why is it so hard to get into dermatology?

[titanlord1]

i know that its difficult but my question is how/why is it so difficult. i know many people want to get into it ( which makes it difficult) but why is there such a drive to enter dermatology?

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[JP2740]

hours and money - the same 2 factors that make any field competitive period.

Money tends to be more important than hours, but if you have both the short hours and money? Competitive as **** dude.

 

[DermViser]

i know that its difficult but my question is how/why is it so difficult. i know many people want to get into it ( which makes it difficult) but why is there such a drive to enter dermatology?

1) Completely outpatient based specialty
2) Ability to go into private practice and set your own hours -- see #1
3) Patients are relatively healthy
4) Patients are thankful for curing their skin problem vs. managing their HTN/DM2
5) Ability to sub-specialize or do it all: pathology, surgery, cosmetics, pediatrics, adult patients
6) Predictable family time in the evenings, not typically interrupted by emergencies.
7) Action-oriented - biopsy, cryo, laser, etc. to solve a patient's problem.
8) High autonomy, you do everything, none of this "team-based" care/PCMH stuff.

 

[Lucca]

Good work hours.
Mostly outpatient.
Incredible renumeration for the hours they put in.
Autonomy.

 

[JP2740]

1) Completely outpatient based specialty
2) Ability to go into private practice and set your own hours -- see #1
3) Patients are relatively healthy
4) Patients are thankful for curing their skin problem vs. treating their HTN/DM2
5) Ability to sub-specialize or do it all: pathology, surgery, cosmetics, pediatrics, adult patients
6) Predictable family time in the evenings not typically interrupted by emergencies.
7) Action-oriented - biopsy, cryo, laser, etc.

2 and 6 only above really apply. + money

 

[DermViser]

2 and 6 only above really apply. + money

Um, no. They all apply. I would know as I'm in the specialty.

 

[JP2740]

Um, no. They all apply. I would know as I'm in the specialty.

Do you pick up a lot of numbers bro?

 

[BestDoctorEver]

Medicine is an altruistic-driven profession, there lies the competition to get into a derm residency. I would like to see the personal statement of these derm residents when they were applying to med school.

 

[Brain Bucket]

Medicine is an altruistic-driven profession, there lies the competition to get into a derm residency. I would like to see the personal statement of these derm residents when they were applying to med school.

I'd like to see their personal statements for the match. Mainly to see what I have to write to get an interview.

 

[BurghStudent]

One reason people forgot: someone has a chokehold on the number of residency spots, just like in plastics. And then the chair of dermatology tells us we have a shortage of dermatologists, with their favorite extrapolated AAMC data.

 

[DermViser]

Medicine is an altruistic-driven profession, there lies the competition to get into a derm residency. I would like to see the personal statement of these derm residents when they were applying to med school.

You do know a personal statement for medical school is on medicine as a profession, not a specific specialty, right?

 

[DermViser]

One reason people forgot: someone has a chokehold on the number of residency spots, just like in plastics. And then the chair of dermatology tells us we have a shortage of dermatologists, with their favorite extrapolated AAMC data.

That someone is hospital administrators who are less likely to fund a derm spot (which is non-hospital based) vs. an inpatient hospital: IM, Ortho, etc.

 

[Dral]

Oh another thread about Derm being competitive. These are getting about as novel as the MD vs DO threads that litter the forums.

And OP, there really aren't a lot of people trying to get into it.

 

[WaylonS]

1) Completely outpatient based specialty
2) Ability to go into private practice and set your own hours -- see #1
3) Patients are relatively healthy
4) Patients are thankful for curing their skin problem vs. managing their HTN/DM2
5) Ability to sub-specialize or do it all: pathology, surgery, cosmetics, pediatrics, adult patients
6) Predictable family time in the evenings, not typically interrupted by emergencies.
7) Action-oriented - biopsy, cryo, laser, etc. to solve a patient's problem.

8) No-show patients are rare
9) For most conditions, results are immediate or fairly quick
10) Patients tend to be fairly compliant with medications and treatment plans

 

[CherryRedDracul]

If only I could get interested in skin pathology ...


Maybe a good Step 1 score will change that.

 

[BestDoctorEver]

You do know a personal statement for medical school is on medicine as a profession, not a specific specialty, right?

I just went thru the process, but that did not stop me from tilting my PS theme toward primary care specialties. After hearing so many drawbacks about being a PCP, it's becoming less and less appealing to me... Now let me get off my high horse and raise my Step1 target score to 240+... Lol

 

[KinasePro]

Medicine is an altruistic-driven profession, there lies the competition to get into a derm residency. I would like to see the personal statement of these derm residents when they were applying to med school.

I never understood the urge to feign interest in primary care in your personal statement. Seems risky to me, bc it's so easy to come across as insincere, cliche, or both.

Also, there's a million ways to express a mature, level-headed interest in the medical profession without pandering to the admission committee's primary care docs.

 

[DermViser]

If only I could get interested in skin pathology ...


Maybe a good Step 1 score will change that.

Yes, hence my avatar: http://www.gomerblog.com/2014/01/ma...ed-school-personal-statement-legally-binding/

 

[Instatewaiter]

Um, no. They all apply. I would know as I'm in the specialty.

 

[DermViser]

 

[mulberry]

Derm daily routine: take byopsy & send to pathology. Rinse and repeat.





(relaximonlykidding)

 

[BarcaBest23]

I think many folks enjoy how tangible disease and treatment results are. What you see is what you treat and you can see it/feel it with your senses vs. having to trend labs and believe you are being a good doctor when you CHF pts BNP comes down 100 points. Derm is similar to surgery in my opinion with obviously less cutting and less demanding hours, its for folks who like to physically sense the product of their work. Unfortunately, because Derm is so competitive, those who get in are often pretty pompous and constantly feel like they need to "prove the worth of Derm" similar to Derm Viser. Relax man, you made it, you are going to make good money working decent hours, go enjoy some of that cash and time not in front of a computer screen bickering about what derm does or doesn't have

 

[titanlord1]

I think many folks enjoy how tangible disease and treatment results are. What you see is what you treat and you can see it/feel it with your senses vs. having to trend labs and believe you are being a good doctor when you CHF pts BNP comes down 100 points. Derm is similar to surgery in my opinion with obviously less cutting and less demanding hours, its for folks who like to physically sense the product of their work. Unfortunately, because Derm is so competitive, those who get in are often pretty pompous and constantly feel like they need to "prove the worth of Derm" similar to Derm Viser. Relax man, you made it, you are going to make good money working decent hours, go enjoy some of that cash and time not in front of a computer screen bickering about what derm does or doesn't have

well said brother.

 

[DermViser]

I think many folks enjoy how tangible disease and treatment results are. What you see is what you treat and you can see it/feel it with your senses vs. having to trend labs and believe you are being a good doctor when you CHF pts BNP comes down 100 points. Derm is similar to surgery in my opinion with obviously less cutting and less demanding hours, its for folks who like to physically sense the product of their work. Unfortunately, because Derm is so competitive, those who get in are often pretty pompous and constantly feel like they need to "prove the worth of Derm" similar to Derm Viser. Relax man, you made it, you are going to make good money working decent hours, go enjoy some of that cash and time not in front of a computer screen bickering about what derm does or doesn't have

I don't feel the need to "prove the worth" of Derm. Pt demand for derm services and happiness for those services speaks for itself. Those who reflexively put down Derm, are displaying their own insecurities.

 

[Evil_Abed]

Unfortunately, because Derm is so competitive, those who get in are often pretty pompous and constantly feel like they need to "prove the worth of Derm" similar to Derm Viser. Relax man, you made it, you are going to make good money working decent hours, go enjoy some of that cash and time not in front of a computer screen bickering about what derm does or doesn't have

I haven't really worked with any dermatologists in real life, so I can't comment on that. But if you're referring to people doing this on SDN, I can understand why. Think about it: every time derm is brought up, people attack those who pick that field as being un-altruistic and motivated primarily by money/cush hours. Look at this thread, for example. Repeat these kinds of posts ad nauseum and you can see why some people might get defensive. They're forced to defend their choice because of how commonly they're attacked. And then, we bitch at them about them feeling like they "need to prove the worth of derm."

Dermviser gave a pretty reasonable list of reasons why people might choose derm and the next poster quoted it and subtracted everything except cush hours and money. If I was going into derm, I'd be kinda annoyed about that too. Is it any wonder why they get defensive, considering we keep giving them so much flak for it?

 

[@JackShephard]

I agree.

I've worked with some fantastic dermatologists who are very intelligent and care about their patients.

I think the internet makes them easy targets ($/lifestyle). But let's be honest, those are great things to have.

Saying they aren't contributing to healthcare is a bad argument though. Each physician does what they can.

I don't see everyone going into general surgery because they want to help people so desperately.

 

[JP2740]

Each physician does what they can

 

[@JackShephard]

I don't get it, why is that funny?

 

[JP2740]

I don't get it, why is that funny?

 

[@JackShephard]

I still don't get it.

Everyone is making a contribution and most everyone is doing the best they can.

 

[JP2740]

I still don't get it.

Everyone is making a contribution and most everyone is doing the best they can.

I guess you have more confidence in our future colleagues than I do. I think you are being ridiculously optimistic about the competence of many physicians.

 

[@JackShephard]

I guess you have more confidence in our future colleagues than I do. I think you are being ridiculously optimistic about the competence of many physicians.

Well, fair enough. I have a lot of faith in our colleagues. I lack the same optimism in our government.

The vast majority of physicians I've worked with have been hard working and competent.

 

[evilbooyaa]

I guess you have more confidence in our future colleagues than I do. I think you are being ridiculously optimistic about the competence of many physicians.

While I may not have confidence in my future colleagues (as in my med school classmates) yet, I trust that residency training will make them into serviceable physicians.

 

[Priapism4tooLong]

do you want to know what else is hard?

 

[Brain Bucket]

do you want to know what else is hard?

Is it wood?

 

[DermViser]

do you want to know what else is hard?

Is it made of bone?

 

[Priapism4tooLong]

oh you guys, i was talking about anesthesiology.

 

[Instatewaiter]

I don't feel the need to "prove the worth" of Derm. Pt demand for services and happiness for those services speaks for itself. Those who put down Derm, are displaying their own insecurities.

What does it speak to... patient vanity?

 

[DermViser]

What does it speak to... patient vanity?

No. Patient satisfaction. I'm sorry you can't see that.

 

[Instatewaiter]

Dermviser gave a pretty reasonable list of reasons why people might choose derm and the next poster quoted it and subtracted everything except cush hours and money. If I was going into derm, I'd be kinda annoyed about that too. Is it any wonder why they get defensive, considering we keep giving them so much flak for it?

If you took out the good work hours, derm would be about as competitive as surgery. If you took out the good money it would be as competitive as PM&R. Derm is not popular because it is derm. It is popular because it pays well for relatively little work. There's not necessarily anything wrong with that (other than needing to sell your soul). but let's call a spade a spade. Skin is not very interesting... but $450,000 for 40 hours a week makes it interesting...

 

[Instatewaiter]

 

[username456789]

If you took out the good work hours, derm would be about as competitive as surgery. If you took out the good money it would be as competitive as PM&R.

And if my aunt had balls, she'd be my uncle.

You've made it abundantly clear that you have disdain for dermatologists. You posted that scrubs clip several times as well, I believe.

You're the kind of person others are referring to when they talk about specialties trying to cut other specialties down, instead of trying to improve the entire profession as a whole. Grow up.

 

[DermViser]

If you took out the good work hours, derm would be about as competitive as surgery. If you took out the good money it would be as competitive as PM&R. Derm is not popular because it is derm. It is popular because it pays well for relatively little work. There's not necessarily anything wrong with that (other than needing to sell your soul). but let's call a spade a spade. Skin is not very interesting... but $450,000 for 40 hours a week makes it interesting...

The average dermatologist doesn't make $450,000 except maybe the ones in NY or LA that are doing cosmetic (cash only) practices. In Derm, we actually CURE many of the things our patients come to see us for and our patients are overall quite happy that we are able to do so, in which the results are visible, unlike say IM and its subspecialties. If you're a visually oriented type of person, then skin disease is very interesting. We get it, you're angry that the rest of us don't have as bad work hours as Cardiology, even though you're in one of the highest subspecialty salaries in IM, besides GI or Heme-Onc. Just goes to show that salary doesn't lead to happiness. You have to enjoy the material.

 

[DermViser]

You do know there is more to skin disease than just melanoma and acne right?

 

[username456789]

You do know there is more to skin disease than just melanoma right?

Sure, we have acne too.

 

[Mad Jack]

Medicine is an altruistic-driven profession, there lies the competition to get into a derm residency. I would like to see the personal statement of these derm residents when they were applying to med school.

I've trolled on derm before, but truthfully derm is an extremely important specialty for those that need it. You'll realize this very quickly the first time you or a loved one has a mole that's gone wonky and you can't get an appointment with a dermatologist for 4 months, an event you will likely experience or have someone close to you experience in their lifetime. Aside from the deadly stuff, derm deals with a lot of disfiguring and unsightly conditions that can significantly impact a patient's quality of life. Medicine isn't just about saving lives, it is (ideally) about improving our patient's lives through medical intervention, thus making them more worth living in the first place.

 

[DermViser]

And if my aunt had balls, she'd be my uncle.

You've made it abundantly clear that you have disdain for dermatologists. You posted that scrubs clip several times as well, I believe.

You're the kind of person others are referring to when they talk about specialties trying to cut other specialties down, instead of trying to improve the entire profession as a whole. Grow up.

I believe part of that stems from hating the specialty he's chosen - due to the ridiculous hours at expense of sleep, etc. That being said Cards is very well compensated (the other being GI), so something tells me he regrets using that as his barometer for his specialty choice.

 

[Slack3r]

I'll never understand why derm alone elicits this "oh, must've done it for the money HUR DUR" response from most med students, and worst of all, practicing physicians.

If someone chooses cardiology (Medscape average = $357k/yr), it's obviously because they love the heart pathology. Someone choosing ortho (Medscape average = $401k/yr <--the highest paid specialty on the list), those osteochondromas must've really spoken to them, huh?

But if someone chooses derm (Medscape average = $305k/yr, behind ortho, cardio, GI, uro, and radiology), it's probably SOLELY because of the money. I just don't get it. If you distill every specialty down to its worst elements, they all sound ****ty. Why derm suffers this more than anyone else is beyond me.

Instate, what's the matter? You didn't like ID or rheum? Throwing stents in fatties all day was your true calling? Probably had nothing to do with the hefty salary and the relative level of "prestige" afforded cardiologists both within and outside medicine, did it?

See? I can generalize too.

 

[Psai]

Every field should be like derm, I don't know why there's so much hate. Props to them for keeping a good wage with reasonable hours.

 

[Kaputt]

If you took out the good work hours, derm would be about as competitive as surgery. If you took out the good money it would be as competitive as PM&R. Derm is not popular because it is derm. It is popular because it pays well for relatively little work. There's not necessarily anything wrong with that (other than needing to sell your soul). but let's call a spade a spade. Skin is not very interesting... but $450,000 for 40 hours a week makes it interesting...

I find it hilarious that a so-called cards-fellow has so much free-time to come on to sdn to bash derm for not being "real docs".