Intergenerational Dermatology: Three Generations of Dermatologists Reflect on the Field

Although many children follow their parents’ paths to medical school, the specialty of dermatology seems to run in the family. Practical Dermatology reached out to several dermatologists with family connections for their perspectives and reflections on the field.

For the Resniks, the family connection encompasses three generations: Sorrel S. Resnik, MD, retired in 2020 after more than 50 years of dermatology practice; his son, Barry, in private practice in Miami for nearly 30 years; and granddaughter, Sydney, a first-year resident at Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL.

All three Resniks share their perspectives on the importance of family support and how dermatology has changed since the first Resnik entered the field.

What inspired you to pursue a career in dermatology?

Dr. Sorrel S. Resnik: My brother, who’s five years older than I, had atopic dermatitis. I remember my mother getting up early each day to clean him up and bandage him so he could go to school. He got better as time went on, but I remember my parents feeling so helpless in treating his disease. There was nothing to do but Vaseline and bandages. I remember his itching was so terrible. That was the genesis of my desire to be a physician, and it followed me all the way into medical school and ultimately into dermatology.

Understanding how illness impacts families, how much, if at all, did you encourage your son to pursue a medical career and specialize in dermatology?

SSR: Barry’s interest in dermatology developed on its own. He used to sit in the bedroom where I kept my medical bag from the Air Force, wearing my Air Force cap and playing with my reflex hammer and stethoscope. I remember him wanting to come with me when I did my consultations at Variety Children’s Hospital, one of the first children’s hospitals in the country. He would wait for me while I saw the patients, and I would talk with him about the things I saw. His interest grew, and he worked for me as a medical assistant for several years; I think that experience cemented his desire to become a dermatologist.

How fortunate for him to have that kind of training—and for you to be able to mentor him. Has training changed since the time you began your career, and when your son, and then granddaughter, entered the field?

SSR: I don’t think training has changed much since I trained in the late 1950s. I was a resident at the University of Pennsylvania Department of Dermatology, and our teachers were giants in the field: Walter Shelley, Donald Pillsbury, and Albert Kligman. They made so many contributions to how we practice today, and there was so much excitement to being in their clinics and watching how they were able to diagnose and treat patients. Our clinics were staffed by community dermatologists, who also taught us a great deal on how to help our patients. Oral and topical steroids were just coming into vogue, and they gave us so much more power to help so many people with so many skin diseases.

When I moved to Miami, I became associated with the University of Miami Department of Dermatology and Cutaneous Surgery as an adjunct professor and maintained that relationship until I retired in 2020 after more than 50 years of practice. Along the way, a small group of colleagues and I founded the American Society for Dermatologic Surgery. The department was the first in the country to have cutaneous surgery as part of its curriculum. It’s exciting for me that Barry, and subsequently Sydney, were both able to do their residencies there. I know from conversations with Barry when he was in residency, and now with Sydney, that they are both learning in the same style. The system of learning from community dermatologists and members of the faculty gives the best perspective on patient care.

How has that community-centered approach translated into the advice you give your son and granddaughter about the joys and challenges of dermatology?

SSR: I gave them both the same advice: When it comes to helping patients, treat patients like people; listen to them as they describe their problems, and then touch them when examining. The art of medicine includes making a connection as well as giving a diagnosis and a treatment plan. I enjoyed practicing medicine every day, and I hope they will feel the same way. It is a thrill to see them following in my footsteps, and an honor that they both chose dermatology, the discipline to which I’ve devoted almost all of my professional life.

Barry Resnik, MD, recalls accompanying his father to the hospital to see patients, and the joy his father had in practicing dermatology.

What inspired you to pursue a career in dermatology?

Barry Resnik, MD: I don’t remember any particular event that inspired my desire to be a physician; it is something that I have always wanted to do. I do remember the excitement my father showed when he talked about dermatology.

Your father shared a lot of his career with you. How much, if at all, did you encourage your daughter to pursue a medical career in general and dermatology in particular?

BR: My father did not push any of his kids towards medicine, nor did I. My wife, an attorney, and I would talk about our days at the dinner table, and I think our kids could tell that each of us loved what we did. When I saw that Sydney had a natural interest in medicine, I tried to foster that interest.

Seeing the field through her eyes must give you interesting insights into the notable evolutions in dermatology training and practice since the time you began your career to when your daughter entered the field?

BR: The changes in technology have been both a blessing and a curse. Electronic medical records enable us to take better care of our patients, but the Internet has proven to be a decidedly mixed blessing. Now, part of our daily practice involves dispelling the often very misleading and potentially dangerous information that patients believe because they read it online. However, the advent of so many new and very effective medicines have revolutionized dermatology and made so many people’s lives better.

What aspects of dermatology training and practice have stayed the same?

BR: The sheer volume of information Sydney will have to master has increased dramatically from when I did my residency. However, residency has always been about learning how to help patients and manage their diseases to improve their lives. That will never change.

Did you advise your daughter on any pearls and pitfalls of practicing dermatology?

BR: From the time Sydney showed an interest in dermatology, I have been sharing my thoughts on how I treat and help patients. I am sure she picked up a lot when she worked for me as a medical assistant while in college, as I worked as a medical assistant for my father. It was my greatest joy to teach her for the first time in clinic this August when she started her residency.

What do you enjoy most about having your daughter follow in your career footsteps?

BR: It will be my greatest honor to have her join me in private practice at the end of her residency. I look forward to learning from her as well. She shares my passion for patient care, particularly for those who suffer with hidradenitis suppurativa, and we both look forward to carrying on the family tradition.

As a third-generation dermatologist currently in her residency, Sydney Resnik, MD, has the benefits of experience from her father and grandfather as she prepares to carry on the family tradition.

Growing up, what did you think about your father’s job? Did that impact your decision to choose a medical career?

Sydney Resnik, MD: My father worked with my grandfather, and he would tell us about various skin problems they were treating and little funny anecdotes from their days. And of course, as a kid, it’s very cool to know that your grandpa and your dad are helping people.

As I grew older, I started wanting to hear more about the why and the how of what he was doing—how did he make that diagnosis? Why was he using this treatment? I think that is around the time I was falling in love with science and biology in school. I knew for certain I wanted to have a career in the scientific field, but I wasn’t necessarily set on medicine. I actually entered college with the idea that I would get my PhD and work in science research.

All that changed the summer after my freshman year of college, when I was home from school and was looking for something to do with my time. My father’s office was busy, and he asked if maybe I’d consider working for him as a medical assistant for a few weeks. I ended up staying and working for almost the entire summer. I enjoyed seeing patients every day, and as we worked, my father would share tips about diagnosing or treating that he had gotten from my grandfather. I loved learning about the conditions I was seeing, and I loved watching as patients improved with the treatments he was prescribing. I went back to school for my sophomore year, declared myself a pre-med student, and the rest is history.

Did you know on entering medical school that you wanted to pursue dermatology?

SR: When I first entered medical school, I had a pretty good idea that dermatology might be where I would end up. On the other hand, I didn’t want to just “end up” in dermatology because I was comfortable there. I did my best to keep an open mind throughout my training, particularly during my third-year clerkships, but I found myself searching out the dermatologic cases within every specialty. During my ObGyn clerkship, I encountered a patient with “pruritic eruption of pregnancy” and was fascinated. In Pediatrics, I volunteered to follow and help treat a child with a severe case of tinea capitis.

Those experiences helped me realize that I didn’t want to become a dermatologist just because it was my father and grandfather’s field. They both fostered and supported my initial interest in skin biology, but my own genuine fascination with the field ultimately drove my decision to pursue dermatology. I know how privileged I am to have the benefits of two generations of dermatologists behind me and look forward to continuing to learn from both my father and my grandfather.

What are some differences about your dermatology training/medical school experience compared to your father’s experience?

SR: Medicine is always evolving, but every year there is more and more to learn. I remember bringing home some of my textbooks during medical school and my father commenting on how they had tripled in length since his time in school. The same is true in dermatology—it is already such a vast subject, but every year, we make more advances.

How have these evolutions in training informed how you practice?

SR: Residents today are lucky to incorporate so much technology into our training. I have access to so many resources in the palm of my hand, and I can learn from videos, vast banks of online images, and directly from other dermatologists via Zoom lectures.

I think the electronic medical record [EMR] is one of the most significant evolutions in medicine since my grandfather’s generation was training. My father incorporated EMR into his practice fairly early, and EMRs have been my only experience when it comes to patient documentation. For me, the EMR is essential to my practice; I can access notes on my phone from almost anywhere to answer patient questions whenever necessary.

What are some of the benefits (expected and unexpected) about having a parent in dermatology?

SR: I never suffered a sunburn as a kid, but I also never had a tan, which as a teenager in the ‘90s was a travesty! However, I’m incredibly grateful to have my father in the same field. He’s there as a sounding board when I need advice, and some of my favorite time is spent volleying ideas back and forth with him, usually still over dinner.