Why is dermatology such a coveted residency?

[Enwysefinest]

I know a a derm doc in nyc who only does sqaumous cell cancer surgery. He has office hours monday, operates the next 3 days, and has friday off. Pulls in 7 figures.

---

Members don't see this ad.

 

[JohnMadden]

1. $ per hour worked is extremely high
2. Low malpractice
3. Most patients pay CASH
4. No overnight call
5. No late nights

Pretty simple.

 

[gujuDoc]

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.

No its not impossible but remember there are tons of people who work hard in med school and still can't be at the top of their class. Its easier said then done. Same with step 1 scores and board scores or standardized test scores in general. No one should be an extreme pessimist but neither should one be an extreme idealist, just somewhere in the middle as a practical person. And in any practical sense its easier said then done.

 

[Towelie]

It should be noted that derm is not even the most competitive specialty to match into. Integrated plastics is, and it's not even close (over 40% of integrated plastics applicants do not match at all).

The ebb and flow of specialty popularity should also be noted. A few years ago, landing a Rad Onc spot was not difficult; now, it's one of the 5 most competitive specialties. We have no idea how competitive derm will be 5 years from now.

 

[dutchman]

who the hell said Rads have low liability. They get their pants sued off their ass more than PCPs. Only surgery and EM has higher liability.

 

[Green Pirate]

lol anybody here ever see that Seinfeld episode where Jerry dates a dermatologist?

and of course Kramer assumes the role of Dr. Van Nostran.

 

[Law2Doc]

who the hell said Rads have low liability. They get their pants sued off their ass more than PCPs. Only surgery and EM has higher liability.

Agree -- missing a diagnosis where the mistake is immortalized on film tends to be the hardest to defend.

 

[Towelie]

lol anybody here ever see that Seinfeld episode where Jerry dates a dermatologist?

and of course Kramer assumes the role of Dr. Van Nostran.

He dates Pimple-popper, MD.

 

[EBI831]

b/c people go into medical school claiming they really really wanna help people and then halfway through realize that they want fast cash, lots of it, their nights and weekends, and if it means holding your stomach while looking at some of the nastiest crap on people's skin they'll rather save time than save the world. the residency, however, is just as long justnot as many calls. that's my two cents from someone who was toying w/ the idea just to raise a fam and then decided that it was stupid to pretend to like fungal skin infections and pretend i was really curing the world's pressing diseases by popping a zit and getting fridays off.

 

[ssquared]

b/c people go into medical school claiming they really really wanna help people and then halfway through realize that they want fast cash, lots of it, their nights and weekends, and if it means holding your stomach while looking at some of the nastiest crap on people's skin they'll rather save time than save the world. the residency, however, is just as long justnot as many calls. that's my two cents from someone who was toying w/ the idea just to raise a fam and then decided that it was stupid to pretend to like fungal skin infections and pretend i was really curing the world's pressing diseases by popping a zit and getting fridays off.

I've always noticed that. People have these large claims of wanting to help people, medicine is a calling, yadda yadda, and then you go and look at the most competitive residency and it happens to be the one where the fewest amount of hours, least amount of work, and biggest payoff come in. The hypocrisy is astounding.

(hey hey, don't get all angry future dermatologists, if you can get it, why not? you can save the world with your money )

I'm extremely tempted to mention it in interviews, but I'll keep my tongue in check. I'll talk about saving the babies in Africa instead.

 

[Wizard of Oz]

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.

Sorry about that. I wasn't intending to reference you. I should have quoted...

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

This is what I was talking about--if the roommate had subpar boards, I don't think that the year off would help.

As far as people making fun of derms, it sometimes has accompanying jealousy (similar to ophtho's being called out or Ph.D.'s saying that M.D.'s are stupid or whatever).

 

[dutchman]

I've always noticed that. People have these large claims of wanting to help people, medicine is a calling, yadda yadda, and then you go and look at the most competitive residency and it happens to be the one where the fewest amount of hours, least amount of work, and biggest payoff come in. The hypocrisy is astounding.

(hey hey, don't get all angry future dermatologists, if you can get it, why not? you can save the world with your money )

I'm extremely tempted to mention it in interviews, but I'll keep my tongue in check. I'll talk about saving the babies in Africa instead.

Premeds are not hypocrites. Perception of life changes real fast when you get those tuition loan statements and see your name sitting next to so many zeros.

 

[braluk]

Lol. I think premed idealism extends as far as M3 (and for some lucky ones- M1 and M2). Once you start those rotations, its less about helping people per se and more about, oh crap what have I gotten myself into lol.

 

[Cirrus83]

Personally I'm annoyed that RadOnc is now super competitive...apparently it's all because you don't have to be a huge computer nerd to be a RadOnc anymore, and there are more computer nerds in general now. Dammit!

I'm especially sad because I'm a huge computer nerd, so if only I was older I'd have been on easy street by now, lol. Dammit all.

Derm is pretty good lifestyle wise, but if I somehow manage to make it as a RadOnc I think I could still feel like I'm really saving lives, while still living a cushy and highly paid lifestyle. Which is probably also why it's more competitive than Opth =(

 

[Green Pirate]

and then there's neurosurgery... where you compete to be treated like crap.

 

[Stolenspatulas]

Premeds are not hypocrites. Perception of life changes real fast when you get those tuition loan statements and see your name sitting next to so many zeros.

I also wouldn't call them hypocrites.

I would call them sell-outs, though.

(it's great to get into your dream med school with stories of your touchy-feely DAB experience plastered in your PS as well as reflected through your tears that just happen always come out during your interview.... ok maybe thats an exaggeration.... or is it?)

 

[MChitty]

This is what I was talking about--if the roommate had subpar boards, I don't think that the year off would help.

Roomate's boards are fine, but my point was to get into a derm residency, they want to see derm related research as well.

 

[greg1184]

I've always noticed that. People have these large claims of wanting to help people, medicine is a calling, yadda yadda, and then you go and look at the most competitive residency and it happens to be the one where the fewest amount of hours, least amount of work, and biggest payoff come in. The hypocrisy is astounding.

(hey hey, don't get all angry future dermatologists, if you can get it, why not? you can save the world with your money )

I'm extremely tempted to mention it in interviews, but I'll keep my tongue in check. I'll talk about saving the babies in Africa instead.

And when you get a serious skin disease or a life threatening melanoma you can just stay home and treat it yourself, since dermatologists are so horrible.

 

[braluk]

Do derms even treat melanomas? Or do they just refer to radOnc?

 

[Towelie]

Do derms even treat melanomas? Or do they just refer to radOnc?

They remove and order a biopsy. Someone with dermpath training reads the biopsy. If cancerous, refer to an oncologist (not a RadOnc).

At least I think that's how it works.

 

[sgglaze]

I've always noticed that. People have these large claims of wanting to help people, medicine is a calling, yadda yadda, and then you go and look at the most competitive residency and it happens to be the one where the fewest amount of hours, least amount of work, and biggest payoff come in. The hypocrisy is astounding.

(hey hey, don't get all angry future dermatologists, if you can get it, why not? you can save the world with your money )

I'm extremely tempted to mention it in interviews, but I'll keep my tongue in check. I'll talk about saving the babies in Africa instead.

Eh it's all a BS Dog and Pony show to begin with. Just based on the fact alone that you really cannot say financial interest is one of the reasons you want to go into medicine shows the grade A level BS of this process. Lets get serious here folks, medicine pays well and offers stable employment with prestige, and that's a VERY large reason so many people are interested in the profession. Mention that any of that on your interviews, however, and I would say good luck to you, one less person to compete with.

So, yes, the fact that so many premeds go in with "medicine is a calling, I want to save lives" mentality, and adcomms actively look for these traits while ignoring the fact that perfectly decent people can be interested in medicine both for the financial rewards, in addition to "yadda yadda I want to help people" encourages hypocrisy from the start.

Someone else summed it up well in the "Would you go into medicine for 50k/year" on the pre allo forum.

 

[abefromann]

Dermatology is competitive to such a degree that if you're not yet in medical school you just can't understand it. You know how tough it is to get into med school? It's a LOT harder to do well once you're in. You're pretty much not going to have a life for the first two years, in general. And it's really only those who are AOA and live at the library and are attractive and honor almost everything that have even a shot at getting a derm residency. A lot of doctors poo-poo it beacuse they don't ever do a clerkship in it, and therefore think it's about warts and acne and chemical peels. Derm is only 5% cosmetics, for you who know nothing about the specialty. There are over 600 systemic diseases that present on the skin, and over 1600 diseases to learn by histopathology. It's quite complex. Lifestyle-wise it's probably the best: very little rounding if any, about 50 hours a week, good compensation, the option to do cosmetics and make a ton, interesting fellowships (dermpath, MOHS cancer surgery). Many doctors have told me they'd go back and do derm if they could do it again (an OB surgeon, a nephrologist). You can cure cancer, take care of translplant patients and burn victims, and recognize life-threatening rashes. And be home in time to see your kids go to bed and be with your wife.

 

[sirus_virus]

Remember that dermatologists, pathologists, rads and rad-oncs spend insane amounts of time studying during residency. A whole lot more than other specialties. So there goes your extra time(at lleast during residency).

 

[Towelie]

Remember that dermatologists, pathologists, rads and rad-oncs spend insane amounts of time studying during residency. A whole lot more than other specialties. So there goes your extra time(at lleast during residency).

I don't know. To me, extra time studying is way better than spending 18 hours a day in the hospital like surgeons do. I like to study at home, with my wife bringing me ice tea

I think people should calm down about derm competitiveness. Saying that you want to get derm now would probably be the equivalent of a high schooler saying that he/she wants to get into a top 10 med school. If you set yourself up in the right way, it's not at all impossible.

 

[Law2Doc]

Saying that you want to get derm now would probably be the equivalent of a high schooler saying that he/she wants to get into a top 10 med school.

Agree with this. No point deciding you are going to be the top of your med school class until you are in the thick of it. You need to walk before you can fly, and talking derm now is more like needing to walk before you can space travel.

 

[sirus_virus]

Agree with this. No point deciding you are going to be the top of your med school class until you are in the thick of it. You need to walk before you can fly, and talking derm now is more like needing to walk before you can space travel.

Oh I am talking derm, I am talking derm big time.

 

[Towelie]

Oh I am talking derm, I am talking derm big time.

Is this your planned escape route?

You would probably be better off getting an MD/MBA and using hospital admin work (or consulting) as an escape route. This is easier to get than derm, and more lucrative.

 

[sirus_virus]

Is this your planned escape route?

You would probably be better off getting an MD/MBA and using hospital admin work (or consulting) as an escape route. This is easier to get than derm, and more lucrative.

No my escape route is to enslave my own crew of idealist doctors that are not in it for the money. BTW, I am finishing my MBA this semster.

 

[Towelie]

No my escape route is to enslave my own crew of idealist doctors that are not in it for the money. BTW, I am finishing my MBA this semster.

Cool. How far out of college are you?

 

[sirus_virus]

Cool. How far out of college are you?

MIS/03

 

[WantsThisBad]

$aving Live$

Ha.

 

[gujuDoc]

Premeds are not hypocrites. Perception of life changes real fast when you get those tuition loan statements and see your name sitting next to so many zeros.

That and the personal statement alot of times forces us to talk about medicine in a touchy feely way. One adcom here even said that's what they want to see. So its like they are telling us to write that. I think most of us could sum up why medicine in 2-3 lines and be done with it if this admissions process involved blunt truths. For some it would be money, for others it would be something like a result of wanting to make a change in the system because they were screwed by the system as a patient, along with a host of other reasons. So the hypocrisy is not solely fostered by premeds.

Secondly, I agree with people in saying that with experience and age people change and their views change. For instance, when a lot of people are younger they are liberal but as they start gaining family responsibilities and get older and realize a lot of their views they become more conservative. Similarly, when we are applying we only see what we want to see and don't know what it is like to live the life until we've gotten there.

After 3 years of tough hours (4th year not counted bc its a bit more relaxed) and another 3+ years of residency in long hours, people are beginning to think about what will give good hours and pay so that they can support their families and still have time with their kids so their kids have a relatively normal life. The responsibilities change as we age. There is nothing wrong with wanting a good lifestyle specialty. I think there's more wrong with going into medicine with an idealist mentality and not understanding what you are getting yourself into ahead of hand.

Go into the field that works best for you and work hard to get the grades and step 1/2 scores it takes to get there but like anything in life, that is easier said then done.

 

[gujuDoc]

Yeah well dermatologists aren't true doctors -- according to my Columbia interviewer.

One could say a cosmetic surgeon isn't either.
Notice I didn't say plastic surgeon but one that deals with cosmetic surgery only cuz other plastic surgeons work with burn victims and people with severe trauma that need reconstructive surgery.