Derm Practice Lifestyle (In Residency/Outside Residency)

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mdquestion

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I'm trying to compare a couple of specialties that I'm interested in. Mainly hematology/oncology, neurology, and dermatology. I'm looking for an academic oriented specialty where I'll be able to be involved in interesting research, pharmaceutical advances, see patients, get involved in health policy/administration, and maybe medical writing/journalism. In all honesty, I'd like a career that balances some of my non-clinical interests (i.e. research, etc.) while still having the mindset to see patients most of the time, like what I do, feel invigorated to get up in the morning and help people etc. I don't care much about money, as I'm sure any specialty will produce enough for me. I'd prefer a career that has a good lifestyle and would allow for time to raise a family, but also keep me interested and excited a 30 year career.

I was wondering if anyone could comment on the patient experience as a resident and as an attending (and maybe how that might compare to the other specialties if you have friends in those programs). What's a typical day like? What sort of patients/diseases do you normally see? Are they satisfying to treat?

I get the sense that dermatology is mainly out-patient medicine, but I was curious as to what in-patient medicine in dermatology is like. Also, compared to many of the other options, derm seems like a very small field (i.e. a hospital department won't have that many attendings). I was wondering if you felt this was a positive or a negative? Also, do you feel as those you have time to pursue other interests as a dermatologist and that the field is exciting enough to keep you entertained for the rest of your life?

Thanks guys! Sorry if the question is ambiguous...just trying to investigate derm a bit more. I'm shadowing this summer, but wanted some thoughts beforehand from those in the know.
 
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mdquestion said:
I'm trying to compare a couple of specialties that I'm interested in. Mainly hematology/oncology, neurology, and dermatology. I'm looking for an academic oriented specialty where I'll be able to be involved in interesting research, pharmaceutical advances, see patients, get involved in health policy/administration, and maybe medical writing/journalism. In all honesty, I'd like a career that balances some of my non-clinical interests (i.e. research, etc.) while still having the mindset to see patients most of the time, like what I do, feel invigorated to get up in the morning and help people etc. I don't care much about money, as I'm sure any specialty will produce enough for me. I'd prefer a career that has a good lifestyle and would allow for time to raise a family, but also keep me interested and excited a 30 year career.

I was wondering if anyone could comment on the patient experience as a resident and as an attending (and maybe how that might compare to the other specialties if you have friends in those programs). What's a typical day like? What sort of patients/diseases do you normally see? Are they satisfying to treat?

I get the sense that dermatology is mainly out-patient medicine, but I was curious as to what in-patient medicine in dermatology is like. Also, compared to many of the other options, derm seems like a very small field (i.e. a hospital department won't have that many attendings). I was wondering if you felt this was a positive or a negative? Also, do you feel as those you have time to pursue other interests as a dermatologist and that the field is exciting enough to keep you entertained for the rest of your life?

Thanks guys! Sorry if the question is ambiguous...just trying to investigate derm a bit more. I'm shadowing this summer, but wanted some thoughts beforehand from those in the know.
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In many academic medical centers, Derm runs a consult service at the teaching hospital. At mine, one person (each of resident and attending) gets "stuck" on consults for the month, and they work longer hours than the usual cush 8-3 you hear for private practice derm (or the 8-5 for academic clinic-based derm.) Certainly no call or anything like that, but I've seen the derm consult person there in the ER into the double-digit PM hours.

Also, essentially all of academic medicine (regardless of the specialty) does what you are talking about: Trade money for lifestyle. Except for stuff like Trauma surgery, when was the last time you saw an attending (of any specialty) take call or hang around past 5? However, they are lucky if they get paid 2/3 of what they can get paid in private practice.
 
mdquestion said:
I'm trying to compare a couple of specialties that I'm interested in. Mainly hematology/oncology, neurology, and dermatology. I'm looking for an academic oriented specialty where I'll be able to be involved in interesting research, pharmaceutical advances, see patients, get involved in health policy/administration, and maybe medical writing/journalism. In all honesty, I'd like a career that balances some of my non-clinical interests (i.e. research, etc.) while still having the mindset to see patients most of the time, like what I do, feel invigorated to get up in the morning and help people etc. I don't care much about money, as I'm sure any specialty will produce enough for me. I'd prefer a career that has a good lifestyle and would allow for time to raise a family, but also keep me interested and excited a 30 year career.

I was wondering if anyone could comment on the patient experience as a resident and as an attending (and maybe how that might compare to the other specialties if you have friends in those programs). What's a typical day like? What sort of patients/diseases do you normally see? Are they satisfying to treat?

I get the sense that dermatology is mainly out-patient medicine, but I was curious as to what in-patient medicine in dermatology is like. Also, compared to many of the other options, derm seems like a very small field (i.e. a hospital department won't have that many attendings). I was wondering if you felt this was a positive or a negative? Also, do you feel as those you have time to pursue other interests as a dermatologist and that the field is exciting enough to keep you entertained for the rest of your life?

Thanks guys! Sorry if the question is ambiguous...just trying to investigate derm a bit more. I'm shadowing this summer, but wanted some thoughts beforehand from those in the know.
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Well...just so you know...we might be out-patient, but we do our fair share of saving lives, just like the other specialties... 😳)

http://www.youtube.com/watch?v=mGFoAX2Rf6g&feature=player_embedded
 
Sol Rosenberg said:
Certainly no call or anything like that, but I've seen the derm consult person there in the ER into the double-digit PM hours.
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Home call. Meaning, if it is serious we go in STAT. No call rooms for us home call persons. *sad face*

mdquestion said:
Haha very cute. Anyway you could give me a better sense of what you actually do everyday? 🙂
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This evening, while on call, I diagnosed TEN and made sure to give the laundry list of recs that goes w/ this.
 
mdquestion said:
I'm trying to compare a couple of specialties that I'm interested in. Mainly hematology/oncology, neurology, and dermatology. I'm looking for an academic oriented specialty where I'll be able to be involved in interesting research, pharmaceutical advances, see patients, get involved in health policy/administration, and maybe medical writing/journalism.
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1. Those are pretty diverse fields, I would recommend shadowing in each clinic to see what you actually like.

2. I cannot speak for the other fields but I have yet to meet a dermatologist who has been able to balance research, pharmaceutical involvement, patients, health policy, and medical journalism. Contrary to what is displayed often in the media, we are busy in clinic.
 
Is it really a myth that derm residency is "easy"? You guys have to rote memorize tons and tons of stuff, more than any other specialty. In the end, aren't you putting in just as many hours?
 
citizenbang said:
Is it really a myth that derm residency is "easy"? You guys have to rote memorize tons and tons of stuff, more than any other specialty. In the end, aren't you putting in just as many hours?
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I'd aim for the middle ground.

It probably varies from program to program but my program is very busy during the day and certainly, there are large amounts of home reading to be done.

That being said, I don't think derm residents are going to net much sympathy if they complain about their schedule.

As a PGY-2, I will say I put in more total hours of "real work" even if it was time spent at home studying than during internship.
 
asmallchild said:
I'd aim for the middle ground.

It probably varies from program to program but my program is very busy during the day and certainly, there are large amounts of home reading to be done.

That being said, I don't think derm residents are going to net much sympathy if they complain about their schedule.

As a PGY-2, I will say I put in more total hours of "real work" even if it was time spent at home studying than during internship.
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If you put in more hours as PGY-2 total than internship, that's saying a lot. It is all rote memorization I believe, its not like neurology/cardiology/pathology where the information is spatial/intuitive, correct? So if one were not good at memorization, do they really become bad dermatologists or do they just not do as well on the boards?
 
citizenbang said:
If you put in more hours as PGY-2 total than internship, that's saying a lot. It is all rote memorization I believe, its not like neurology/cardiology/pathology where the information is spatial/intuitive, correct? So if one were not good at memorization, do they really become bad dermatologists or do they just not do as well on the boards?
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There has been some criticism that the boards aren't a true reflection of what you will see in actual clinical practice. So I'm not sure having a bad memory will doom you to become a bad dermatologist.

The hours you put in as a PGY-2 will also vary with your program. Some programs have a study day or academic time, some don't. Some programs have an organized lecture day to review textbook reading, journal reading, dermatopathology sessions, etc... etc...

Obviously the more of these a program has (and the more hours you are asked to spend in clinic) may contribute to how many hours you spend outside of work preparing. Those hours (as I have found) can add up quickly especially if you are coming from a cush internship
 
asmallchild said:
There has been some criticism that the boards aren't a true reflection of what you will see in actual clinical practice. So I'm not sure having a bad memory will doom you to become a bad dermatologist.

The hours you put in as a PGY-2 will also vary with your program. Some programs have a study day or academic time, some don't. Some programs have an organized lecture day to review textbook reading, journal reading, dermatopathology sessions, etc... etc...

Obviously the more of these a program has (and the more hours you are asked to spend in clinic) may contribute to how many hours you spend outside of work preparing. Those hours (as I have found) can add up quickly especially if you are coming from a cush internship
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I see. I asked in an earlier post about what specialty was best for me. I enjoy problem solving and "detective work". Derm seems to be very diagnosis based, but I wasn't sure if it was problem solving you're utilizing or just knowing things from experience. Would someone who likes puzzle solving enjoy derm?
 
citizenbang said:
I see. I asked in an earlier post about what specialty was best for me. I enjoy problem solving and "detective work". Derm seems to be very diagnosis based, but I wasn't sure if it was problem solving you're utilizing or just knowing things from experience. Would someone who likes puzzle solving enjoy derm?
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Yes. Example, contact dermatitis may be one of the biggest detective operations in all of medicine, IMHO.

Clarification, dermatitis in general...
 
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