Should you still consider derm if you didn’t enjoy your home derm rotation?

[odyssey2]

Does it get better when you are more confident in your clinical skills and can set up your practice however you like? I found clinic unbelievably draining despite the relatively short hours I worked and didn’t feel like a really “clicked” with the personalities I was working with, but I wonder if the immense lifestyle benefits of dermatology would outweigh that down the line.

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[dermie1985]

I think these are red flags that you should pursue another specialty. You can find balance and income in many other specialties if you're self-driven and smart...so if that is your goal, I'd choose a specialty you like / click with.

 

[PhillyMed777]

Completely agree w above
Clinic can be draining, just a matter of fact. It won’t get better during residency however. So if you didn’t like the rotation, I advise to look elsewhere. Good luck.

 

[asmallchild]

I agree with the others: it is worth exploring other options if the only thing tying you down to dermatology are the immense lifestyle benefits. There are plenty of fields that are just as lifestyle friendly and that flexibility increases further once you become an attending.

That being said, I had a similar experience where I was kind of turned off by my home derm department when rotating through as a student. I flirted very seriously with the idea of pursuing residency elsewhere or perhaps even switching into another field but ultimately decided I did like the field itself and wanted to stay in Texas for training. Personalities change especially with a shorter residency like derm. Your views and how you are viewed by residents/staff will also change once you match. If you are confident the field is right for you and it's just a personality clash issue, I think you can still confidently move forward with derm and keep an open mind about where you want to train. FWIW, I ended up matching at my home program and loved my time there as a resident despite not enjoying my student rotation there.

 

[Dr. Doctor MD]

Does it get better when you are more confident in your clinical skills and can set up your practice however you like? I found clinic unbelievably draining despite the relatively short hours I worked and didn’t feel like a really “clicked” with the personalities I was working with, but I wonder if the immense lifestyle benefits of dermatology would outweigh that down the line.

If your only issue was personality mismatch then I would say that you should still go for dermatology, as I don't believe that stereotypes or personalities should influence your decision of which specialty you choose. Any doctor can set up any practice setting how they want, so it doesn't matter what all the other specialists in that field are like.

However, when you say "I found clinic unbelievably draining despite the relatively short hours I worked" that's a huge red flag and is highly suggestive that you would not enjoy the day to day of dermatology. If you hate it and feel drained as a medical student (where you essentially do next to nothing and are just there to learn), you would be absolutely crushed in residency and eventually in practice when you realize that you have to slog through 30+ patients a day, do all the procedures, type up 30+ notes, actually deal with the difficult patients (anxious, morgellons, body dysmorphia, needy, angry patients) and do callbacks and follow ups for all your biopsies, labs, and medication refills. It's exhausting, even for people who enjoy the field. If you can't handle that as a medical student when you're protected from 99% of the scutwork and slog, I don't see you being happy in residency and beyond. The people who do well in dermatology tend to thrive on (or at least not mind) the breakneck pace and high volume of the specialty.

As has been mentioned before, you can find "immense lifestyle benefits" in a ton of other fields. You need to find something you enjoy or at least don't mind doing for the next 40 years, and dermatology doesn't sound like a match for you. If you want an unbeatable lifestyle and want a slower more relaxed clinic you should definitely consider rheumatology, endocrinology, PM&R, or psychiatry. There are way more options than just those for great lifestyle specialties, but if you're a clinic person and want to have a more relaxed pace while still being a specialist and in high demand, you can't go wrong with any of those fields.

 

[OraclePL]

yeah, your post is triggering some red flags. there are obviously exceptions, but most of the people that I know immensely enjoyed their rotations, putting aside the stress of the competitiveness. I would consider other options.

 

[drpatricktran]

Does it get better when you are more confident in your clinical skills and can set up your practice however you like? I found clinic unbelievably draining despite the relatively short hours I worked and didn’t feel like a really “clicked” with the personalities I was working with, but I wonder if the immense lifestyle benefits of dermatology would outweigh that down the line.

i didn't do derm based on some home rotation experiences and matched into integrated plastic instead. then did derm rotation as an intern and switched to derm lol. i would say experience some different clinical settings because some academic places are super inefficient and the bureaucracy is insane. some clinics have no support staff. private practice is a different beast. procedural derm, mohs, and cosmetic derm is very different from gen derm clinic in an academic center.

clinic can be draining based on what types of chief complaints you see, how many, what hmo insurances or whatever hold you back from doing, how much scut work you have to do, do you have a scribe or not, whatever. so many variables.

practice settings can vary from seeing like 60+ patients a day with a whole team of scribes and ma's and a well oiled machine. or seeing 20 patients a day with 1 staff at a VA.

 

[odyssey2]

If your only issue was personality mismatch then I would say that you should still go for dermatology, as I don't believe that stereotypes or personalities should influence your decision of which specialty you choose. Any doctor can set up any practice setting how they want, so it doesn't matter what all the other specialists in that field are like.

However, when you say "I found clinic unbelievably draining despite the relatively short hours I worked" that's a huge red flag and is highly suggestive that you would not enjoy the day to day of dermatology. If you hate it and feel drained as a medical student (where you essentially do next to nothing and are just there to learn), you would be absolutely crushed in residency and eventually in practice when you realize that you have to slog through 30+ patients a day, do all the procedures, type up 30+ notes, actually deal with the difficult patients (anxious, morgellons, body dysmorphia, needy, angry patients) and do callbacks and follow ups for all your biopsies, labs, and medication refills. It's exhausting, even for people who enjoy the field. If you can't handle that as a medical student when you're protected from 99% of the scutwork and slog, I don't see you being happy in residency and beyond. The people who do well in dermatology tend to thrive on (or at least not mind) the breakneck pace and high volume of the specialty.

As has been mentioned before, you can find "immense lifestyle benefits" in a ton of other fields. You need to find something you enjoy or at least don't mind doing for the next 40 years, and dermatology doesn't sound like a match for you. If you want an unbeatable lifestyle and want a slower more relaxed clinic you should definitely consider rheumatology, endocrinology, PM&R, or psychiatry. There are way more options than just those for great lifestyle specialties, but if you're a clinic person and want to have a more relaxed pace while still being a specialist and in high demand, you can't go wrong with any of those fields.

It seems like hardly anyone who goes into dermatology regrets it though. Is this just because of the process filtering for people who are right for it?

 

[Dr. Doctor MD]

It seems like hardly anyone who goes into dermatology regrets it though. Is this just because of the process filtering for people who are right for it?

I personally think so. There are so many hoops to jump through to become a dermatologist, that almost everyone who matches knows what they're getting into, and hopefully at least somewhat enjoys dermatology. I don't think many people dislike dermatology and then go through the grueling steps to become a dermatologist, although I'm sure there are a fair amount of people who may be apethetic to dermatology and/or apathtic towards all fields of medicine, but still pursue dermatology anyways. But if you actively dislike the field or find a sincere interest in another field instead, then you're likely going to be unhappy in dermatology. You're right though that these people are fairly few and far between, and I would imagine a lot of that is self-selection.

 

[MedicineZ0Z]

Not if you don't actually like it.

 

[Earl Simmons]

Depends. I wasn't a big fan of my first home program rotation, which was just a ton of bread and butter that we got exposed to. I did not get to see specialty clinics. Additionally, I knew nothing as a med student. The second time I did a rotation, I knew much more and had more autonomy and it was awesome. Specialty clinics on aways confirmed my interest. And now as a resident, I love the bread and butter because they are fast, fun visits. So, just take a step back and try and do some deep self reflection. You can't force the interest. Needs to be organic.

 

[JSU]

Does it get better when you are more confident in your clinical skills and can set up your practice however you like? I found clinic unbelievably draining despite the relatively short hours I worked and didn’t feel like a really “clicked” with the personalities I was working with, but I wonder if the immense lifestyle benefits of dermatology would outweigh that down the line.

It gets way better

 

[finalpsychyear]

It seems like hardly anyone who goes into dermatology regrets it though. Is this just because of the process filtering for people who are right for it?

money and lifestyle. Cut salaries down to pcp level and you'd have the same satisfaction. Everything gets old after a few years.