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[PhillyMed777]

I'll try to help-but there are a few issues with the goals as outlined above

1) If you are interested in rheum-derm or onco-derm, adding IM will not make you better at either. Most IM docs are not educated in those topics
2) If you want to practice rheum-derm or onco-derm, you need to realize that they are becoming very sub-specialized within themselves. It is not a norm to try to become a pro at both. In fact I'm not entirely clear what you mean by "the intersection of these fields"
3) Complex med derm fellowships vary in exposure - if you want rheum derm, go for a rheum derm fellowship after derm residency. If you want onc, do a cutaneous onc fellowship after derm. Alternatively, work at a department with strong, subspecialization in either field and work with experts to gain knowledge and experience (i.e. may not have to do a fellowship).
4) Be a self starter - read deeply in those fields and keep up with developments.
5) I do not personally recommend IM-derm combined residency.
6) complex med derm fellowship is fine. In many instances, you may end up spending a lot of time in the inpatient setting. Take that into consideration. Ask prior fellows about their experience and cases. It may be that some of the complex med derm fellowships are better suited for "derm-hospitalist" type of direction, where you run the consult service. Academic depts are increasingly looking for dedicated inpatient dermatologists, or those that want to prioritize inpatient encounters in their work week

 

[The kitchen sink]

Thank you for your detailed and helpful responses!
To clarify, when I said the intersection of these fields, I meant specifically the intersection of rheum and derm or onc and derm.
Do you think there's any utility in having IM training to help with the inpatient/hospitalist side of being a derm-hospitalist, or in general just the medicine knowledge-base IM provides when dealing with systemic conditions that may affect the skin? If not, I'm wondering why these combined residencies exist if you can get to your end goal of complex med derm or inpatient derm without the IM component. Is it specifically for people who want to practice both IM and derm?

Derm-hospitalist?

Lol.

 

[sloh]

Thank you for your detailed and helpful responses!
To clarify, when I said the intersection of these fields, I meant specifically the intersection of rheum and derm or onc and derm.
Do you think there's any utility in having IM training to help with the inpatient/hospitalist side of being a derm-hospitalist, or in general just the medicine knowledge-base IM provides when dealing with systemic conditions that may affect the skin? If not, I'm wondering why these combined residencies exist if you can get to your end goal of complex med derm or inpatient derm without the IM component. Is it specifically for people who want to practice both IM and derm?

Cheap labor.

 

[PhillyMed777]

Thank you for your detailed and helpful responses!
To clarify, when I said the intersection of these fields, I meant specifically the intersection of rheum and derm or onc and derm.
Do you think there's any utility in having IM training to help with the inpatient/hospitalist side of being a derm-hospitalist, or in general just the medicine knowledge-base IM provides when dealing with systemic conditions that may affect the skin? If not, I'm wondering why these combined residencies exist if you can get to your end goal of complex med derm or inpatient derm without the IM component. Is it specifically for people who want to practice both IM and derm?

You need your intern year to meaningfully contribute to complex cases and understand their context —- it becomes most helpful for inpatient side of things in particular

Beyond that I don’t think adding additional IM training years does anything. Again, IM docs arnt spending time on cutaneous onc or rheum/derm. Most of those people in joint residencies Im-derm end up sticking to derm or something else in the derm sphere.

 

[Dral]

Agree with others here. I interviewed at a few of these med/derm programs back in the day. Personally glad I didn't end up at one. The idea of what you could do with the training before one starts seems much better than what one actually does on the other side post-training, at least in my opinion.