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  • So you want to be a dermatologist. You like the idea of treating nails, hair, and the

  • largest human organ, the skin. Let's debunk the public perception myths of what it means

  • to be a dermatologist, and give it to you straight. This is the reality of dermatology.

  • Dr. Jubbal, MedSchoolInsiders.com.

  • Welcome to our next installment in So You Want to Be. In this series, we highlight a

  • specific specialty within medicine, such as dermatology, and help you decide if it's

  • a good fit for you. You can find the other specialties on our So You Want to Be playlist.

  • A lot of you asked for dermatology, so that's what we're covering here. If you want to

  • vote in upcoming polls to decide what future specialties we cover, make sure you're subscribed.

  • If you'd like to see what being a dermatologist looks like, check out my second channel, Kevin

  • Jubbal, M.D., where I do a second series in parallel called a Day in the Life. Once the

  • world is back to a more normal baseline, we'll be doing a Day in the Life of a Dermatologist.

  • Dermatology is the specialty that manages diseases of the skin, hair, and nails, and

  • involves both medical and procedural aspects. Skin may seem relatively straightforward,

  • but it's far more complicated than it seems. A dermatologist can identify and treat more

  • than 3,000 conditions, including eczema, psoriasis, and skin cancer, among others.

  • You can think of dermatology as falling within 4 main categories:

  • Medical dermatology deals with the general and common dermatologic concerns, such as

  • skin cancer, viral warts, acne, rosacea, hair loss, and rashes. This also includes some

  • procedures such as injections, skin biopsies, and excisions.

  • General dermatology is very predictable, with fast-paced office visits but also longitudinal

  • continuity with patients. At academic institutions, you can expect to manage more complex skin

  • diseases as well.

  • It's much more than just acne though. The conditions they treat are wide ranging, such

  • as inflammatory skin conditions, psoriasis, eczema, ulcerative skin conditions, and blistering

  • skin conditions that may requite systemic medications or chronic management.

  • Aesthetic dermatology primarily deals with cosmetic concerns, such as rhytides and wrinkles,

  • volume loss, hyperpigmentation, textural changes, scar revisions, and rednessall through

  • cosmetic procedures and laser technologies. This is also clinic-based with in-office procedures.

  • Procedures include blepharoplasties to fix droopy eyelids, rhytidectomies also known

  • as facelifts, fat transplantation, laser resurfacing, chemical resurfacing, microdermabrasion, collagen

  • fillers, botox, sclerotherapy, and scar revision.

  • Surgical dermatology focuses on Mohs micrographic surgery, which is a precise surgical technique

  • used to treat skin cancer. Mohs surgeons don't just do Mohs surgery, though. They often overlap

  • with simple excisions, as you would in general dermatology, as well as cosmetic dermatology

  • procedures.

  • While this is as surgical as dermatology gets, understand that these are still clinic-based,

  • in-office procedures. This doesn't happen in the operating room. Patients generally

  • only need local anesthetics.

  • You're also more likely to have repeat customers. Not only do these patients need follow up

  • for monitoring their excised skin cancers, but once you get skin cancer, you're also

  • at higher risk of getting another.

  • Inpatient dermatologists work as a consult to primary services in the hospital, such

  • as internal medicine, pediatrics, or surgery, who are managing hospitalized patients with

  • dermatologic conditions. These dermatologists work in other capacities and have their own

  • clinical practices, but can be on call for the hospital.

  • There is a short list of dermatologic emergencies, and while there aren't many, these are the

  • dermatologists who would be providing recommendations to the managing service.

  • Patients in this category can be very sick and develop skin diseases concurrently, or

  • alternatively the skin disease can be a systemic disease manifestation, telling the story of

  • what other disease processes are occurring under the surface.

  • After finishing medical school, you'll complete a 1 year prelim year or transitional year.

  • This first year is called your intern year. After that, dermatology residency is 3 years.

  • There are a few combined internal medicine/dermatology 5 year programs, but there are only a few

  • in the entire country. The 1 + 3 model is much more typical.

  • In terms of competitiveness, dermatology is consistently the first or second most competitive

  • specialty in medicine, switching off with plastic surgery depending on the year. The

  • average Step 1 score is 249 and average Step 2CK score is 256.

  • Approximately half of practicing dermatologists are female, and about 2/3 of dermatology trainees

  • are women.

  • Dermatology residency is more cush than most, and you'll on average be enjoying fewer

  • and more predictable hours than even your nonsurgical colleagues.

  • There are a handful of fellowships to choose from after residency, each lasting between

  • 1 and 2 years.

  • Mohs surgery requires a 1-2 year fellowship. The joke is that these people wanted to become

  • surgeons, but also wanted a good schedule and lifestyle. Compared to other dermatologists,

  • the stereotype is that they may have a lower tolerance for mistakes, work at a fast pace,

  • and tend to be perfectionists.

  • This is the specialty for those dermatologists who enjoy working with their hands and the

  • process of spending years fine tuning nuanced technique.

  • Cosmetic dermatology is a 1 year fellowship. You're more likely to be doing private practice,

  • and to be successful here you should have an entrepreneurial inkling.

  • If you love children and want to work with kids, but also love skin, then pediatric dermatology

  • is a good fit for you.

  • Peds derm is a 1 or 2 year fellowship for those who want to work with the pediatric

  • population exclusively. While generally clinic-based, this may require visits to the operating room,

  • usually at academic institutions, as kids sometimes require sedation to tolerate procedures.

  • Dermatopathology is a 1 or 2 year fellowship after completing either a pathology or dermatology

  • residency. You may choose to be focused exclusively on dermatopathology, or you may choose to

  • have a few days of clinic. This is ideal for those who are highly visual, love recognizing

  • patterns, and love histology. Plus, it offers a highly predictable schedule, as you're

  • looking through a microscope for most of the day.

  • There's a lot to love about dermatology, and it attracts a large number of medical

  • students. It's no surprise that it's one of the most competitive specialties. In a

  • recent Medscape Lifestyle, Happiness, & Burnout Report, dermatology ranked first in terms

  • of happiness compared to other specialties.

  • Dermatology is a highly visual field with high clinic volume that's relatively fast-paced

  • compared to other specialties. It's also a field that allows for both medical aspects

  • and procedural aspects, which is appealing to someone who desires continuity with patients

  • in addition to performing detail-oriented procedures.

  • You may not fully appreciate this now if you're early on in your training, but dermatologists

  • also spend less time than the average physician on paperwork and administration. That's

  • a huge deal.

  • And if you appreciate beauty in your work, in a visual way, cosmetic dermatology is an

  • attractive optionno pun intended.

  • One of the strongest draws is the excellent lifestyle and work-life balance that isn't

  • afforded by most other disciplines within medicine. Given the outpatient nature, low

  • acuity of medical conditions, limited call, and flexible workdays, dermatologists generally

  • have more control over how they work.

  • It also doesn't hurt that dermatologists are highly compensated, usually ranking in

  • the top 5 highest paid specialties in medicineon average over $400,000 per year.

  • Dermatology isn't perfect. One of the most obvious downsides is how insanely competitive

  • it is. It's a desirable specialty, but a small specialty, with a limited number of

  • residency spots. For this reason, many applicants find it necessary to take several years off

  • during medical school to bolster their application with dermatology research to improve their

  • chances.

  • You may find the field often misunderstood. Those who don't fully understand and appreciate

  • the specialty may dismiss your profession as being only skin-deep. Typical surgeons

  • often won't consider your work real surgery, even if you specialize in Mohs.

  • The fast-paced nature of clinic is a double edged sword. On one hand it's exciting and

  • engaging, but on the other hand it may not suit all personalities, particularly if you

  • want to spend more time with a patient.

  • How can you decide if dermatology is a good fit for you?

  • If you love the pathologies related to skin, enjoy working in clinic at a fast pace, like

  • procedures, but not so much to be surgical, and are willing to be a self-directed learner

  • to tackle the amount of independent study that is required to be successful, then dermatology

  • may be worth considering.

  • And finally, dermatology is one of the most competitive specialties, so you'll need

  • to be willing to put in the time and effort to become a top student. That translates to

  • more than just high board scores, but also playing the research game, being a leader,

  • and acing your clinical rotations.

  • And who better to learn from and be mentored by than dermatologists themselves. Big shout

  • out to the dermatologists at Med School Insiders that helped me in the creation of this video.

  • If you need help acing your MCAT, USMLE, or other exams, our tutors can maximize your

  • test day performance. If you're applying to medical school or dermatology residency,

  • our dermatologists can share the ins and outs of what it takes and how to navigate the highly

  • competitive process most effectively. We've become the fastest growing company in the

  • industry, and it's no surprise. Our customers love us because we're committed to delivering

  • results, period. Learn more at MedSchoolInsiders.com .

  • Thank you all so much for watching! What specialty do you want me to cover next? Leave a comment

  • down below, and make sure you're subscribed to vote in the upcoming polls. If you enjoyed

  • the video, hit that thumbs up button to keep the YouTube gods happy. Much love to you all,

  • and I will see you guys in that next one.

So you want to be a dermatologist. You like the idea of treating nails, hair, and the

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B1 skin specialty clinic dermatologist residency cosmetic

So You Want to Be a DERMATOLOGIST [Ep. 11]

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    Summer posted on 2020/07/30
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