Tis the time of the year when most programs are starting to send out invites for residency interviews. This exciting time is often mixed with the anxiety of the unknown, the headaches of winter travel, and feeling pressured to impress.
With dermatology, and other competitive specialties, where only a handful of applicants are interviewed, even the smallest detail of an applicant can be a topic of discussion when we (the faculty members) deliberate and generate our match list. In this post, I will share with you some of my tips on how to best prepare for that nerve racking interview, and share some how tips on how to have an enjoyable and ultimately successful interview season.
Happy first week of residency to those of you who have recently transitioned from the short white coat to the long. As a dermatologist I fortunately only work during the day. However, I still remember back during intern year, the dreadful long night shifts. When I start residency, the 16-hour work restriction was just implemented. Although I lucked out of 24 hour shifts, the night floats did equal damage to my sleep schedule and skin. For residents, nurses, respiratory therapists or other healthcare providers that routinely work long over night shifts in the hospital, I have some easy and quick tips to salvage or maintain your skin.
Most entrepreneurs aren’t physicians, and most physicians don’t realize that they can start companies. It’s beautiful thing, though, to see more doctors and doctors-in-training becoming interested in healthcare innovation, digital health and the entire healthcare ecosystem outside of traditional clinical medicine. As an adjunct professor at Stanford School of Medicine, when I spend time with first and second year medical students, they are most often curious about what opportunities are available to them outside of clinical practice in an academic setting or private group setting. It turns out that you no longer have to choose between being clinical and doing something more innovative and entrepreneurial. You can have your cake and eat it too, actually. You just have to know what is out there and how to carve our opportunities for yourself.
For medical students who truly love 2 different specialties and vacillate between the two, there are accredited combination programs in the country that allows for residents to be board-certified in 2 different specialties. Combined Internal medicine-dermatology (Med-Derm) is a much sought-after program; other ones include internal medicine-pediatrics and internal medicine-emergency medicine, just to name a few.
Many of you have asked me to do a post on what is it like to be on call as a dermatologist. First, I would like to clarify the terminology “Dermatology Hospitalist.” Unlike true internal medicine hospitalists who admit patients and are the primary physicians for hospitalized individuals, dermatology hospitalist is a new term coined to describe medical dermatologists that care for hospitalize patients with “a focus on education, research, development of new treatment algorithms, and identification of emerging patterns in disease.” This is the goal of the Society of Dermatology Hospitalists, which I am a member of.
With increasing complexity in medical care and drug interactions, skin findings are often one of the first signs of an underlying problem or even the primary problem for someone to be hospitalized. This is especially true for any hospital with a burn center, where patients are often transferred due to their life-threatening skin diseases. At my hospital, we have a busy inpatient consult service that our residents are an integral part of. Those of you who are in medicine know that patient’s responses and symptoms can be in constant flux and require diligent follow through in order to ensure the proper diagnosis and treatment. My philosophy on how a consult service should be is to offer prompt advice and maintain follow up throughout someone’s hospitalization, both of which are much appreciated by our medicine hospitalist colleagues. We are available 24/7, but thankfully there are very few dermatologic emergencies at night that cannot be taken care of the next day.
My team is made up of three residents and four attendings who take turns being on call. Our residents, drawn from the best medical students, take care of all the information gathering and communications with the various hospital teams. This is the educational and service opportunity for our residents, who must change their mental gears towards a completely different set of problems and take their time to review the latest research. Overwhelmingly, our residents are correct and then it is up to the attending physicians to challenge the residents to think more broadly and systematically. The fun part is when the diagnosis and treatment is elusive, and everyone is able to pitch in to find the right diagnosis. This is probably the closest we come to being Dr House, but more collegiality and less snark.
In a future post, I will be sharing some of the rare and challenging cases that we’ve seen inpatient!