I've mentioned on this blog before that I had good grades and scores in med school, although not freaking awesome. So it seems like the reason I didn't do dermatology should be obvious: I wasn't freaking awesome. And that's what you need to be to match in derm these days.
But between you and me, I actually did have a possible opportunity to do derm. My cousin is a big cheese dermatologist and assured me multiple times that he'd get me a residency spot if I wanted it. I don't know if this was a true offer, but needless to say, I didn't take him up on it. It was tempting, for sure. Dermatologists make good money and have a great lifestyle. I like procedures and dermatologist get to do lots of those. Part of the reason I didn't try was because of location (yet again), but there were some other reasons:
1) I looked at the people in my class who matched in derm and I thought about those people being my colleagues for the rest of my life, and I felt ill.
2) I felt that as a dermatologist, the pressure to have perfect skin would be too intense, and would cause me to break out.
3) I have a slight inherited tremor in my hands that I worry might get worse with age and keep me from doing really fine work.
4) I didn't like the idea of getting a spot through nepotism. Everything I've ever gotten in my life was earned through my own hard work and it didn't feel right to take a coveted spot just because of connections.
All that aside, I feel angry at the culture of dermatology. When I was in med school, a young girl came to talk to our class about her experience with bullous pemphygoid and how it inspired her to want to be a dermatologist, and all I could think was, "Good luck with that." Here was a person who was genuinely interested in skin conditions, yet she had very little chance of becoming a dermatologist because it's so damn competitive. Your dermatologists don't have a passion for skin, trust me.
I've heard that the number of dermatology spots are intentionally limited, so that it continues to stay competitive and salaries remain high. This is why we have to wait so long to see a dermatologist. Plus a lot of the females who go into the field do it for lifestyle, and the first thing they do after graduating is to cut back to parttime. I can't personally throw stones at that, but it kind of sucks to limit the number people going into a field, when many of those people don't intend to work full time.
In general, I don't think it says anything great about physicians that the most competitive fields are the ones with the highest pay and best lifestyle. But again, can't throw stones.
You nailed it. Derm MD I knew from FancyPants Medical school/residency was a male who worked 4 days a week and hated it. Wished he became a musician instead (his true passion).
ReplyDeleteThe one girl I knew who matched into Derm at my school was really quite nice. However, she studied HARD (at levels no one could match). Furthermore, she studied everything without joy or love of the material. While most of what we study in medical school is dry and hard to love, there is always something that catches our attention. With her it seemed that nothing but matching derm would make her happy. It was a little sad to see, but in a sense I really admired her focus.
ReplyDeletePDG
Very interesting, because it's a little different in South Africa... there is a shortage of dermatologists working in public hospitals (not really a shortage in private), and med students tend to consider it "lovely but lame".
ReplyDeleteThe dermatologists on my rotation were also awesome people, but obviously very bright.
I think #2 would be a very valid reason for me too, and #4 is a good reason too.
Wow, it's so different here. Derm is usually for the ones who don't have the best grade. I had a friend who really wanted to do derm, but changed his mind against it, because he felt he was too smart for it, and would rather go into neuro. It's kinda sad how these things work.
ReplyDeleteI also think it is funny how the general public has no idea about all this nonsense. There's too much physician on physician hate out there.
ReplyDeleteI thought about derm, briefly, after I got my step 1 score. My own doctor's wife does derm. She works 2 days a week. My doctor works 5. He told me she makes more than he does. Compelling, if you like it, not worth it if you don't,
ReplyDeleteMy biostatistician (who is Australian) told me that in Aus, Dermatologists are kind of like dentists.
ReplyDeleteFizz, can you do PM&R even though you did it?
ReplyDeleteBelieve it or not, I actually understand this request. I'll try to do it.
DeleteHaha...thanks! :)
DeleteCould you do rad onc? It's such an obscure field yet very attractive to a lot of students..
ReplyDeleteI would if I knew anything about rad onc or even considered it for a half second.
DeleteMS3 here. I have the grades and board scores for derm, but sadly I don't have the heart. You can't beat the pay (and I'm going to be over 300k in debt) for that lifestyle (and I'd like to be involved in my kids' lives), so I feel like I SHOULD be gunning for derm. Like you said, however, I look at the people in derm... and that's just not me. I'm more excited by the idea of running around an ED at 3am with no makeup and my hair in a messy bun than the idea of sitting in a cushy office all day evaluating/treating acne, rashes, skin cancers, etc. Maybe that will change someday. I think I'll end up in IM subspecialty, EM or critical care... but I'll always wonder if I could have done derm without wanting to shoot myself in the face.
ReplyDeleteHi there! I'm a nursing student & also a recent patient of a dermatologist.
ReplyDeleteI live in a mid-sized city in Northern Ontario and the dermatologist who has an clinic here (make that a doctor's office/expensive cosmetic/aesthetic procedure clinic) is the only dermatologist for all of Northern Ontario with a very long waiting list.
Last year I got a referral from my family doctor to see her for some issues I was having with slight hirsutism (which ended up only being more of a inheritance compared to a hormonal problem, according to my bloodwork.) I think the only reason I was able to see her so quickly was also because I made an appointment for laser hair removal at her clinic, and since I was already there for that and they were getting paid for the consult, the doctor saw me.
She prescribed me 100mg of spironolactone for its androgen reducing qualities (my nursing drug guide has done me well) and I'm just about to refill my prescription, which will give me at least 100+ days until I need to renew my prescription.
My only problem is that I'll probably need to make the appointment now to be seen in time to refill the prescription.
I mean, I could be wrong seeing as this is my first time seeing a dermatologist and being prescribed medications, so I really don't know what the routine is for renewing prescriptions, but I have a feeling it's not going to be working in my favour.
I just thought this post was really interesting (and I now I realize I probably didn't need to post my whole life story here) and I wanted to share my experience with a derm who seems to be like the ones you mentioned in the above post.
haha, here's it's known as dermaholiday, and really isn't competitive!
ReplyDeleteYou are really bitter about not being a dermatologist. That's unfortunate. There are a lot of Derms who are excited and invested in treating skin disease. Most of us do work full time. You should work on giving accurate information. There is a shortage of dermatologists because the federal government refuses to fund more spots as they do not feel that the field is a priority and would rather fund spots for primary care. Try reducing the vitriol and increasing the factual information. Thanks....
ReplyDeleteI'm not bitter about not being a dermatologist, since as I said, I could have gotten a spot if I wanted one. I *am* bitter about the incredibly unpleasant interactions I've had with future dermatologists that I worked with. And hey, here's one more! Way to prove the stereotype.
DeleteYou have no idea at all if you would have got into a residency position, the influence of 'one big cheese' is often overstated, decisions are made by committees to avoid such influence.
ReplyDeleteYou need good grades because it is a demanding speciality with hundreds of disease that are difficult to diagnose.
Sorry you did not like your colleagues in Medical School. I wont what they would have thought of you?
Shame thats enough for you to tar an entire speciality.
There are 'shortages' of dermatologists because 25% of the population has skin issues and all the other doctors out there know very little about skin problems.
Do you know for sure that the person with experience in BP did not get in? Places do get filled you know, and a lot of the time its not the best and the brightest even though it should be. Just wanting to do something does not automatically get you in, how many people did you beat out to get into medical school? I bet some of them were really passionate about wanting to be a doctor. Passion alone does not get you there.
Forgive me for not "trusting you" that doctors who choose and work hard to get into a specialty they love "do not have a passion for skin". Your comments really show you have no idea what you are talking about and belittle the many doctors who work hard for people suffering with skin disorders.
There is no one specialty better than another. A dermatologist is as much use to a person having a heart attack as a cardiologist is to someone with lichen planus. We all do good work, we are all needed. Your simple minded dismissal of a specialty reveals more about you than the specialty.
here let me save you some finger taps
"well...uhhh..you just proved (my made up) stereotype"
The few people in my class who matched in derm were universally despised by the rest of the class for their behavior in clerkships. One of them was so passionate about skin that on every clerkship he was on, he swore to the attendings he was interested in that particular specialty. On peds? "I want to be a pediatric cardiologist!" Their behavior was abominable. It's a shame that's what it takes to match in derm, but it's just a fact.
DeleteActually, you've just inspired me to write a new post about competitiveness! Thanks! To be continued....
What are derm wannabes/residents like, exactly?
ReplyDeleteLoved this post. #1 was the major reason I can't stand people applying into derm, either.
ReplyDelete