So you want to be a Board Certified Dermatologist?

03 Jan So you want to be a Board Certified Dermatologist?

The practice of dermatology is centralized around the medical treatment of diseases, impairments, and issues related to the skin, as well as scalp, hair and nail. While there are many avenues and possibilities for a rewarding career as a medical professional, dermatology is one of the most appealing and consequently one of the most competitive fields to pursue

While dermatology and cosmetic surgery has a tendency to be glamorized or simplified as a manipulation of self image, removing blemishes, or luxury skin care treatments for wealthy clients, dermatology is unique in that it serves all demographics, ages, abilities, genders, ethnicities and economic backgrounds. Dermatology is much more than having good nails and skin care

Dermatologists can identify diseases, perform surgery, and prescribe treatment just by looking at the skin. The practice of dermatology bridges many fields including internal medicine, resolving life threatening diseases and cancers, cosmetic enhancements, repairing disfiguring traumas or burns, and helping to create life changing and emotional breakthroughs, restoring confidence, dignity and health from the inside out. Dermatologists see an entire age range of patients, from children, to teens, to adults.

 

Dermatology Residency

Source: The Mayo Clinic Dermatology Residency

To be a Dermatologist certified by the American Board of Dermatology, many preparations and years of schooling must be considered and completed in order to satisfy requirements and move into the dermatology career. A board certified dermatologist includes a full MD licensure and complete medical school training and residency.

The dermatology path is appealing to many pre-med candidates because it involves a majority of outpatient care, and usually carries a lighter work load than other general practice disciplines or other specialized fields. Hair, nail and skin care covers everything from common cosmetic enhancements, to serious ailments and diseases. A board certified dermatologist can diagnose a skin ailment by studying the affected area and prescribing a specific treatment.

Because of the niche practice of dermatology boasts fewer demanding, around-the-clock hours than other fields of medicine, there is a lot of competition to enter the field. Securing a residency is difficult because there are only about 100 dermatological residency programs in the U.S. Each dermatology residency program receives over 250 applications per year to fill a handful of available positions. To see a complete list of residency programs required to be a board certified dermatologist, see the Accreditation Council for Graduate Medical Education.

Because of the competitive nature of the residency program, it is very important for aspiring dermatology candidates to decide on the dermatology field early in medical school. For a comprehensive review of the requirements to be a board certified dermatologist, see The American Board of Dermatology, Inc.

Training to be a Dermatologist

It would be great if we could all jump into a serious career right out of high school. Considering the cost and commitment to undergraduate, medical school, and residencies takes time, careful planning, flexibility and openness to alternative options and careers. An undergraduate degree with solid grades and pre-medical or biology courses from an accredited college in the United States or Canada is acceptable preparation for the MCAT Examinations and subsequent application and acceptance to medical school.

College Preparations for Dermatology

Taking the Medical College Admission Test (MCAT), coupled with a lengthy application process for acceptance into medical school, takes about a year. Often pre-med majors will begin the process in the winter of their junior year of college. High scores on this exam are an important consideration for acceptance into top medical school programs. Study plans and exam preparation courses are highly recommended. This is especially important for candidates considering the dermatology field, due to the competitive nature of the field. More information on the MCAT exam and medical school applications can be found at the Association of American Medical Colleges.

Preparing for a Dermatology Residency

Standing out as a good candidate for a dermatology residency is extremely important for medical school graduate students. It is always important to consider a wide range of possibilities in moving forward as an MD or Osteopath. If dermatology is your motivation, make sure to consider it as an elective in the third year. Become familiar with dermatology professors, demonstrate an eagerness for the field, ask about dermatology related research opportunities, demonstrate an eagerness to advance the field to your dermatology professors, and secure solid letters of recommendation.

Another way to establish rapport with your professors and increase your exposure to experience and your personal confidence in the medical field is to attend Grand Rounds. This will also solidify your letters of recommendation when it comes time to apply for the highly competitive residency for dermatology. For more tips on succeeding in medical school, see the AAMC website: AAMC Medical School Tips

Graduation from medical school is usually followed by four years of clinical experience in a residency program. The first year is Post Graduate Year 1 (PGY1) and is a transitional program with choices in broad based residency of emergency medicine, family medicine, general surgery, internal medicine, obstetrics & gynecology, or pediatrics.  For more information and a complete list of broad based residency programs, see the Accreditation Council for Graduate Medical Education

Dermatology Residency Programs

The next challenge posed to future dermatologists is securing the competitive residency. The American Board of Dermatology requires PGY2, 3 and 4 in an accredited dermatology residency program. According to the American Medical Association, there are only about 100 dermatology residency positions nationwide and each program receives about 250 applications per year for 1-3 openings. It is estimated that nearly 33% will fail to match with a dermatology residency program, and it is highly recommended that residency applicants apply for an alternate residency program in another practice. Dermatology residency interviews are generally scheduled for later than internal medicine interviews. During the interview process, use your experience in PGY1 to demonstrate what you have gained from medical school. Show that you are a solid candidate and demonstrate your extensive knowledge of your commitment to dermatology, and prepare for extensive and comprehensive interviews, as well as solid letters of recommendation from your medical school professors.

 

Woman looking through microscope

Source: The Mayo Clinic Dermatology Residency

Apply to your desired dermatology residency program, and apply to as many programs as possible. You can visit the program’s website and follow their application process or you can use a program called ERAS, Electronic Residency Application Service. If a match in a dermatology residency is not made, consider completing an internship or field related research fellowship, and re-apply for the residency the following year. For more information about residency programs, visit the American Medical Association

Go to the interview for your prospective residency. Tell the interviewer how well you performed in medical school, your PGY1 and tell them about any prestigious internal medicine residencies you may have been offered. This will increase your chances of securing a dermatology residency.

The resident’s time throughout each year (PGY2 – PGY4) will be primarily clinical work, related to outpatient and inpatient care. The resident will also need to attend clinical conferences and didactic lectures relevant to patient care, consultations, inpatient rounds, and other research, rotations and lectures concerning dermatology. For a complete list of guidelines for determining adequacy of clinical residency training, see the http://www.abderm.org/residency/guidelines.html

American Board of Dermatology website

Once the clinical training has been completed, the dermatology candidate will take a final certifying board examination. The comprehensive exam includes multiple choice questions, identifying histopathologic slides, and digital image identification.  For further information on the Board examination process, visit the American Board of Dermatology website.

Once the candidate has successfully passed the examination and receives approval from the American Board of Dermatology on meeting the full requirements, the candidate will be licensed to practice dermatology in the United States and Canada. Please note that the American Board of Dermatology has maintenance of certification program which is designed to assess the competence of physicians on an ongoing basis. Visit ABD for more information about recertification and certification maintenance.

A Variety of Career Paths and Specialties in the Dermatology Field

Dermatopathology

A dermatologist may specialize in the behavior of diseases related to the skin, usually a dermatologist or pathologist will complete one year of dermatopathology fellowship consisting of six months in general pathology, and six months in dermatopathology. Alumni of both specialties can qualify as dermatopathologists. At the completion of a standard residency in dermatology, many dermatologists are also competent at dermatopathology. Some dermatopathologists qualify to sit for their examinations by completing a residency in dermatology and one in pathology.

Immunodermatology

is a sub specialty field of dermapathology, but relates specifically to the treatment of immune-mediated inflammatory skin diseases and disorders. This sub-specialty focuses on everything from photo immunology (effects of UV on skin defense), to inflammatory and microbial diseases.

Pediatric Dermatology

Candidates wishing to specialize in dermatology related to the care of children must complete one additional year of fellowship training in Pediatric Dermatology. Prior pediatric training is helpful, and candidates will often seek a residency in both pediatrics as well as dermatology to fulfill the requirements for this specialty, or the candidate can complete a post-residency fellowship.

Teledermatology

A new form of dermatology where telecommunication technologies are used to exchange medical information via media, audio, visual, data and photo communication of dermatologic conditions (usually made by non-dermatologists for evaluation off-site by dermatologists). This subspecialty deals with options to view skin conditions over a large distance to provide treatment for those in economically or physically isolated or rural areas where access and distance to dermatology specialists are limited.

Mohs surgery

The surgical practice focuses on the excision of skin cancers using a tissue-sparing technique that allows intraoperative assessment of 100% of the peripheral and deep tumor margins. Dermatologists trained in for Mohs surgery are must have residency experience in both dermopathology and cosmetic surgery, and are encouraged to seek additional training either through preceptorships to join the American Society for Mohs Surgery or complete a one- to two-year Mohs surgery fellowship training programs.

Cosmetic dermatology

Some dermatology candidates complete a fellowship in surgical dermatology is also an optional path for a dermatology specialty. Some residencies train dermatology candidates on the use of botox, fillers, laser surgery, as well as cosmetic surgical procedures including liposuction, blepharoplasty, and face lifts. However, some dermatologists choose to focus on minimally invasive procedures. Other cosmetic procedures practiced by cosmetic dermatologists include but are not limited to:

Laser hair removal

Hair transplantation

Intralesional treatment

Laser therapy

Tattoo removal

Photodynamic therapy

Phototherapy

Tumescent liposuction

Chemical or topical treatment

Allergy testing

Cryosurgery

Skin grafts

Systemic therapies

 

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