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I realized that despite having been in my dermatology residency for nearly 1.5 years now, I have never explained what exactly I do on a day-to-day basis! I’ve written about what it means to be “on call” as a dermatologist but I’m on call on average only once per week to once every other week (and I’ll be done with call by December 2016! Can you tell I’m excited :). The rest of the time, my life is clinic clinic clinic, studying, and some interesting consults thrown in the mix. Photos are a mix of ones I took randomly and ones I took as part of my Figs instagram takeover (check out their account @wearfigs on Instagram). So here is a typical day in the life of a dermatology resident:
8:00 – 9:00 Lecture
Every morning starts with a lecture for all of the residents in the program, regardless of which hospital rotation we are on. I think our didactic program is especially strong, and I actually genuinely enjoy going to lecture. Each week we have one lecture that is a textbook talk given by one of the residents (we are going through [amazon text=Jean Bolognias %22Dermatology%22&asin=B00866HDZK], kind of like the Bible of Dermatology), a faculty lecture, a dermatopathology session at the multi-headed scope, some visiting faculty lectures (Grand Rounds), and then random ones thrown in like clinicopathologic correlation conferences, journal clubs, or research presentations. My personal favorite lectures are the Grand Round lectures; I find it so cool that we get to hear from some of the giants in Dermatology about their lifelong work, anecdotes, advice, and research. This is how you know you’re in the right field — you’re actually excited to get up early to learn about it!
9:00 – Noon: After lecture we break up to go to our scheduled hospitals depending on which rotation we are on. We see patients in clinic until lunchtime. Clinic volume is totally variable; some days are lighter and some days are crazy, just like you would expect. In outpatient clinic we see a variety of skin diseases, ranging from the routine like acne, rosacea, and psoriasis, to complicated ones like blistering diseases (bullous pemphigoid, pemphigus vulgaris), connective tissue diseases (lupus, dermatomyositis, scleroderma); then there are the zebras (strange autoimmune diseases that aren’t well described, infections we don’t commonly see anymore like leprosy or leishmaniasis, etc.). You never know what is going to walk through your door and I love the variety of pathology we get to see! On certain days we have specialty clinics where we see specific types of diseases, and those clinics are always great learning opportunities because the attendings on those days are experts in those diseases.
Noon to 1:30: LUNCH! I’ve been trying to bring lunch more often but it’s hard >_< I end up getting salads or soups at nearby delis most of the time. Lunch is also the time for us to finish up clinic notes, call patients back if there’s questions, get in touch with other fields if we need a consult or to discuss patient cases, call pharmacies to make sure our medication orders are all squared away, or call insurance companies for prior authorizations, etc. Another thing I like to do during lunch is to go through lab results, dermatopathology results, mostly follow-up stuff for patient care.
1:30 – 5:00 Afternoon clinic with patients. Once to twice per week as seniors we get to do surgery clinic too, where we do excisions for skin growths like skin cancers or cysts. We work with attendings who are usually Mohs surgeons in their own practices, and they teach us proper surgical techniques. It has been really rewarding to see how I’ve gotten more and more comfortable with surgery, and now I take pride in how nicely the wound heals and looks when the patient returns for follow up.
Sometimes instead of being in clinic we are assigned to be on a dermatopathology rotation. We spend this rotation, usually a week at a time, learning how to diagnose skin conditions by looking at slides of skin biopsies. Dermatopathology has been really challenging for me to learn because it is pure pattern recognition, and you really need to spend time with the slides to learn what features to look for. Not only do we have to recognize what skin diseases look like on the skin, but we also need to be able to diagnose skin disease on a microscopic level as well. Now in my second year of dermatology residency I’m finally starting to feel a little more comfortable with dermpath, but as a first year I often would not have even heard of the name of the diagnosis before, much less recognize what it looks like at 10X.
This is an example of what stitches look like when they are being expelled through the skin. See all the little threads? This is actually considered an “easier” case to diagnosis because the suture is quite striking and stands out as foreign material. There are a whole slew of diagnoses that are extremely subtle, and you have to look really carefully to find the clues to the disease, or else you’ll accidentally call it normal skin. I’ve been tricked by dermatophyte so many times; those thin hyphae are tricky to locate in the stratum corneum (uppermost layer of the epidermis) and you have to have the patience to zoom in and look for those little buggers.
5:00 onwards: In the evenings we do a mix of things. We usually stay behind a little bit to tie up loose ends, make sure all patient follow up has been completed and labs and biopsy results are tended to. Then we usually go home, but once in a while we have training sessions in the evening. We have cosmetic dermatology training sessions in the evening when we learn how to inject fillers or botox or most recently Kybella from experienced attendings. The other thing I do in the evenings is…you guessed it, try to study. Medicine is a lifetime dedication to studying, so if studying and learning is not your thing, this probably isn’t the right career for you. Many of my friends are shocked that I’m still a “student,” but I try to explain that we don’t actually learn dermatology in medical school or intern year, so we have to learn it now in residency. Seeing patients is wonderful learning but we don’t get to see everything in dermatology so reading textbooks and studying is a HUGE part of residency. I’ve been trying to spend quality time with my textbooks this year and though it’s not always easy to motivate myself to study (more on that and my study tips here), it has been getting easier now that I’m more familiar with the subject.
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After that, I cook, order in, or eat out with my husband, and then it’s pretty much bedtime! An occasional workout may sneak its way in once in a while too…but I’m trying to improve on that as well.
There’s never a boring day in residency, and I really love what I do. Hope you enjoyed learning about a day in the life of a dermatology resident!
I find it interesting that a lot of your stuff looks like Laura Lacquer’s (example: https://www.instagram.com/p/BC-8DTiuCeo/
It’s just getting tiring of seeing everyone take the same photos with their huge engagement rings with Figs scrubs – you feel me?
Hi S, I get that there are similarities, especially since Laura and I are both in dermatology and it seems like we have common interests (though she has way cuter babies than I do in her feed, esp since I don’t have any!). Even though our derm programs are different, a lot of what we do day to day are the same (i.e. Drink coffee go to clinic see patients which we can’t share go home and study etc). I try to write pieces about skincare and beauty as well as share parts of my personal life or life out in NYC exploring the city, including times that are stressful but also great. Now that my busy consult weeks are coming to a close I’ll have a little more time to write some of my science based pieces I’ve been researching.
Figs uniforms are skin friendly and comfortable to wear all day long. My sister has good experience with the scrubs like this. Companies like Figs, http://www.salusuniforms.com/, Maevn,etc never lets down anybody who shops with them.
Are dermatology residents allowed wear nail polish, etc? In my country we aren’t even allowed wear clear nail polish, and our nails have to be VERY short, for infection reasons.
It looks like dermatology residents have very little time off, despite it being a specialty that has little on-call time, compared to others, such as surgery, etc. I am curious because I want to pursue hobbies such as acting and writing while entering a dermatology residency, and it looks like that’s very hard… any experience or friends with similar desires in medicine or dermatology?
Hi Noreen, we are allowed to wear nail polish at my program but I can’t speak to other programs. We were not allowed to wear nail polish in the operating room as medical students on surgery rotations, but we are not performing surgery in the OR as dermatologists. As for the time we have off, I find that compared to other specialties, derm residents seem to have more time off. We work the weekends that we are on call, but in my case (large program) we end up working around 8 weekends for all of residency. We also work clinic hours for the most part. Clinic hours usually run from 9 am to 5 or 6 pm. Dermatology involves a lot of studying and at home reading as well. I have enough time for my hobbies such as cooking and blogging but I don’t know how possible an acting job on the side would be. It all depends on how much you want to budget your time on various things.
Hey Joyce. I enjoyed reading about this post and the one about your journey to entering Dermatology. But I was wondering if you have any advice for me in my situation based on your experience on the road to become a medical professional (sorry in advance for the long post). I am a senior as a pre-med student and next year will begin my application process to medical schools. However, I have been feeling anxious about this entire process. I don’t know if I am just nervous about going to medical school and becoming a doctor, or if I have reasonable worries. For my first three years as a pre-med student, I was determined that my plan was to go to medical school and specialize in an area of medicine after. I knew I wanted to help people and work in a field in science or a clinical setting. Some fields that interest me are Obstetrics, Urology, and Dermatology. But now, what is beginning to worry me is my life once I complete the education side and begin practicing my specialty. I am worrying about the balance with my personal life that I may not have as a doctor. Is it possible? Am I cut out for it? I’m a male and have been told that it is much easier for a male since they are not usually the ones taking care of the household. However, that factor is important to me and I want to be there for my wife and children and be a present figure in there lives. Growing up, I had a father who worked nearly all day and wasn’t around much. I love him and he loves me, but it seems like that played a role in our relationship not being as strong as it could be due to his time constraints. I want to be there for my kids as much as I can and experience events with them while I can before they grow up and go off to do great things. Also, the fear of divorce because of lack of time with my spouse doesn’t help 🙁 I enjoy learning about science and would enjoy learning about medicine in medical school, but family time has been running through my mind a lot lately. I know there are specialties that claim to have a nice balance, but what if that is not a specialty I am interested in? What if I fall in love with a field that requires a lot of time out of me? Is it worth pursuing if it means it will affect time with family despite my interest and liking for the field? Or are doctors able to have more control over their hours than what I may think? I want to be able to help protect and maintain people’s health in some way and make a positive impact in someone’s life by building new relationships, and helping overcome difficult situations and analyzing them as much as I can, but still have the time to enjoy my family and also enjoy my success with my family. I have been told by my nephew’s Pediatrician once that there can’t be a balance in this field. It is either you choose to have more success (meaning more money) but less personal life and family time, or you choose to have less success (less money) but more personal life with family. I’m not sure how specific this is or what exactly he meant by less success. If I were to decide at this point, I would choose to not work as much in order to have a more personal life with my family, but work enough where I am able to still enjoy the career I chose. Being financially stable is a nice incentive for this field, but it is not my main influence. Although I would enjoy my career, I would take priority in my family and don’t feel I would be able to enjoy it if it meant hindering family time. Is this possible for multiple specialties to choose to not work crazy hours and enjoy both aspects of life even if that means a pay cut? Or am I looking into a career that does not give me that option? I didn’t really think about another career because this was my main interest and this was my entire plan since day 1. I am asking you because of your further experience and I don’t know who else would be able to guide me. Did you ever think about this? Do you have any advice for me? I would really appreciate it! Thank you 🙂
Mark, first of all, thank you for your extremely thoughtful comment. You voice concerns that a LOT of premed and even medical students and residents have. I’ve had those thoughts myself too. Because your question is such a universal one, I’m going to actually write an entire post dedicated to it! Be on the lookout for a post coming soon, dedicated to your concerns.
Wow! Thank you for taking the time to make that post! I really appreciate it! And thank you for the reply. I was hoping I wasn’t a part of a small group of pre-med or medical students that struggled with this. I will keep an eye out for that post! 🙂
I’ve been following your instagram for a while now. I want to thank you for all the information and motivation that you share with your followers:) It must be different per field and program but I am just curious, typically, how many vacation days does a resident have in a year?
Hi Betty, thanks for your kind words! Typically per ACGME requirements all residents get 4 weeks of vacation a year. I know that varies depending on the program though. For example, at my program we get all 4 weeks as vacation to do as we please. Other programs do 3 weeks of vacation and one week of days off to go to an academic conference. Hope that helps!
I’ve been interested in dermatology for a while now, but I’ve heard that it’s a very competitive field. Would you mind sharing some tips on how you were able to land a spot in a derm residency? (I’m going into my first year of medical school)
Hi Yana, I actually posted all my tips on how to get into competitive residencies in a blogpost under my path to md series! Good luck!
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