why is it so hard to get into dermatology?

[username456789]

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.

Jealousy and a lack of understanding of what Derm actually is/involves.

Part of the problem likely stems from our poor ability to convey to medical students the breadth of dermatological disease. As a result, we end up with dolts like Instatewaiter who, whether they genuinely believe it or not, propagate the idea that Derm is all acne and eczema (and cosmetics!).

I respect all specialties (although that is not synonymous with all specialists). I find it unfortunate that working conditions for many of them are less than desirable. I find it ridiculous and kind of sad that the overlying sentiment by many in those fields is that they would prefer us to come join them in their misery rather than improve their own working conditions.

It's easy to throw stones from a glass house when you're never home anyway.

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[Nasrudin]

I don't have player hater bone in my body and am entering perhaps the most maligned and misunderstood field and have nothing but admiration for those who were good enough to match into derm. If you can crush the boards like a monster and crank out publications during medical school and make sure every supervising physican adores you....then you're just simply better at stuff than me. And you deserve the prize--whatever you decide that is.

Judging people for choosing flexibility, compensation, hours, etc while all around us is sinking into a morass of frustration just makes you a zealot with your head up your @ss.

 

[notbobtrustme]

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.

ya, that'd be nice in an ideal world, but unfortunately, many emergencies don't happen between office hours, Monday through Friday 🙁

 

[Instatewaiter]

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, so something tells me he regrets using that as a barometer for his specialty choice.

Nah, I love my specialty of choice and chose it for the pathophysiology. Had I wanted $ and lifestyle alone, I would have done derm or allergy or whatever. I don't begrudge derm for the good lifestyle or money nor do I fault people for choosing lifestyle and money because it is a reasonable choice. In all honesty, most specialties can have good money/lifestyle with a little innovation and the right patient population- even general medicine, general peds and FM.

More importantly, it's just too much fun to pick on you and your specialty. You get so defensive.

 

[Instatewaiter]

Jealousy and a lack of understanding of what Derm actually is/involves.

Part of the problem likely stems from our poor ability to convey to medical students the breadth of dermatological disease. As a result, we end up with dolts like Instatewaiter who, whether they genuinely believe it or not, propagate the idea that Derm is all acne and eczema (and cosmetics!).

I respect all specialties (although that is not synonymous with all specialists). I find it unfortunate that working conditions for many of them are less than desirable. I find it ridiculous and kind of sad that the overlying sentiment by many in those fields is that they would prefer us to come join them in their misery rather than improve their own working conditions.

It's easy to throw stones from a glass house when you're never home anyway.

So, how did it feel when you sold out?




I kid, I kid...

 

[Instatewaiter]

No but really, did they give you the money for your soul up front or did you get it in installments?

 

[username456789]

No but really, did they give you the money for your soul up front or did you get it in installments?

There was a stack of crisp Benjamins in my match day envelope.

 

[Instatewaiter]

There was a stack of crisp Benjamins in my match day envelope.

Touche

 

[Psai]

Nah, I love my specialty of choice and chose it for the pathophysiology. Had I wanted $ and lifestyle alone, I would have done derm or allergy or whatever. I don't begrudge derm for the good lifestyle or money nor do I fault people for choosing lifestyle and money because it is a reasonable choice. In all honesty, most specialties can have good money/lifestyle with a little innovation and the right patient population- even general medicine, general peds and FM.

More importantly, it's just too much fun to pick on you and your specialty. You get so defensive.

More like you get so offensive.

 

[Kaputt]

Nah, I love my specialty of choice and chose it for the pathophysiology. Had I wanted $ and lifestyle alone, I would have done derm or allergy or whatever. I don't begrudge derm for the good lifestyle or money nor do I fault people for choosing lifestyle and money because it is a reasonable choice. In all honesty, most specialties can have good money/lifestyle with a little innovation and the right patient population- even general medicine, general peds and FM.

More importantly, it's just too much fun to pick on you and your specialty. You get so defensive.

You're not as amusing as you think you are

 

[DermViser]

Nah, I love my specialty of choice and chose it for the pathophysiology. Had I wanted $ and lifestyle alone, I would have done derm or allergy or whatever. I don't begrudge derm for the good lifestyle or money nor do I fault people for choosing lifestyle and money because it is a reasonable choice. In all honesty, most specialties can have good money/lifestyle with a little innovation and the right patient population- even general medicine, general peds and FM.

More importantly, it's just too much fun to pick on you and your specialty. You get so defensive.

I don't see how it's so hard for you to believe that those who are visually-oriented and have an acute attention for colors, detail, and morphology are a good fit for dermatology. Dermatologic pathology, esp. at academic medical centers in major cities, is much more expansive than community suburbia. It's an inherently outpatient specialty based on its subject matter.

Up until recently, Radiology, which was even a better option money-wise than Derm, also attracted those who are visually-oriented and Rads also had a good lifestyle. Yet Radiology doesn't get any flack from you vs. Derm.

Cardiologists may proclaim their love for pathophysiology, but if they're interventional cardiologists, the truth is they more like doing procedures - stents, etc. Cardiologists that aren't interventionalists do pill titration, nuclear imaging, etc. If Cardiology was only allowed pill titration they'd be making much lower.

 

[titanlord1]

why is it that for residencys they would rather pick US students rather than caribean med students to match in lets say dermatlogy? whats the reasoning.

 

[username456789]

why is it that for residencys they would rather pick US students rather than caribean med students to match in lets say dermatlogy? whats the reasoning.

The same reason I take my wife to a fancy restaurant for our anniversary instead of McDonald's.

 

[titanlord1]

but lets say we get the same step 1 score.

 

[username456789]

but lets say we get the same step 1 score.

The quality and consistency of US allopathic medical schools and the clinical education their students receive can be vouched for. The same cannot be said of Caribbean schools.

 

[Psai]

why is it that for residencys they would rather pick US students rather than caribean med students to match in lets say dermatlogy? whats the reasoning.

The same reason I eat steak instead of potatoes.

 

[JP2740]

but lets say we get the same step 1 score.

Do derm residencies have trouble filling their spots? There are plenty of explanations, but for a residency that is consistently full- I think the discussion can simply end at the fact that they really have no reason whatsoever to consider carribean students. There are a plethora of qualified US students.

 

[Nasrudin]

but lets say we get the same step 1 score.

Are you trolling? Do have any idea about the level of competition to match derm? They don't need to sift through a stack of applicants who didn't have the stuff to make it into a US school. They have tons of superbly qualified applicants from top US medical schools with known derm people backing them.

Not everyone gets a trophy for showing up in this contest. Get used to it.

 

[Kaputt]

why is it that for residencys they would rather pick US students rather than caribean med students to match in lets say dermatlogy? whats the reasoning.

It's not just dermatology. Caribbean students have no shot at ENT, ophtho, ortho, urology, plastics, or top-tier programs in IM, radiology, or gen surg. There are enough awesome US med students that come from high-quality, LCME-accredited institutions to fill those spots. A medical student is not judged solely on Step 1 score alone. The quality of education is vastly different when you compare US schools and Caribbean schools.

 

[FIREitUP]

after telling people about my decision to go into derm i've caught a lot of flak. but to be honest, i couldn't care less. being in derm clinic was one of the only times during third year that i actually enjoyed myself.

 

[titanlord1]

what shot do caribean students have at residency? can you name them please?

 

[KinasePro]

The amount of **** derm catches from everyone is a just another indicator of exactly how great the field is. I believe it was Socrates that once said "Haters will indeed hate."

 

[Nasrudin]

It's not just dermatology. Caribbean students have no shot at ENT, ophtho, ortho, urology, plastics, or top-tier programs in IM, radiology, or gen surg. There are enough awesome US med students that come from high-quality, LCME-accredited institutions to fill those spots. A medical student is not judged solely on Step 1 score alone. The quality of education is vastly different when you compare US schools and Caribbean schools.

While I agree with your broadening the point to include other competitive specialties I think only part of it is educational quality. Because there is most certainly people just as capable from schools all over the world from all manner of institutional quality.

I think of it more like...say I'm a Derm PD...in all my years in derm I've met hundreds of people on the inside. How many calls from personal friends and close colleagues or superstars in the field who I respect do I get every year trying to convince me to take this kid they've reared up personally who is the next Derm Jesus. And so on.

I just don't have to look through that stack of "others" who come unknown and untitled to my doorstep with a good step 1 score in hand that is common as dirt in the derm game.

 

[titanlord1]

AUA is a caribean school and this is where they obtained rotations http://www.auamed.org/graduate-success
some people obtained radiology ( i count three), some neurology, general surgeregy, the list goes on. its hard but it can be done to match to dermatology.

 

[Nasrudin]

The amount of **** derm catches from everyone is a just another indicator of exactly how great the field is. I believe it was Socrates that once said "Haters will indeed hate."

But whatever though. It's only during med school you will even notice or encounter this. When you guys get thousands of internet wingnuts making conspiratorial documentaries about the sinister intent of the Dermatology/pharmaceutical cabal....come talk to me about field haterism.

 

[mcloaf]

AUA is a caribean school and this is where they obtained rotations http://www.auamed.org/graduate-success
some people obtained radiology ( i count three), some neurology, general surgeregy, the list goes on. its hard but it can be done to match to dermatology.

You enter thread, ask about Caribbean grads matching derm. Then ask about carib grads matching anything. Then look up a match list and conclude that because it contains radiology, neurology, and gen surg that matching derm is possible. Nothing is impossible, strictly speaking I guess, but are you for real with this logic?

 

[titanlord1]

You enter thread, ask about Caribbean grads matching derm. Then ask about carib grads matching anything. Then look up a match list and conclude that because it contains radiology, neurology, and gen surg that matching derm is possible. Nothing is impossible, strictly speaking I guess, but are you for real with this logic?

its crazy but it might just work....

 

[mcloaf]

its crazy but it might just work....

Honestly I feel like this should be the motto of carib schools.

 

[username456789]

But whatever though. It's only during med school you will even notice or encounter this.

That's definitely not true.

 

[username456789]

its crazy but it might just work....

Well, you're half right.

 

[titanlord1]

Honestly I feel like this should be the motto of carib schools.

lol spot on. carib schools can be so sketchy.

 

[Nasrudin]

That's definitely not true.

Ok I'll take your word for it. I don't hate so I guess I'm not up on it. I still think you have a ways to go to get to where psych is--who's enemies are legion.

 

[titanlord1]

also to add to that list, two managed to match into anethioslogy. (spelling)

 

[Kaputt]

While I agree with your broadening the point to include other competitive specialties I think only part of it is educational quality. Because there is most certainly people just as capable from schools all over the world from all manner of institutional quality.

I think of it more like...say I'm a Derm PD...in all my years in derm I've met hundreds of people on the inside. How many calls from personal friends and close colleagues or superstars in the field who I respect do I get every year trying to convince me to take this kid they've reared up personally who is the next Derm Jesus. And so on.

I just don't have to look through that stack of "others" who come unknown and untitled to my doorstep with a good step 1 score in hand that is common as dirt in the derm game.

I agree that in many specialties, especially derm, connections help. The people who are writing your letters or stepping up to bat for you can really make the difference. But I think it goes beyond that, and beyond "quality of education". Competitive residencies love pedigree. Just like how top tier med schools love taking students from Ivy/top colleges. There is a clear pecking order, and competitive programs, no matter how pretentious anyone finds it, don't want Caribbean grads. They want US grads. Because the perception is that Caribbean grads only get the residencies that US grads don't want (which is kind of a self-fulfilling cycle).

 

[Instatewaiter]

why is it that for residencys they would rather pick US students rather than caribean med students to match in lets say dermatlogy? whats the reasoning.

The same reason I take my wife to a fancy restaurant for our anniversary instead of McDonald's.

So, dermatology residency take more US students because they put out more?

 

[Instatewaiter]

I don't see how it's so hard for you to believe that those who are visually-oriented and have an acute attention for colors, detail, and morphology are a good fit for dermatology.

Really? Your reasoning is that you like colors and shapes so you choose derm.

Now you're just grasping at straws

 

[notbobtrustme]

You enter thread, ask about Caribbean grads matching derm. Then ask about carib grads matching anything. Then look up a match list and conclude that because it contains radiology, neurology, and gen surg that matching derm is possible. Nothing is impossible, strictly speaking I guess, but are you for real with this logic?

gonna go out on a limb and say that his verbal score was not the highlight of his application

 

[Instatewaiter]

The amount of **** derm catches from everyone is a just another indicator of exactly how great the field is. I believe it was Socrates that once said "Haters will indeed hate."

IM catches a lot of **** as well. That is not an indicator that it is a great field.

 

[notbobtrustme]

I agree that in many specialties, especially derm, connections help. The people who are writing your letters or stepping up to bat for you can really make the difference. But I think it goes beyond that, and beyond "quality of education". Competitive residencies love pedigree. Just like how top tier med schools love taking students from Ivy/top colleges. There is a clear pecking order, and competitive programs, no matter how pretentious anyone finds it, don't want Caribbean grads. They want US grads. Because the perception is that Caribbean grads only get the residencies that US grads don't want (which is kind of a self-fulfilling cycle).

Nobody wants Carib/IMGs grads. Some residencies have no choice to take Carib grads because AMDs won't touch their program with a 10 ft pole.

 

[Kaputt]

AUA is a caribean school and this is where they obtained rotations http://www.auamed.org/graduate-success
some people obtained radiology ( i count three), some neurology, general surgeregy, the list goes on. its hard but it can be done to match to dermatology.

There is a broad spectrum of competitiveness of radiology programs (just like internal medicine). The 3 programs that AUA people matched at (Dartmouth, St Joseph Mercy Oakland, and Stony Brook) are not terribly competitive programs. It's virtually impossible for a Carib applicant to be considered by the top radiology programs, which is what my prior post stated. That's just the way it is. If you can find a Carib grad who has matched to MGH or Hopkins radiology I would graciously retract that statement but I don't think it's ever happened.

The point is that there is a certain tier of competitiveness that Caribbean folks are simply locked out of. That includes virtually all of derm, ENT, ortho, ophtho, and urology and the top programs in IM, radiology, and gen surg.

Mad props to that one AUA person who matched integrated plastics. A true blip in the data that should be taken as the exception, not the rule.

 

[KinasePro]

IM catches a lot of **** as well. That is not an indicator that it is a great field.

It's not even comparable though. IM catches **** on SDN (especially recently...), but not nearly as much IRL.

Besides, IM docs run most med schools and have what is essentially a bully pulpit. Maybe it's just my institution, but I've heard countless subtle and not-so-subtle jabs at Derm since MS-1 from various faculty. Meanwhile, IM is portrayed as the gold standard, the "real" brand of medicine that everyone allegedly writes about in their personal statements, etc...

 

[Anastomoses]

Really? Your reasoning is that you like colors and shapes so you choose derm.

Now you're just grasping at straws

I give you that DermViser has some weaknesses with logic but in this case he's just positing a possibliity that may very well be true. Let's face it, if someone does that well, they'll join the type of medicine they like best out of the top options. There isn't JUST derm available to such people. So they picked derm. Some high scoring individuals pick FM or Pediatrics...I don't get it, but they may genuinely like it.

I don't understand why this topic even comes up. I figure if the greatest minds in medicine want to do derm and plastics and ortho - fantastic for their patient populations! You do you.

 

[titanlord1]

It's not even comparable though. IM catches **** on SDN (especially recently...), but not nearly as much IRL.

Besides, IM docs run most med schools and have what is essentially a bully pulpit. Maybe it's just my institution, but I've heard countless subtle and not-so-subtle jabs at Derm since MS-1 from various faculty. Meanwhile, IM is portrayed as the gold standard, the "real" brand of medicine that everyone allegedly writes about in their personal statements, etc...

what is MS-1

 

[username456789]

So, dermatology residency take more US students because they put out more?

Two all-beef patties, special sauce, lettuce,cheese, pickles, onions - on a sesame seed bun.

 

[username456789]

what is MS-1

You'll know when you get there.

 

[Instatewaiter]

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.

You spoke of patient satisfaction in this thread and another... It's a worthless metric. Here's proof:
http://archinte.jamanetwork.com/article.aspx?articleid=1108766

"Conclusion In a nationally representative sample, higher patient satisfaction was associated with less emergency department use but with greater inpatient use, higher overall health care and prescription drug expenditures, and increased mortality."

 

[Psai]

There's a difference between patients being happy with their treatments and "patient satisfaction" scores as graded by people that wouldn't know good medical care if it bit them in the ass and give you a bad score for their chronic dilaudidopenia and lack of prescription antibiotics for their viral infection.

 

[DermViser]

Really? Your reasoning is that you like colors and shapes so you choose derm.

Now you're just grasping at straws

You say you like Cardiology bc you like pathophysiology. Obviously that's not entirely the case, bc you're so angry that your specialty's hours are pretty bad. So instead of taking it up with your specialty society, you hate on Derm.

 

[DermViser]

You spoke of patient satisfaction in this thread and another... It's a worthless metric. Here's proof:
http://archinte.jamanetwork.com/article.aspx?articleid=1108766

"Conclusion In a nationally representative sample, higher patient satisfaction was associated with less emergency department use but with greater inpatient use, higher overall health care and prescription drug expenditures, and increased mortality."

Genius, I never said that it's a metric that should be used to objectively evaluate doctors. The patient satisfaction is re: results after the patient and I both agree on a management/treatment plan. This gives me personal satisfaction. I'm not talking about patient satisfaction in choosing his/her own treatment plan that I disagree with and that may be harmful to the patient's health.

 

[Priapism4tooLong]

How many imgs match into derm? I doubt very many.