When lay people think of dermatology, they likely think only of acne and of the face. The dermatology specialty, however, expands well beyond that. The dermis and its underlying structures constitute the largest organ of the human body, the integumentary system. Skin.
Dermatologists are responsible not just for treatment of skin disorders and cosmetic issues, but for serious conditions such as skin cancer. Their treatment methods range from simple medications to complex surgical procedures. As such, the resident interested in the dermatology specialty must look further than skin deep.
SELECTING DERMATOLOGY
One of the more attractive aspects of the dermatology specialty is the wide array of experiences it provides. Using broad medical knowledge, the dermatologist will treat a variety of patients, from children and teenagers up to and including the elderly. And there is just as much diversity in the methodology of treatment. While one case may call for something as simple as a topical cream, the next case may involve the surgical scalpel.
Dermatology requires an extensive, generalized knowledge of medicine. Such knowledge is important in determining how to prescribe potentially dangerous drugs such as intravenous steroids, or in performing delicate surgery. The dermatologist will also need that scope of knowledge to identify whether conditions are benign or life threatening.
A dermatologist must also possess superior interpersonal skills in dealing with patients. Dermatologists handle something extremely important to patients: their appearance. Even the most minor skin conditions, like mild acne, can be scarring in more ways than one.
Therapeutic procedures such as Mohs micrographic surgery are also life-changing to the dermatological patient. Mohs is a method of removing cancer from areas of the skin where the ability to excise skin is impaired, such as the face or ears. It minimizes the loss of healthy, unaffected skin.
Beyond Mohs, surgical dermatologists will also perform such procedures as face-lifts and liposuction, generally considered within the realm of the plastic surgeon. Rejuvenating and cosmetic treatments, such as laser skin resurfacing, chemical peels and Botox injections can also be commonplace.
With the growing acceptance of plastic surgery and other appearance enhancing procedures, the field of surgical dermatology has seen rapid growth.
Residency training in dermatology requires four years of postgraduate training. The first year is spent in general internship.
With such enticing qualities as low stress, regular hours, and diverse patient care, the competition for dermatology residency matches is strong. However, in the last few years, the ratio of applicants to available positions has been trending down according to the National Resident Matching Program.
CAREER OPTIONS
Overnight calls, irregular shifts, lagging compensation and limited employment opportunities are not things associated with this particular job.
Generally, dermatological treatments are scheduled on an outpatient basis during normal business hours. While life-threatening emergency calls can happen, they are extremely rare. Whether the treatments are therapeutic or surgical in nature, there is a rigid control on professional time maintained by the dermatological physician.
In private practice, a dermatologist will build a client base and maintain his/her own office or work in conjunction with a medical group or clinic. This does not prevent dermatologists from also teaching residents in academic settings as well. Academic dermatologists can be found in research facilities or as faculty in teaching hospitals.
Dermatology offers a certain degree of flexibility to customize the practice to the individual. Dermatopathologists, for instance, tend toward the research side of the profession and rarely see clinical patients, working mainly with microscopes in a lab setting.
Further specialization in the field of dermatology is also available by way of fellowships. Board certifications are offered by organizations such as the American Academy of Dermatologists.
The subspecialty of Clinical and Laboratory Dermatological Immunology (or CLDI) offers certification, requiring additional training beyond the four years of required postgraduate training. This subspecialty covers laboratory procedures used in treating disorders of the immune system. Dermatopathology also offers certification.
Other fellowships include Mohs surgery and pediatric dermatology.
In terms of compensation, the American Medical Association's surgery of practicing dermatologists report that over half find their salary to meet or exceed their expectations. Figures from the American Medical Group Association indicate a mean average salary in excess of $220,000 a year. Specialization will increase that figure. Those specializing in Mohs surgery can expect to clear nearly $290,000 a year.
FINAL CUT
The rewards of dermatology reach beyond the stable hours, career flexibility, significant compensation and low stress. Dermatologists can be instrumental in improving the self-esteem of young acne victims or of those with cutaneous disfigurement. Their diagnosis and treatment can also save lives from immunological disorders and cancer.
For the physician looking for a specialty that provides an interesting education, substantial personal time, and the chance to make a significant difference in the lives of patients, dermatology might be the ideal choice.
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