Columbia interviewer. :rolleyes:
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exactly, who cares if the skin is the body's largest organ...its evil

_41381405_skin_cancer.gif


=

satan_saddam.jpg
 
What's the point of doing a year of research to increase your chances of getting into a residency (i.e. dermatology)? It's kinda hard to get a publication in a year. Is it just the notion of having some research experience?
 
I was reading the chapters in my patho book on skin and it was pretty interesting. I especailly liked the gruesome pics. :thumbup:

Still I'd have a hard time staring at the pimples on rich teenagers faces for 40 years.

If I was gonna go for a lifesytle specialty it would be optho (surgery potential/procedures/decent money/hours).

Gas is cool too- the ability to take folks to the brink of death without actually killing them- BUWHAAAAAA!!!
 
TSK said:
I really don't see why people ridicule the surgeons on Dr. 90210 so much on this site. "You're young, financially successful, attractive, and have a loving family/spouse. Hahaha, youre such a joke.":thumbdown:
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I dont personally ridicule Dr. 90210 myself, if anyone can do what they do, earn an excellent living and still have a working family, more power to them- Im speaking about the mentality that if you can do all that, why have a television show on E! and feature promos with pictures of you with scores of attractive ladies. The time spent on promoting your show, taking press pictures, etc..etc.. could be spent more constructively. Hell, that'd be awesome if that was me, and my tune would be different if I was in his shoes, but had his show been on the discovery channel, without the hollywood type media around it, you'll find that the attitude towards those type of doctors will change differently.
 
sunnyjohn said:
Still I'd have a hard time staring at the pimples on rich teenagers faces for 40 years.
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there could be worse fates... :cough: geriatric gynecology :cough:
 
braluk said:
I dont personally ridicule Dr. 90210 myself, if anyone can do what they do, earn an excellent living and still have a working family, more power to them- Im speaking about the mentality that if you can do all that, why have a television show on E! and feature promos with pictures of you with scores of attractive ladies. The time spent on promoting your show, taking press pictures, etc..etc.. could be spent more constructively. Hell, that'd be awesome if that was me, but had his show been on the discovery channel, without the hollywood type media around it, you'll find that respect will suddenly go up tenfold.
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I have a sneaking suspicion Dr 90210 's home life is not all that happy.

His wife looks pissed and is annoying half the time.

I'm sure he's a nice dude, but he really needs to dial it back a notch.
 
QuantumMechanic said:
there could be worse fates... :cough: geriatric gynecology :cough:
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"I'll take old **** for $500 Alex!"

Have you ever seen the look on the face of a husband after his wife's gotten an A&P repair? PRICELESS! :smuggrin:
 
NovemberWhiskey said:
Right, I was generalizing. There are always exceptions, there will be some people even if they did their absolute best, they still couldn't hack it, but my comment was in response to Braluk's mentality that it is basically impossible for anyone, which is obviously not the case.
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Im sorry if I conveyed that it was impossible for anyone, that is not my contention. My point reflects that there seems to be alot more at play than students are in control of themselves (their connections, how strong your letters are from M3 years, how strong your deans letter is, etc..etc..). You could have a genius come in, ace every exam, be in the 99th percentile on steps but have terrible rotations because you dont click well with other people. Everything needs to be in order for someone to place into the most competitve spot in the nation. For the average student who wants it badly and works their ass off more than any other student, make AOA, do all of the above and garner the best letters, theres still no remote guarantee that they will be accepted into any derm spot. It certainly isnt an impossible field to get into, but relatively speaking, its certainly one of the hardest to secure a placement into. There are many factors that needs to align just right to be extended a derm placement on match day- this seems to be the case moreso than any other specialty

As a comparison, take med school applicants. Its not impossible to get into Harvard or Mayo (and ive known a few who have), but relatively speaking, for many students it certainly is. Even for the "perfect student", there are random factors at play that the student is not in control of that can preclude them from admission. (maybe this year the adcoms are looking for a particular quality of a student that may be different than another year's, etc..etc..)
 
mintendo said:
What's the point of doing a year of research to increase your chances of getting into a residency (i.e. dermatology)? It's kinda hard to get a publication in a year. Is it just the notion of having some research experience?
Click to expand...

I had posted this about my roommate not myself, who's a third year right now. She's done research getting into a derm residency and apparently if you want to do derm, they like you have to have derm related research experience on your resume because it shows commitment to the field. Now this is all hearsay and hence I'm not sure if it's accurate, but she was conveying this to me since I am interested in derm and am pre-med, hence I wouldn't have to take a year off. I don't really know about having a publication vs. not...
 
Something regarding pay per hour between different specialties doesn't seem right. Derm gets regarded as the best per hour specialty vs Neurosurgery or Orthopedic surgery, or Cardiology.

But if you look at the data it doesn't quite match up.

Derm earns about 200,000 for about 40-50 hours of work.

Non-Interventional Cardiologist earns about 350,00 for 55-65 hours per week. ENT and Urology are similar to Cardiologist with about $350,000 and about 60 hour work week.

Then of course there are orthopedic joint surgeons and neurosurgeons who work closer to 70-80 hours and earn closer to $450,000.

It seems like salary is proportional to the # of hours you work.
After concluding this I have decided that it doesn't matter what specialty you choose. They all pay about the same.

One difference though with derm might be night-time cases. Dermatologists also don't have to work at hospitals.

Key Advice: PICK A SPECIALTY THAT YOU ACTUALLY LIKE!:p
This way you can actually work 80 hours and earn more money in a specialty you actually care about!
 
Tain't no daggum way I'm workin 80 hours a week after residency...


No daggum way.
 
JohnnyQ said:
Something regarding pay per hour between different specialties doesn't seem right. Derm gets regarded as the best per hour specialty vs Neurosurgery or Orthopedic surgery, or Cardiology.

But if you look at the data it doesn't quite match up.

Derm earns about 200,000 for about 40-50 hours of work.

Non-Interventional Cardiologist earns about 350,00 for 55-65 hours per week. ENT and Urology are similar to Cardiologist with about $350,000 and about 60 hour work week.

Then of course there are orthopedic joint surgeons and neurosurgeons who work closer to 70-80 hours and earn closer to $450,000.

It seems like salary is proportional to the # of hours you work.
After concluding this I have decided that it doesn't matter what specialty you choose. They all pay about the same.

One difference though with derm might be night-time cases. Dermatologists also don't have to work at hospitals.

Key Advice: PICK A SPECIALTY THAT YOU ACTUALLY LIKE!:p
This way you can actually work 80 hours and earn more money in a specialty you actually care about!
Click to expand...

Derms have less liability (making it cheaper to practice and more importantly less stressful), also the work itself is less stressful. Derm practice (and most IM and intellectual rather than procedural fields) is different than a surgical practice which is much more demanding physically. Derm residency is infinitely cushier than these other fields. It still wins in the end, unless you want to be ridiculously rich.
 
your patients never die and they always come back
 
armybound said:
it is?

I thought people always made fun of dermatologists
Click to expand...

I hope this was you being sarcastic. But if it wasn't yes it is one of the most coveted fields because these days doctors are looking for fields that will give good pay with good hours rather then good pay for bad hours as the exchange rate. Derm pays a lot and has awesome hours so its one of the hardest fields to get into. There was a thread about this on here some time back but the mods decided to move it to allo which I still don't think there was a need for.
 
jc357 said:
your patients never die and they always come back
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Not necessarily true on either counts. They don't always come back if say they only needed a short term treatment to get over things like acne. A lot of times for those patients aren't even seen by the doc so much as they are by the mid level practitioners: PAs and NPs. On the other count, there are patients who may be diagnosed with skin cancer. Reminds me of that episode of Seinfield where he's dating a dermatologist and refers to her as pimple popper and then she tells him off with how one of her patients had skin cancer.
 
QuantumMechanic said:
the issue is of timing. most people concede that your choice of specialty really isn't confidently set until M3 at earliest. by this point you have already taken Step1...the problem is that if one isn't gunning for a competitive specialty from day one, they might not have this Step 1 score to get into derm.
Click to expand...

That's why it pays to be gunning for the best from day 1, leaves all the doors open for you come third year.
 
gujuDoc said:
I hope this was you being sarcastic. But if it wasn't yes it is one of the most coveted fields because these days doctors are looking for fields that will give good pay with good hours rather then good pay for bad hours as the exchange rate. Derm pays a lot and has awesome hours so its one of the hardest fields to get into. There was a thread about this on here some time back but the mods decided to move it to allo which I still don't think there was a need for.
Click to expand...

I don't think he was being sarcastic.

Many doctors I've talked to make fun of the following: anesthesiologists, radiologists, and dermatologists.

I think its sour-grapes bc those are hard residencies to get into (though anesthesia I believe is becoming easier...) that have less relative risk, much less work, much better $$$$/hour, reasonable hours, easier work schedules compared to most/all other types of specialities.

I personally think these fields take a lot out of what it means to be a doctor.
 
JohnnyQ said:
Something regarding pay per hour between different specialties doesn't seem right. Derm gets regarded as the best per hour specialty vs Neurosurgery or Orthopedic surgery, or Cardiology.

But if you look at the data it doesn't quite match up.

Derm earns about 200,000 for about 40-50 hours of work.

Non-Interventional Cardiologist earns about 350,00 for 55-65 hours per week. ENT and Urology are similar to Cardiologist with about $350,000 and about 60 hour work week.

Then of course there are orthopedic joint surgeons and neurosurgeons who work closer to 70-80 hours and earn closer to $450,000.

It seems like salary is proportional to the # of hours you work.
After concluding this I have decided that it doesn't matter what specialty you choose. They all pay about the same.

One difference though with derm might be night-time cases. Dermatologists also don't have to work at hospitals.

Key Advice: PICK A SPECIALTY THAT YOU ACTUALLY LIKE!:p
This way you can actually work 80 hours and earn more money in a specialty you actually care about!
Click to expand...

And that's just the point, Derms work less hours then many primary care physicians, don't have as much over night call, and still have less liability, more pay, and better hours. Not every field is equal. PCPs make less money and work harder hours cuz they have more call and yet they get paid much less then dermatologists. Why? Rads is the same deal as so is Radiation Oncology. They both have lesser hours then some other fields and get better pay rates then these other fields with less liabilities. So I don't necessarily a gree with you.

However, I do agree with the go with a field you like. Unfortunately not everyone gets in a field they like just like not everyone gets in a med school they like.
 
Wizard of Oz said:
Plus to whoever mentioned it, I don't think that taking a year off for research will help if you don't have the numbers to start with.
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I actually said folks often do a year of research even if they HAVE the numbers to start with, just because it's so competitive. But yes, that reportedly does help if you otherwise have the stats.
 
Stolenspatulas said:
I don't think he was being sarcastic.

Many doctors I've talked to make fun of the following: anesthesiologists, radiologists, and dermatologists.

I think its sour-grapes bc those are hard residencies to get into (though anesthesia I believe is becoming easier...) that have less relative risk, much less work, much better $$$$/hour, reasonable hours, easier work schedules compared to most/all other types of specialities.

I personally think these fields take a lot out of what it means to be a doctor.
Click to expand...

Yeah. You can add Radiation Oncology to the Lifestyle specialty list although not to the same degree as Derm or Rads.
 
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