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Dr ILYAS talks to US NEWS & WORLD REPORT about becoming and being a Dermatologist

Posted by Erum Ilyas on
Dr ILYAS talks to US NEWS & WORLD REPORT about becoming and being a Dermatologist

Read more at US NEWS AND WORLD REPORT about becoming and being a Dermatologist

 

What advice would you give to a medical school

hopeful who was interested in becoming an dermatologist? 

The most important advice is to really focus on working hard to do well in your coursework and clinical years. By doing well, you will not only be a better physician you will also be able to prepare yourself to  compete when the application time comes. 

Work with dermatologists at your home institution and outside your institution. Really learn and understand what Dermatology is all about. Most people have a false sense that we have an ‘easy’ life style. Although I concede that we have more control over our lifestyles given the outpatient nature of our practices, the reality is that the sheer volume of demand for our services we must manage is simply not for everyone.

What should that person know about the time and effort required for
this type of career? 

If it’s to attain a residency then the effort is steep. There is a full picture that needs to be painted of a well rounded academic foundation supplemented with demonstrable interest through research, writing, and presentations. 

 

If it’s in practice, the time and effort are also significant simply because as specialists we rely on developing strong relationships with our referring physicians- primary doctors in addition to other specialists. I built my practice from scratch 10 years ago starting with one chart on the wall and grew to 30,000 patients in 10 years that I serve. This didn’t happen without me building relationships with referring doctors and patients and making myself available and approachable. (I think the 3 a’s were available, affable and able?)

 

How competitive is it to get a dermatology
residency, and what types of skills are necessary?

There’s no sugar coating this one- it’s highly competitive. For those that come to find Dermatology late in their medical school life and have not necessarily built the strong academic backbone needed for applying, all is not lost. There are opportunities to pursue research if needed to demonstrate a passion for the field. 

 What sort of medical school should someone aim to attend if they want to
become a dermatologist?


This technically doesn’t matter. The reality is that if you attend an allopathic medical school accredited by the AAMC then as long as you work hard you are in the running for a position. 

Also, what is it like to work as a dermatologist?

Dermatology combines the best of all medicine has to offer. Of course I’m biased but I can support this statement:) We see babies, pediatrics, adults, geriatrics. We see the full spectrum of medical dermatology and see the correlation to internal diseases such as rheumatology, endocrinology, hematology, oncology, etc. We perform a wide range of procedures from skin cancer excisions, lipoma and cyst removals, nail avulsions, just to name a few.  We are board certified in the full spectrum of cosmetic dermatology. We have tons of lasers and devices.

My favorite part about what we do is simply that we do it all. 

 What are their typical day-to-day assignments, what are their usual hours, and how is the work-life balance? 

This is the part that can shock people less familiar with what we do. We see a lot of patients. I do not take breaks. I do not sit down for lunch. I go right through the day going room to room to room. I switch gears constantly. I can go from a skin cancer screening in one room, to acne in the next, to a melanoma excision, to psoriasis in the next, to botox, to a wart, to an autoimmune rash, to a boil, to a laser- all in the span of a few hours.  We just keep moving. When patient hours end, I can finally make calls to patients, make sure I have completed notes in the charts, contacted primary doctors, and complete out any administrative activities. Most typically do this 4-5 days weekly. 

The work life balance is challenging but manageable. I am a strong believer in controlling our schedules. I find that as physicians we can be more present for our patients and focus on their concerns if our minds are not distracted by outside of work challenges. If we are able to control our hours and we will be able make it to our kids performances or events and not get frustrated! I have 3 kids and have managed to be a parent coordinator for at least one of them each year continuously from 13 years (my oldest is a junior now). It’s professionally and personally satisfying to ‘do it all’.

What are the typical salaries?

This can vary based on academic or private practice and how many patient hours you put in. For full time, the  ranges I have seen are between $250k and $350k. 

 

What is the job market like for dermatologists, and how much demand is there for dermatology services? 


There is a strong demand for Dermatologists in most parts of the country.  In general, this goes for all fields, physicians that take the time to really connect to their patients to develop a strong physician patient relationship with all of their patients will build and grow a practice rapidly no matter where they are. 

 

How would you define the term dermatologist to someone who was
unfamiliar with this branch of medicine? 

 

So many times I hear from patients they didn’t even know what type of doctor to go to for various conditions. For the average person I say that we manage anything hair, skin or nail related. But a far better way to really understand where to go is that if you can see it ( meaning it’s on a surface of your body you can see ) then a dermatologist can treat it. 

Why should someone consider a career in this field? 

Dermatology is not for everyone. When choosing a field to pursue remember that you have to love your bread and butter - the most common diagnoses you will see routinely. And you should still enjoy it:) I really appreciate  treating acne, warts, eczema and skin cancer and in spite of treating these literally thousands of times I still recognize that each time we make a diagnosis and manage the condition effectively we make a real difference in people’s lives. That is really why we do this. I also love when  interesting rashes and autoimmune conditions are seen. 

 

What kinds of health conditions do dermatologists confront and address? 

The most common conditions are skin cancer, acne, warts, eczema, rashes, itching, autoimmune conditions, cysts, hair loss, nail disorders, psoriasis, etc. 

What common misconceptions do people have about dermatology that you would want to correct?

Some think we just do cosmetic work all day long. Most of us do a good amount of cosmetic work however the bulk of what many of us do is still medical dermatology given the demand for services. 

 


Also, how common are the types of skin conditions that
dermatologists treat, and how are scientific advancements and
cosmetic trends changing the profession? 

Extremely common! Although not everyone knows or thinks to see a dermatologist I would suggest that everyone needs to see one. If it’s not for things like acne or rashes, everyone should consider an annual skin cancer screening to evaluate their moles, freckles and lesions. 

 

Trends in cosmetics are shifting more minimally invasive cosmetic treatments in our direction as patients seek out less down time and have learned that dermatologists are trained as a part of our board certification to perform these procedures. Many times at spas and other facilities the physicians performing these procedures went to residencies in other fields that did not prepare them for this type of work. They instead attend courses on their own afterwards which can simply not replace years of training and board qualifications recognized by the American Board of Medical Specialties (ABMS). 

How does dermatology and caring for the skin align with other aspects of medicine, and why is it important?

As I’m sure you have heard - the skin is the largest organ our body has. It reflects internal health and understanding the complex interplay between internal disease, the skin and the environment is key to providing patients with the best care possible. I have countless examples of diagnosing patients with internal conditions based on subtle clinical exam findings on their skin. I’ll give you two quick examples:
1- I had a gentleman come in for ‘dandruff’. As soon as I walked in the room I noted red patches on his hands and he was kind of slumped over like he was tired. i suspected he had findings consistent with a condition called ‘dermatomyositis’. As he asked about his scalp we talked more and I learned he had been to 9 different doctors trying to find the cause of his sudden fatigue and was told a range of things from he was stressed to not eating well to they just don’t know because he didn’t have any obvious blood work changes for routine tests. We did a skin biopsy and blood work that confirmed the diagnosis as dermatomyositis. This condition is linked to internal malignancy. We did a malignancy work up and found he had an early stage lung cancer. 
2- I had a gentleman come in for new onset sweating that he found embarrassing. he had also been to 3 doctors and told they couldn’t find anything wrong. When I examined him, he had these little red macules on his fingertips. I suspected they were possibly Janeway lesions. I ordered an echocardiogram and he had endocarditis. Luckily he was able to be treated with antibiotics and his sweating resolved as did his condition. 
3- I had a female patient come in after going to a med spa to have a freckle lasered on her face. She spent over $1000 at the spa and the freckle persisted and got worse. They never at any point suggested to her to seek a dermatologist or consider a biopsy. She only saw me because she was accompanying her husband for his appointment and asked in passing if my lasers would treat it. I asked her if we could biopsy it as I was concerned for the potential for skin cancer given the history. The biopsy came back as a melanoma. 

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