Great Pay, Normal Hours: How Dermatology Became The Best Job In Medicine


 
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By Te-Ping Chen

Dermatology has become highly competitive because of its desirable work-life balance, high salaries and minimal on-call hours.

The surge in skin-care popularity and social-media presence have contributed to the field’s allure, with some dermatologists earning significant income from sponsored posts.

Despite the field's growth, diversity remains an issue, with efforts under way to encourage more minorities to consider dermatology.

Four-day workweeks, double the salary of some colleagues and no emails at night. If those perks sound like they belong to a few vaunted tech jobs, think again. Dermatologists boast some of medicine’s most enviable work lives, and more aspiring doctors are vying for residency spots in the specialty.

“It’s ungodly competitive,” says Dr. Lindsey Zubritsky, a dermatologist in Ocean Springs, Miss., who finished her residency in 2018 and now splits her time between clinical work with patients and her social-media feed, where the “dermfluencer” has three million followers on TikTok and Instagram.

Medical residency applications for dermatology slots are up 50% over the past five years, according to data from the AAMC, with women flooding the zone. A younger generation of physicians wants better work-life balance than their predecessors and, unlike pressure-cooker medical specialties such as cardiac surgery, dermatology fits the bill.

“It’s one of the only fields where you can work 40 hours a week like a normal person,” says Zubritsky, 36, who has two children and sees patients between 8 a.m. and 4 p.m., three days a week.

Dermatologists earn a median $541,000 a year, according to a recent survey of more than 150,000 U.S. physicians conducted by Medical Group Management Association, a trade group. Pediatricians, by contrast, earn a median $258,000 annually.

Given the infrequency of skin emergencies, far fewer dermatologists are on call at night and on weekends. The more traditional schedule—and flexible hours—are drawing more women into the field. Seventy-one percent of applicants who selected dermatology as their first choice when applying for their residency match this year were women, up from 63% two years ago, according to the National Resident Matching Program.

The boom in skin care, and its popularity on social media, has added to the profession’s allure. Some dermatologists have built commanding presences on Instagram and TikTok, earning as much as $30,000 for each sponsored post to promote various brands’ skin products.

“People are much more aware about our field now,” says Dr. Shereene Idriss, 40, a dermatologist who owns a cosmetic practice in New York City that doesn’t take insurance. That is, in part, thanks to the countless hours Americans spend on Zoom scrutinizing their faces, she says.

“All our attention turned to skin care versus makeup,” says Idriss, who has used her platform on sites such as Instagram and TikTok to launch her own skin-care line.

At Idriss’s clinic, patients pay out of pocket for $500 microneedling sessions and $4,000 laser and filler treatments to smooth skin tone and texture and reduce lines and wrinkles. The procedures can last from 20 minutes to an hour. Idriss declined to say how much she makes but says that for dermatologists offering cosmetic treatments, “the sky’s the limit, depending on how efficient you are.”

It wasn’t always this way. The work of early dermatologists was far from glamorous. They tended to treat venereal diseases, including syphilis, that manifested on the skin, says Dr. Donna Stockton, a 65-year-old dermatologist in Chicago. During her residency in New York City in the late 1980s, Stockton treated patients who experienced skin eruptions stemming from HIV.

The field started attracting more would-be practitioners in 2002, when the Food and Drug Administration approved Botox for frown lines, Stockton says. She chose dermatology because she liked feeling that she could have mastery over a single organ—the skin. Residents she has worked with in recent years have been “more interested in how much I charged for Botox,” she says.

Many dermatologists perform both medical and cosmetic treatments, says Dr. Mary Alice Mina, 44, an Atlanta-based dermatologist who specializes in skin cancer and offers cosmetic surgeries such as neck lifts.

Cosmetic procedures aren’t necessarily an easy road to riches, she cautions. A dermatologist might see as many as 60 medical patients a day, but cosmetic patients paying out of pocket for elective treatments demand more time and tend to expect white-glove treatment.

“It’s a little bit of a misnomer to think you’ll do cosmetics and be churning patients,” Mina says. “Those patients want individual attention and personalized care.”

Though dermatology is often pooh-poohed—think “Seinfeld,” where Jerry nicknames his dermatologist girlfriend “pimple popper MD”—its importance in medicine shouldn’t be dismissed, says Dr. Jane Grant-Kels, 74, vice chair of dermatology at UConn Health in Farmington, Conn. Skin cancer is the most common cancer in the U.S. Because dermatologists rely on physical exams that other physicians may bypass, Grant-Kels says they often catch early signs of diseases, including other types of cancers that manifest as rashes or tumors.

“There are some lesions you can feel before you can see,” she says.

Grant-Kels founded her hospital’s program nearly 50 years ago and has witnessed the field’s explosion in popularity. Recently, her hospital’s dermatology program received more than 600 applications for four residency slots.

“The quality of these applicants is scary,” she says, adding that some take off a year after medical school to focus on dermatologic research to give themselves an edge.

Dermatologists say their work offers plenty of immediate gratification, compared with other physicians, such as in primary care, who rely more on tests and scans.

“We can walk into a room and sometimes in seconds know what’s wrong,” says Dr. Jules Lipoff, 44, a Philadelphia-based dermatologist, adding that the profession’s stock-in-trade is still the old-fashioned physical exam.

Lipoff says dermatology patients can often see their skin issues firsthand and are motivated to address them. (And, yes, he is asked by acquaintances at parties to examine their moles.)

Diversity in the field is a continuing issue, says Dr. Roopal Kundu, 48, a dermatology professor at Northwestern University Feinberg School of Medicine. A 2020 study found dermatology was the second-least-racially-diverse specialty in medicine, behind orthopedic surgery. The American Academy of Dermatology recently launched an effort to encourage more minorities to consider the field, with guidance on applying to medical school and tips about building a personal brand.

Dr. Oyetewa Asempa, 33, says she rarely encountered photos of Black skin in her textbooks when she was a medical student. Skin issues present differently across skin tones, she says, noting that some practitioners are unaware of that. Unless more people of color enter the profession, that isn’t likely to change, she adds.

When Asempa finished a dermatology residency program affiliated with Harvard in 2022, she was one of just two Black dermatology residents to graduate from the program in 15 years.

Last year, she founded a Skin of Color Clinic at Baylor College of Medicine in Houston. Her appointments are booked out for months, and she has been mentoring medical students from minority backgrounds who are interested in dermatology, telling them success is possible, even if the odds seem long.

“I wanted to make a difference,” she says. “I don’t care about the stats.”


 
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