schpurp88 Posted September 9, 2018 Report Share Posted September 9, 2018 Buds, i recently developed an interest in derm especially in terms of the content (not as much the procedural aspect). Derm is also mad competitive, so im not trynna kill myself to get into it. What is a specialty that is close to derm in terms of content? I was thinking doing internal and then allergy or immunology or infectious diseases. I know i can build a gp practice with a focus in derm, but that doesn't appeal to me. Link to comment Share on other sites More sharing options...
rmorelan Posted September 9, 2018 Report Share Posted September 9, 2018 2 hours ago, schpurp88 said: Buds, i recently developed an interest in derm especially in terms of the content (not as much the procedural aspect). Derm is also mad competitive, so im not trynna kill myself to get into it. What is a specialty that is close to derm in terms of content? I was thinking doing internal and then allergy or immunology or infectious diseases. I know i can build a gp practice with a focus in derm, but that doesn't appeal to me. well with a family doctor route out I think you are right that internal is the closest you can get to the day to day work load is internal (well after you get to the subspecialty level ha) Rheumatology springs to mind for some reason. Link to comment Share on other sites More sharing options...
jlkhhylyiluh6 Posted September 9, 2018 Report Share Posted September 9, 2018 family for sure...that was one of the biggest surprises to me on my fam med rotation, how high the % of patients you saw was derm complaints lol. Link to comment Share on other sites More sharing options...
rmorelan Posted September 9, 2018 Report Share Posted September 9, 2018 7 minutes ago, beeboop said: family for sure...that was one of the biggest surprises to me on my fam med rotation, how high the % of patients you saw was derm complaints lol. and many have a medical cosmetics side business too - but the OP I guess isn't interested in that route for some reason (I should ask what exactly is the concern there) Link to comment Share on other sites More sharing options...
schpurp88 Posted September 9, 2018 Author Report Share Posted September 9, 2018 idk, I don't like being a generalist as supposed to a specialist, and I wouldn't like seeing 25 patients a day. If I do an internal medicine subspeciality, I like that I would have less patients and become more specialized and make the same amount Link to comment Share on other sites More sharing options...
Edict Posted September 9, 2018 Report Share Posted September 9, 2018 Rheum or Allergy/Immuno. If you like the surgical side of derm then plastics but that is only more competitive. Link to comment Share on other sites More sharing options...
goleafsgochris Posted September 9, 2018 Report Share Posted September 9, 2018 I agree that rheum/allergy are probably the closest. That being said...the day to day of both of those is INSANELY different than derm. I would strongly strongly recommend doing an elective in these before you get the sense they are that similar to derm, because they really aren't very similar; its more they are totally different specialties which happed to have derm findings. Same with general internal. There really is no specialty like derm aside from family with a derm-focused practice. Link to comment Share on other sites More sharing options...
rmorelan Posted September 9, 2018 Report Share Posted September 9, 2018 45 minutes ago, schpurp88 said: idk, I don't like being a generalist as supposed to a specialist, and I wouldn't like seeing 25 patients a day. If I do an internal medicine subspeciality, I like that I would have less patients and become more specialized and make the same amount well I mean some derm practices see a ton of patients per day I should mention. I mean a ton. It is the volume that makes derm pay relatively well. Link to comment Share on other sites More sharing options...
GrouchoMarx Posted September 9, 2018 Report Share Posted September 9, 2018 1 hour ago, schpurp88 said: idk, I don't like being a generalist as supposed to a specialist, and I wouldn't like seeing 25 patients a day. If I do an internal medicine subspeciality, I like that I would have less patients and become more specialized and make the same amount derm is exceptionally high volume thats why the pay is good 40-50 patients a day at specialist rates. Link to comment Share on other sites More sharing options...
Lactic Folly Posted September 9, 2018 Report Share Posted September 9, 2018 How about dermatopathology? Link to comment Share on other sites More sharing options...
GrouchoMarx Posted September 9, 2018 Report Share Posted September 9, 2018 1 hour ago, Lactic Folly said: How about dermatopathology? its not a clinical discipline so there isnt any overlap in the daily work style. as with most pathology its high volume 40-50 cases a day Link to comment Share on other sites More sharing options...
goleafsgochris Posted September 9, 2018 Report Share Posted September 9, 2018 1 hour ago, rmorelan said: well I mean some derm practices see a ton of patients per day I should mention. I mean a ton. It is the volume that makes derm pay relatively well. Wow I didn't catch this. Derm is THE highest volume specialty...they often see patients more quickly than orthopods do in their fracture clinics. I think OP may need to actually experience some of these specialties in more detail to grasp the pros and cons. "Interest in material" in medicine is nice, but cool pathology often in no way correlates to how the experience of a specialty is, and IMO is a pretty terrible way to choose a specialty if you haven't at minimum done shadowing. Take it from a neurologist, the disease process may sound cool but that doesn't necessarily mean youll enjoy doing a 75 minute Parkinsons consult. Link to comment Share on other sites More sharing options...
rmorelan Posted September 9, 2018 Report Share Posted September 9, 2018 4 minutes ago, goleafsgochris said: Wow I didn't catch this. Derm is THE highest volume specialty...they often see patients more quickly than orthopods do in their fracture clinics. I think OP may need to actually experience some of these specialties in more detail to grasp the pros and cons. "Interest in material" in medicine is nice, but cool pathology often in no way correlates to how the experience of a specialty is, and IMO is a pretty terrible way to choose a specialty if you haven't at minimum done shadowing. Take it from a neurologist, the disease process may sound cool but that doesn't necessarily mean youll enjoy doing a 75 minute Parkinsons consult. ha yeah you have to enjoy the day work - the bread and butter aspect of the job because that is what you are doing 95% of the time. A ton of stuff in medicine is very interesting - well at least on paper of course - but may not get to do that all much even if you are in that field. Plus most of us aren't going to be at academic centres statistically speaking, so a lot of things people automatically think as exciting stuff won't be as common or at all where we work. Link to comment Share on other sites More sharing options...
schpurp88 Posted September 9, 2018 Author Report Share Posted September 9, 2018 aahh thanks for the info budzz. Yeah i know derm is high volume and often its the same cases coming in and its very procedural. I still want to something outpatient, that has some relation to derm. I thought internal medicine would be similar to my needs and will allow me to learn more about derm related things, esp since most people who are learners of medicine go into internal. Otherwise I might do family med with a focus in derm and high volume work. Link to comment Share on other sites More sharing options...
shikimate Posted September 10, 2018 Report Share Posted September 10, 2018 You could do dermatopathology, but getting a fellowship in the US is madly competitive (and many places don't accept non-US for electives). Link to comment Share on other sites More sharing options...
ploughboy Posted September 10, 2018 Report Share Posted September 10, 2018 On 9/9/2018 at 2:41 PM, schpurp88 said: I still want to something outpatient, that has some relation to derm. I thought internal medicine would be similar to my needs and will allow me to learn more about derm related things, esp since most people who are learners of medicine go into internal. I suggest you shadow a few internists ASAP. Link to comment Share on other sites More sharing options...
schpurp88 Posted September 11, 2018 Author Report Share Posted September 11, 2018 3 hours ago, ploughboy said: I suggest you shadow a few internists ASAP. wordd Link to comment Share on other sites More sharing options...
LittleDaisy Posted September 11, 2018 Report Share Posted September 11, 2018 On 9/9/2018 at 10:09 AM, schpurp88 said: idk, I don't like being a generalist as supposed to a specialist, and I wouldn't like seeing 25 patients a day. If I do an internal medicine subspeciality, I like that I would have less patients and become more specialized and make the same amount I think that a dermatologist sees a patient every 5 minutes, for new consults, 10-15 minutes? They definitely see more patients than GPs Most dermatologists in community don't subspecialize, and see the bread and butter in dermatology. To sub-specialize in dermatology, for example, melanoma, you have to do additional trainings and hoping to get an academic position. No one is going to refer a metastatic melanoma patient or vasculitis patient with rash NYD to a community outpatient dermatologist. If you are really keen on dermatology, you should definitely go for it, and back up with family medicine. I really don't see how internal medicine is closely related to dermatology's outpatient pace, let along, general internal medicine. The pace is so different, a new GIM outpatient consult is 60 minutes long even for staff physicians, and 30 minutes follow-up as GIM patients are complex. Whereas dermatology new patient consults in academic centres are like 10-15 minutes, with a staff doing clinic & inpatient consult at the same time. You end up seeing the rash most of the time, and give a diagnosis along by visualizing the rash, it trumps >> history. But if you only like the diagnostic part of dermatology, you won't get much exposure in internal medicine either. As all the patients with derm complaints pass through their family physicians' office, and get referred then to dermatologists. Internists are notoriously known for bad at diagnosing rashes given the lack of exposure during their training. Link to comment Share on other sites More sharing options...
A-Stark Posted September 12, 2018 Report Share Posted September 12, 2018 23 hours ago, LittleDaisy said: I really don't see how internal medicine is closely related to dermatology's outpatient pace, let along, general internal medicine. The pace is so different, a new GIM outpatient consult is 60 minutes long even for staff physicians, and 30 minutes follow-up as GIM patients are complex. Outpatient consults do not take 60 minutes except apart from some slow academic GIM staff. All patients are complex, but just because you get a consult as an internist does not mean you're going to be exhaustively counselling someone about every last issue. A lot of community internists (and, really, any FFS staff in an academic centre) do fairly high volume clinics. 23 hours ago, LittleDaisy said: But if you only like the diagnostic part of dermatology, you won't get much exposure in internal medicine either. As all the patients with derm complaints pass through their family physicians' office, and get referred then to dermatologists. Internists are notoriously known for bad at diagnosing rashes given the lack of exposure during their training. Meh. Rashes are boring. Link to comment Share on other sites More sharing options...
LittleDaisy Posted September 12, 2018 Report Share Posted September 12, 2018 3 minutes ago, A-Stark said: Outpatient consults do not take 60 minutes except apart from some slow academic GIM staff. All patients are complex, but just because you get a consult as an internist does not mean you're going to be exhaustively counselling someone about every last issue. A lot of community internists (and, really, any FFS staff in an academic centre) do fairly high volume clinics. Meh. Rashes are boring. I was referring to academic GIM outpatient clinics, but you do have to take into consideration that academic internists love to teach, and perhaps spend the majority of 60 minutes reviewing with residents and teaching around cases. Also, the most complex patients tend to be referred to academic hospitals. Community internists do see new consults faster for sure! Lol, all my internists friend think about the same about rashes. Link to comment Share on other sites More sharing options...
NLengr Posted September 12, 2018 Report Share Posted September 12, 2018 5 hours ago, LittleDaisy said: Lol, all my internists friend think about the same about rashes. Hahaha. That's how the entire medical community feels. Link to comment Share on other sites More sharing options...
shikimate Posted September 12, 2018 Report Share Posted September 12, 2018 Rashes are interesting. People don't like it because they weren't taught well, and when they biopsy it and it returns as a pattern rather a discrete diagnosis they get confused because they don't know what a "pattern"* means in inflammatory dermatopathology. * See Ackerman, AB "Histologic Diagnosis of Inflammatory Skin Diseases: A Method by Pattern Analysis" (1978) Link to comment Share on other sites More sharing options...
NLengr Posted September 12, 2018 Report Share Posted September 12, 2018 4 hours ago, shikimate said: Rashes are interesting. People don't like it because they weren't taught well, and when they biopsy it and it returns as a pattern rather a discrete diagnosis they get confused because they don't know what a "pattern"* means in inflammatory dermatopathology. * See Ackerman, AB "Histologic Diagnosis of Inflammatory Skin Diseases: A Method by Pattern Analysis" (1978) I fell asleep before the end of that sentence. Hahaha Link to comment Share on other sites More sharing options...
LittleDaisy Posted September 12, 2018 Report Share Posted September 12, 2018 4 hours ago, shikimate said: Rashes are interesting. People don't like it because they weren't taught well, and when they biopsy it and it returns as a pattern rather a discrete diagnosis they get confused because they don't know what a "pattern"* means in inflammatory dermatopathology. * See Ackerman, AB "Histologic Diagnosis of Inflammatory Skin Diseases: A Method by Pattern Analysis" (1978) You sound like a pathologist shikimate Link to comment Share on other sites More sharing options...
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