Written by Paul M. Graham, D.O.
Since the release of A Day in the Life of a Dermatologist: Part 1 was an absolute hit, I have decided to keep it going. In the last post, I left everyone on edge wondering what was to come during this crazy journey through the painstaking process of working toward a career in medicine. We have already touched on the beginning of my journey so now we will delve a little bit deeper. As most medical students are aware, dermatology is one of the most sought-after residency specialties in medicine. This is likely, in part, due to the of the variety of procedures performed and the lifestyle flexibility that it has to offer. From the moment that I set foot in a dermatology office, I knew this is what I wanted to do with my life.
During college, I had the opportunity to work in the emergency room as an ER tech at Sentara Obici Hospital in Suffolk, VA. This was made possible because I took an EMT course during my senior year of high school and got my certification prior to graduation. If this opportunity did not exist, I don’t think I would have chosen a path in medicine. The reason I am telling you all of this is because I was almost certain that going into medical school that I would pursue a career in emergency medicine. What I loved about the ER was the variety of procedures and the surprise factor that it offered. No one could ever predict what was going to come through those ER doors and that excited me. I worked four 12 hour shifts every week for 5 years in that ER and this taught me a lot of what has made me successful today, most of which is only learned by being in the moment. The ER taught me patience, empathy, perseverance, and respect. It is these traits that are acquired by “putting in the time” and not easily learned from reading a textbook.
Dermatology is very similar to emergency medicine in that it offers a large variety of procedures and that “surprise-element” that I crave. Each day is different and can range from patients with rashes, skin cancers, hair loss, pathology, skin surgery, cosmetic procedures, and life-threatening systemic diseases. For the most part, dermatology is a “happy” specialty meaning that people are generally more healthy and “chipper’ during their appointments and as a dermatologist, I strive to promote a positive and encouraging environment for all of my patients. We diagnose skin cancer on a daily basis, but fortunately, a lot of these cancers are easily treated. Unlike most other specialties, dermatologists can diagnose and cure cancer on the same day!
OK, back to why I spent a whole paragraph telling you about my background in emergency medicine… During my first rotation as a medical student in the ER, my whole perspective on this specialty changed. I was not just an ER tech anymore, I was actually responsible for over ten patient’s lives at a time while simultaneously juggling the heavy burden of maintaining medical records. I found myself becoming very overwhelmed with the stressful environment and didn’t truly realize the responsibility that an ER physician had to take on. The ups and downs really weighed on me and I began looking elsewhere for that perfect fit. Not one month later, I had the rare opportunity to work with a local dermatologist and this experience solidified my desire to pursue this medical specialty.
Fortunately, I realized this change early on and had time to shift my focus on dermatology. What most people don’t realize is that for you to be a competitive candidate for dermatology residency, you need to have a near perfect resume, which I did not have at the time. I had great grades but did not have any research experience so I saw my chances of landing a spot in dermatology as very slim. Out of nowhere, I was presented with an opportunity to do laboratory research over the summer with one of our pharmacology instructors at the medical school. We work together doing experiments on cells and proteins to determine the exact mechanism of action of mesalamine, a medication used to treat inflammatory bowel disease. After 2 months of intensive laboratory experiments, we were able to isolate the precise mechanism by which this medication works to suppress inflammation. This was truly a chance event that somehow ended up succeeding. With the residency application process quickly approaching, we put together a scientific paper on these findings. (Here is the link to our paper: https://link.springer.com/article/10.1007%2Fs11010-013-1620-z) After approximately three months, I had my first publication and I knew this would really benefit my residency application. I continued to pursue opportunities to “beef up” my resume and by the time the dermatology application submission deadline arrived, I had a total of 3 scientific paper publications.
As an osteopathic medical student (DO), the application process into dermatology was different than allopathic medical students (MD). One of the main differences was that osteopathic medical students had to first apply to their internship program and did not apply for dermatology residency until after starting internship, whereas, allopathic medical students were able to apply to both the internship and residency program of their choice at the same time. The problem with this is that osteopathic medical students had to “risk” taking a year off to reapply to dermatology if they did not match the first time around, whereas allopathic medical students had a guaranteed residency spot upon finishing the internship. This process was extremely stressful and risky, but I decided to take the “leap of faith” and go for it! Fortunately, I ended up matching into dermatology the first time around and did not have to take that “dreaded” year off to reapply. As a side note, each time you do not match into dermatology, your chances of getting a position shrink significantly.
I was fortunate enough to land a residency spot in dermatology and I am forever grateful to God, my family, and my friends for all of their enduring love and support through this incredible journey.
In our next post, we will delve into the details of my experience during residency. Dermatology residency was one of the most intense rollercoaster rides of my life and I look forward to telling you this story. Stay tuned…