How difficult is a dermpath match?

[odyssey2]

How hard is it to get a dermpath fellowship from a dermatology residency?

---

Members don't see this ad.

 

[PhillyMed777]

Overall, if you are derm trained you have a good shot.
There are few positions in general, this poses a hurdle. If you go to a strong program, and/or have internal program, that helps your chances tremendously. All programs, including the well known programs will often times take many strong and qualified internal candidates, and this will significantly eat away available positions (esp at those coveted big name/ top programs). This creates a situation where there is an illusion of available spots, which don't actually exist.

That being said, if you are derm trained, and apply broadly chances are quite solid. It really does vary from year to year. Some programs don't take applicants every year. Some vary in the number of positions. Some may have so many internals, there's no chance they'd ever even open your file. Also, dermpath positions as a function of time is quite stable and hasn't seen the relatively speaking rise in spots as say derm itself.

Contrary to popular belief, there are many highly qualified path trained folks. I've seen plenty of their CVs - very impressive. These folks do occupy the majority of spots in general, since dermpath is not as popular in general coming from derm side.

Another very overlooked fact. MANY places, including at highly coveted positions, like path trained people. Some prefer derm trained. Some people from the derm side propagate this notion that we are universally desired. That is true sometimes/with some program directors. Sometimes it follows the department (i.e. if dermpath is housed in path perhaps they on avg like Path trained folks more). If its a "large program" i.e say 2 spots, they like to mix it up usually, one path and one derm trained. This again, has a negative impact on the total number of spots at your disposal.

If you are a classic academically strong dermatology resident, again, in general that strong CV will help.
If you are really good at dermpath and impress your faculty, that can help quite a lot too. Get reading and go beast mode. Could try doing aways and impressing, though that is hard with COVID.

 

[dermapp2023]

I'm generally curious about what qualifies as "dermpath research"? I feel like most derm translational research will have at least a figure or two with some sort of histology involved, but would these pubs be seen as primarily and specifically a dermpath research project? Will be helpful to know in looking for potential research mentors!

 

[Dral]

I would not consider those primarily dermpath research unless the point of the article was some new or different histology finding that translated into a change in the way something was treated clinically. If the histo is just 'part of the story' I wouldn't consider it as dp research. That being said, that kind if research still holds a lot of value.

 

[dermapp2023]

I would not consider those primarily dermpath research unless the point of the article was some new or different histology finding that translated into a change in the way something was treated clinically. If the histo is just 'part of the story' I wouldn't consider it as dp research. That being said, that kind if research still holds a lot of value.

Thanks for clarifying! Do you have any recs for common, widely read journals for dermpath research? Would love to peruse through articles and see what kinds of questions can be asked.

 

[Dral]

Journal of Cutaneous Pathology would be a good place to get some general ideas.

 

[yungspleen]

Any dermatology resident with a pulse can get a dermpath fellowship since there are not a high number of derm-trained applicants. The attractiveness of the fellowship has dramatically dipped as 88305 reimbursement has dropped. MOHS fellowships are more competitive. Dermpath fellowships are still competitive for pathology residents since there are a lot of path applicants.

What average salary now for full-time dermpath? How common are hybrid practices where you do a few days clinic and a few days dermpath? Would you take a salary hit if you did hybrid?

 

[asmallchild]

What average salary now for full-time dermpath? How common are hybrid practices where you do a few days clinic and a few days dermpath? Would you take a salary hit if you did hybrid?

I don't have the figures but I would assume average salaries for full-time dermpaths have dropped over the last few years as 88305 reimburesement has dropped.

It could also explain why we've gone from having dermpaths try to beat down our doors for a fulltime gig to actually having a few leave our practice in the last few months.

That being said, I could not imagine you would take a salary hit if you did a hybrid (unless your group has extremely low dermpath volume). I think you would see a significant drop in interest in dermpath fellowships if that were true.

 

[Skindoc83]

What average salary now for full-time dermpath? How common are hybrid practices where you do a few days clinic and a few days dermpath? Would you take a salary hit if you did hybrid?

I think hybrid would be the norm. There are not that many full time derm path positions because one derm path can read so many cases

 

[MohsHopeful]

I think hybrid would be the norm. There are not that many full time derm path positions because one derm path can read so many cases

There are some full-time dermatologist trained Dermatopathologist positions. Some derms prefer dermatopathologists that are dermatologists.

 

[Shufflin]

Genuine question here from a non-derm, but what's the draw for a dermatologist to switch to dermpath? Doing derm and pushing glass are so vastly different. I would think if you want dermpath you go path first. Just curious.

 

[PhillyMed777]

Genuine question here from a non-derm, but what's the draw for a dermatologist to switch to dermpath? Doing derm and pushing glass are so vastly different. I would think if you want dermpath you go path first. Just curious.

Dermpath is extremely interesting tbh. It’s about 1/5 to 1/4 of our residency training.
Many inflammatory rashes need tons of clinic-pathological correlation.
being Derm trained is a huge plus.
also you may find that seeing 40 patients a day is exhausting. That with follow up, calls, notes, inbox stuff - you may find it’s not what you thought.

 

[asmallchild]

Genuine question here from a non-derm, but what's the draw for a dermatologist to switch to dermpath? Doing derm and pushing glass are so vastly different. I would think if you want dermpath you go path first. Just curious.

$



Less cynically, I didn't realize how much pathology there is in dermatology until I rotated through as a medical student. This varies from program to program as well, we had a very strong dermpath department and spent closer to 50% of our didactics time touching on some form of dermpath.

As PhillyMed mentioned, clinic-pathological correlation makes for a better clinician. I think understanding a condition under the microscope and being able to link it to the clinical picture is a very powerful tool even for someone who has no interest in being a dermatopathologist. (I don't think it is powerful / interesting enough to warrant doing a fellowship in dermpath if you don't intend to utilize that skill but I am sure there are those out there who disagree and have pursued dermpath fellowships just to make themselves more complete clinicians)

Finally, having the ability to mix up clinic days with path days is a big draw for dermatologists too, I think it will definitely cut down on risk of burnout. My understanding is that reimbursement has changed but in the past, working full time as a dermatopathologist was significantly more lucrative so some may have started with a split in their schedule (some clinic, some path) and if the opportunity presented itself, it is natural to tilt your interests/efforts towards the job that pays better.

 

[Shufflin]

very interesting. thanks for the insight.

 

[yungspleen]

Finally, having the ability to mix up clinic days with path days is a big draw for dermatologists too, I think it will definitely cut down on risk of burnout. My understanding is that reimbursement has changed but in the past, working full time as a dermatopathologist was significantly more lucrative so some may have started with a split in their schedule (some clinic, some path) and if the opportunity presented itself, it is natural to tilt your interests/efforts towards the job that pays better.

Ya my ideal practice setup would be seeing 15-20 patients in the morning and then reading all the biopsies my practice did in the afternoon. Hopefully I can find a setup like that in a desirable location

 

[Sailor Senshi Dermystify]

I did research in dermpath and loved reading the slides and matching it with the derm dx. I am interested in derm and want to do dermpath fellowship. I want a hybrid practice, where I see patients in the day and dermpath afterwards lol.
I do not think I can see 50 to 60 patients a day. Currently, I am not fast in writing my medical notes and feel like I would definitely bring my work home .

 

[PhillyMed777]

I did research in dermpath and loved reading the slides and matching it with the derm dx. I am interested in derm and want to do dermpath fellowship. I want a hybrid practice, where I see patients in the day and dermpath afterwards lol.
I do not think I can see 50 to 60 patients a day. Currently, I am not fast in writing my medical notes and feel like I would definitely bring my work home .

True
However don’t forget it’s your residencies job to teach you to be efficient. I feel that’s an important part of clinic training in Derm - you need to use your support staff well and cleverly use EMR

a weaker residency won’t try to teach you these things

 

[infiniteregress2020]

Overall, if you are derm trained you have a good shot.
There are few positions in general, this poses a hurdle. If you go to a strong program, and/or have internal program, that helps your chances tremendously. All programs, including the well known programs will often times take many strong and qualified internal candidates, and this will significantly eat away available positions (esp at those coveted big name/ top programs). This creates a situation where there is an illusion of available spots, which don't actually exist.

That being said, if you are derm trained, and apply broadly chances are quite solid. It really does vary from year to year. Some programs don't take applicants every year. Some vary in the number of positions. Some may have so many internals, there's no chance they'd ever even open your file. Also, dermpath positions as a function of time is quite stable and hasn't seen the relatively speaking rise in spots as say derm itself.

Contrary to popular belief, there are many highly qualified path trained folks. I've seen plenty of their CVs - very impressive. These folks do occupy the majority of spots in general, since dermpath is not as popular in general coming from derm side.

Another very overlooked fact. MANY places, including at highly coveted positions, like path trained people. Some prefer derm trained. Some people from the derm side propagate this notion that we are universally desired. That is true sometimes/with some program directors. Sometimes it follows the department (i.e. if dermpath is housed in path perhaps they on avg like Path trained folks more). If its a "large program" i.e say 2 spots, they like to mix it up usually, one path and one derm trained. This again, has a negative impact on the total number of spots at your disposal.

If you are a classic academically strong dermatology resident, again, in general that strong CV will help.
If you are really good at dermpath and impress your faculty, that can help quite a lot too. Get reading and go beast mode. Could try doing aways and impressing, though that is hard with COVID.

How difficult is it to match into dermpath coming from the path track rather than the derm track?

 

[Dral]

Not an easy answer. In general, Derm applicants had to get into a derm residency which typically means better scores and such. So the Derm applicants are generally more attractive to programs. However, good path folks are certainly always in the running. It really depends on the individual more than where they came from.