PracticalDermatology

Dear New Resident, Part II

Practical Dermatology® reached out to a handful of established and respected dermatologists to find out what they wish they had known during this chapter of their illustrious careers. If you missed Part I, read the June issue online at PracticalDermatology.com/2018/06.

Connect, Advocate, and Diversify

I wish I had had more information about industry and the productive relationships that can come from it. I do a lot of clinical research now, and I enjoy working on developing projects and seeing new treatments through to their availability to patients. Residency was where I got my start and learned how much I liked research. However, our interaction with industry was limited due to lack of knowledge and limited connections. If I had it to do over again, I would pay more attention during meetings and try to meet Medical Science Liaisons (MSL) from different companies I was interested in and learn more about the upcoming science.

I hear from many emerging residents that their business education is limited. With today’s Internet resources, there are a lot of ways one can educate oneself on various practice management topics as well as increasing one’s financial awareness. I would also have begun my involvement with organized medicine at an earlier stage, becoming involved with my local, state, and national medical societies as a resident member or board member. The American Medical Association has many opportunities for residents, and membership is very affordable or free.

One of the major concerns of the American organized medicine community is physician burnout. With increasing regulation and constant pressure, this has become a reality, resulting in morbidities, including physician suicide. Along with making time for family, friends, and things you enjoy, a healthy work balance is important. Lifelong learning can be critical so one does not become stagnant, doing the same thing every day.

At work, find ways to increase variety. My way was to participate in clinical research as a way of diversifying my work to include other methods of productivity and learning. Yours might be a different approach. The people that I know who are happiest are on the move, teaching, learning, developing, researching, and helping. Make time for life, but also make work fun and interesting.

Todd E. Schlesinger, MD, FAAD
Dermatology and Laser Center of Charleston
Clinical Research Center of the Carolinas
Charleston, SC

Get Out!

It’s important to realize that “another day in the office” isn’t going to be a major deviation from the one before or after and that opportunities to attend meetings and interact with colleagues are priceless. You can never imagine or predict the wealth of information and fun you can accumulate from collegial interactions, so make time to get out of the office and learn, and have fun doing it!

The other piece of advice for younger and more experienced dermatologists is to pay attention to what your younger and older colleagues have to say. It is important for more experienced dermatologists to embrace “reverse mentors”— who are younger than the mentees—so they can learn about social media and current trends in younger generations. At the same time, younger practitioners can benefit from the wealth of experience their more senior colleagues have gathered over the years. There’s a real tendency for each group to dismiss what the other says, and this creates a major lost opportunity to learn.

Eric F. Bernstein, MD, MSE

Main Line Center for Laser Surgery

Ardmore, PA

Know the Secret of Your Success

The definition of success depends on the individual. For some, it’s publishing a certain number of articles. For some it’s making a certain amount of money.

But true success is finding the right balance between work, family, and hobbies.

Mark D. Kaufmann, MD
Associate Clinical Professor
Dept of Dermatology
Icahn School of Medicine at Mount Sinai
New York, NY

Uncover the Real Art of Dermatology

Residency is a time to learn not only dermatology, but how to be a dermatologist, how to talk to patients, explain their condition and expectations of treatment, and how to communicate with staff and colleagues. Listen to how your mentors interact with their patients—that’s the real art of medicine.

Be interested in all aspects of dermatology. Don’t limit yourself to medical or surgical or cosmetic only. One never knows where his/her career will take them.

Work hard, smart, and efficiently, to find the time to disconnect from work and connect with family and friends every day.

Gary Goldenberg, MD
Goldenberg Dermatology
Clinical Professor of Dermatology
Icahn School of Medicine at Mount Sinai
New York, NY

Pay Attention

Residency is your time to see the fascinomas you may never see again and spend time with many different attendings who trained at different places and at different times.This isn’t the time to skip a rotation where you aren’t “necessary” in order to attend a spin class. Because once you are out of training, those dermatology experiences won’t exist. I remember things my attendings said or did 20+ years ago, and they still shape my practice.

And don’t lose your fear.

You may be called a dermatologist on July 1, but fear will keep you on the right track until you actually are one.

Heidi Waldorf, MD
Waldorf Dermatology & Laser Associates PC,
Nanuet, NY

Focus on “The Way”

Residency is really short, although the days are long. Suck the marrow out of it as it will be limited and, although it sounds corny, it is a special time of learning and growth that will never really be available again. Beyond the knowledge, which is in some ways the easiest to acquire post-residency, it’s key to focus on the “way”: how our teachers navigate the patient experience as well as how they balance the humanism part of medicine with the scientific. That is the hardest part—the art, if you will—and that is something that is best learned by following a model rather than reading a book.

Peter A. Lio, MD
Clinical Assistant Professor of Dermatology and Pediatrics
Northwestern University Feinberg School of Medicine
Medical Dermatology Associates of Chicago

Build Your Brand and Your Brain Trust

There is this invisible force that makes first year residents want to study the nitty gritty complexities of dermatology. You need to walk before you run and focus on the fundamentals, such as lexicon and properly formulating a differential diagnosis based on your verbose description. I live, breathe and bleed the reaction pattern approach (papulosquamous, eczematous, vesicolbullous, vascular, dermal) and share this enthusiasm with all the residents in my area. Regardless of how you do it, stick to the basics, become fluent in the language of dermatology, and all else will fall into place after.

While it is important not to dilute your training, residency is also a time for early career development. There are numerous opportunities specific to residents from free conferences, to committees, to grants, to awards, to editorialships to...you get it. Get started early, build your brand the right way through productivity (not posting on Instagram). Get involved early and show the world what you are made of.

No one ever does it alone. I recommend building your brain trust of mentors early. These are confidants, door openers, collaborators. In this case, more is better.

Adam Friedman, MD, FAAD
Associate Professor of Dermatology
Residency Program Director
Director, Translational Research
George Washington School of Medicine and Health Sciences
Washington, DC

Be Passionate

Keep your mind open and try to identify fields of interest or diseases of interest. You should also try to build relationships inside your department and with various specialists from outside the department to establish collaborations that will be perhaps valuable in the future.

If you are interested in basic or translational research, you should identify mentors who can be important to set up research projects that can result in publications and presentations in meetings. It is important to identify good mentors. In my view, it is all about mentorship.

I owe a very large part of my success to my mentors—starting with my PhD mentor that set me up on a path of research, and continuing with my post doc mentor, who mentored me on immunology of skin diseases and helped me identify my translational path. Mark G. Lebwohl, MD, my chair, mentored me on clinical trials and study design. I, in turn, try to be a good mentor to my students and fellows and position them for success.

Thus, identifying your mentors (and do some research before you choose them, so that you make the best choice possible of the mentor that will support you best) matters.

Focus on what you are passionate about—if you are not passionate, you will not succeed. You need to pick a disease or area of interest that you are very passionate about and would want to devote your time to.

It is important to find the balance between life outside and our professional life, and compromises may be needed. Find a partner who will understand you and support you and your career. You do not need to feel guilty if you like what you do and like to devote your life to it.

Emma Guttman-Yassky, MD, PhD
Vice Chair, Department of Dermatology
Icahn School of Medicine at Mount Sinai
New York, NY

AMA Calls for More Residency Slots

The number of US medical student graduates is growing more rapidly than the number of residency slots, and the American Medical Association (AMA) is calling for change. AMA adopted policy at its Annual Meeting last month that reaffirmed the need for an increased number of medical residency slots. The new policy also calls on legislators, private sector partnerships, and existing and planned medical schools to create and fund graduate medical education (GME) programs that can accommodate the equivalent number of additional medical school graduates, consistent with US workforce needs.

The new policy asks medical school accrediting bodies to prospectively and retrospectively monitor medical school graduates’ rates of placement into GME as well as GME completion. The AMA also encourages medical schools to increase efforts to educate students concerning educational debt, medical specialty choice, and potential career paths.

Cosmetic Surgery Forum Grants: Application Deadline Looms

Cosmetic Surgery Forum is offering fellow and resident grants to this year’s meeting. The grants cover meeting registration ($750), hotel (four nights in a shared room or half the cost of a single room), a $150 travel stipend, breakfast and lunch Thursday through Saturday, and inclusion in ancillary social and education events (Wednesday through Friday evenings).

Grants are available to fellows and residents in the core specialties. To qualify, fellows and residents must submit a 500-700 word abstract covering a dermatology or cosmetic surgery topic that has not been submitted for publication elsewhere.

For details or to apply, visit Cosmeticsurgeryforum.com/grants/