TheRealRonald
New Member
- Joined
- Feb 15, 2019
- Messages
- 3
- Reaction score
- 6
I finished my dermatology residency application and matched last year. Had to go through the process twice since I didn't match the first time around, but in the process I learned a lot along the way. One thing I noticed is that people often ask the wrong questions. They are far too generic and for the most part, residents give cursory answers and often will lie or cover up the truth.
For example:
-Do you like your program?
-Is there anything about your program that you would change?
-Are the residents here happy?
Since you're unlikely to get any real answers from these questions, they aren't good questions.
Instead, the key is to ask SPECIFIC questions that people are less likely to be able to lie or hide the truth about. The questions should be focused on aspects of what the training is like. I've made a sample list of the questions below and broken them into categories to make it easier to parse.
Surgical:
-How many excisions do you complete as the primary surgeon as a first year resident? How many by the end of second year? How many by third year? I was surprised to see how some programs had residents barely reaching the minimum required by graduation, but when I saw people asking how the surgery experience was, the residents said they had no concerns and they felt the training was excellent!
-Does your program teach you how to do basic flaps? Do residents get hands on practice with flaps and if so, what ones and how many do they perform as the primary surgeon?
-Do residents get to perform surgeries on the head and neck?
-Is surgery time compromised by other obligations such as clinic?
-How frequently do you do surgery? Is it evenly spaced throughout the training, or do you go long periods of time without doing surgery? If so, how long can someone go without doing a surgery?
-Do you have a Mohs fellow? Do you feel the Mohs fellow takes cases away from the residents?
-Who does the complex closures for your Mohs cases? Do they get outsourced to a plastic surgeon?
-Is your surgery time mostly dedicated to resident appropriate dermatology surgery, or is it mostly Mohs?
-What are the resident responsibility on your Mohs rotation? Is it an active role, or is it mostly observational/closing simple repairs?
-Do residents feel comfortable performing dermatologic surgery by the time of graduation? Do you feel you need more hands on training?
Cosmetics:
-Who teaches you cosmetics?
-Are there any private practice dermatologists that are part of the faculty that teach you cosmetics?
-How many cases of Botox/filler did you complete independently by the end of your first year, second year, and third year?
-Do graduating residents feel comfortable using lasers for common conditions such as redness?
-What training do you get on assessing facial aesthetics? Who teaches this and how is it done?
-Is your cosmetic training mostly observational, or is there a significant hands on component?
-How much time is dedicated to teaching cosmetics as a first year, second year, and third year?
-How many lectures are dedicated to cosmetics per year?
-Do your residents get free product to use? Can your residents practice cosmetics on each other under supervision?
-Do residents feel comfortable when they graduate performing routine cosmetic procedures on patients, or do they need to seek additional training after graduation? Once again, residents rarely offered up the lack of a real cosmetics experience when asked in generic way, but when asked specifically, I often found graduating residents tell me their residents barely get any hands on experience and most either never practice cosmetics after residency or have to seek training on their own!
Dermatopathology:
-How much time is dedicated to dermpath teaching?
-Who does the majority of dermpath teaching, residents, fellows, or attendings?
-Is there a specific dermpath rotation? If so, is there time dedicated during the first year, second year, and third year of training?
-Do residents get 1:1 teaching from dermpath attendings, if so how much and when?
-Do residents feel relatively comfortable with dermpath by the time they graduate, or do they mostly have to "learn it on their own"?
Pediatrics:
-Is there a pediatric dermatologist at your program?
-How much time is dedicated to pediatrics? Or is it just mixed in with general clinic?
-Do residents ever go into pediatric dermatology?
-Is there a pediatric dermatology fellow? If so, do you find them helpful, or do you feel they take away cases from the residents?
Other:
-Who gives most of the lectures? Residents or attendings?
-Is there diversity among the faculty, or did they mostly come from the same institution? Do you think the attendings eacheach unique approaches to dermatology, or does everyone use the same cookie cutter approach?
-How does your program rate on the annual ACGME survey? Are there any issues with this?
-Has your program had any known ACGME violations or known citations recently? If so, what has been done to fix them?
-How much time is dedicated to lectures? Do you have to miss lectures frequently for any reasons?
-Have any residents left your program that you know of? If so, why?
-How is the faculty retention rate? Is there high turnover?
-Does your program have any prominent faculty members, or ones that are well known for their ability to teach? If so, how many and who? How often do they contribute to your education?
-Does the department rely heavily on any one individual to carry the educational "burden", or are a lot of attendings involved in teaching?
-Tell me who the best teacher is in your program and why.
-Do your attendings use dermoscopy? If so, how many and do they teach you the specifics in clinic?
-About how many hours a week do you work? Do you feel like you have enough time to study?
-How do residents in general perform on the mock board exam?
Hopefully, this gives you a better idea of how to gather some important information about a program. Just because residents "seem happy" somewhere, doesn't mean the quality of the education is good. Just because people tell you their program isn't malignant, doesn't mean the program is going to train them well. On the same note, perceived reputation doesn't always mean a good education either. I found places many people would consider a "top" program to have absolutely abysmal training. I think it also says a lot about a program when residents tell you how much they love their program and how great it is only to find out minutes later how many deficiencies they "mistakenly" failed to mention.
The program you go to plays a large part in your career, so don't take it lightly. Ask tough questions, get real answers, and make an educated decision, not a decision just based on how you felt after your interview day or whether you think the residents you talked to seemed happy. Doctors like making decisions based on evidence, so try and bring some of that into the application process. Best of luck!
For example:
-Do you like your program?
-Is there anything about your program that you would change?
-Are the residents here happy?
Since you're unlikely to get any real answers from these questions, they aren't good questions.
Instead, the key is to ask SPECIFIC questions that people are less likely to be able to lie or hide the truth about. The questions should be focused on aspects of what the training is like. I've made a sample list of the questions below and broken them into categories to make it easier to parse.
Surgical:
-How many excisions do you complete as the primary surgeon as a first year resident? How many by the end of second year? How many by third year? I was surprised to see how some programs had residents barely reaching the minimum required by graduation, but when I saw people asking how the surgery experience was, the residents said they had no concerns and they felt the training was excellent!
-Does your program teach you how to do basic flaps? Do residents get hands on practice with flaps and if so, what ones and how many do they perform as the primary surgeon?
-Do residents get to perform surgeries on the head and neck?
-Is surgery time compromised by other obligations such as clinic?
-How frequently do you do surgery? Is it evenly spaced throughout the training, or do you go long periods of time without doing surgery? If so, how long can someone go without doing a surgery?
-Do you have a Mohs fellow? Do you feel the Mohs fellow takes cases away from the residents?
-Who does the complex closures for your Mohs cases? Do they get outsourced to a plastic surgeon?
-Is your surgery time mostly dedicated to resident appropriate dermatology surgery, or is it mostly Mohs?
-What are the resident responsibility on your Mohs rotation? Is it an active role, or is it mostly observational/closing simple repairs?
-Do residents feel comfortable performing dermatologic surgery by the time of graduation? Do you feel you need more hands on training?
Cosmetics:
-Who teaches you cosmetics?
-Are there any private practice dermatologists that are part of the faculty that teach you cosmetics?
-How many cases of Botox/filler did you complete independently by the end of your first year, second year, and third year?
-Do graduating residents feel comfortable using lasers for common conditions such as redness?
-What training do you get on assessing facial aesthetics? Who teaches this and how is it done?
-Is your cosmetic training mostly observational, or is there a significant hands on component?
-How much time is dedicated to teaching cosmetics as a first year, second year, and third year?
-How many lectures are dedicated to cosmetics per year?
-Do your residents get free product to use? Can your residents practice cosmetics on each other under supervision?
-Do residents feel comfortable when they graduate performing routine cosmetic procedures on patients, or do they need to seek additional training after graduation? Once again, residents rarely offered up the lack of a real cosmetics experience when asked in generic way, but when asked specifically, I often found graduating residents tell me their residents barely get any hands on experience and most either never practice cosmetics after residency or have to seek training on their own!
Dermatopathology:
-How much time is dedicated to dermpath teaching?
-Who does the majority of dermpath teaching, residents, fellows, or attendings?
-Is there a specific dermpath rotation? If so, is there time dedicated during the first year, second year, and third year of training?
-Do residents get 1:1 teaching from dermpath attendings, if so how much and when?
-Do residents feel relatively comfortable with dermpath by the time they graduate, or do they mostly have to "learn it on their own"?
Pediatrics:
-Is there a pediatric dermatologist at your program?
-How much time is dedicated to pediatrics? Or is it just mixed in with general clinic?
-Do residents ever go into pediatric dermatology?
-Is there a pediatric dermatology fellow? If so, do you find them helpful, or do you feel they take away cases from the residents?
Other:
-Who gives most of the lectures? Residents or attendings?
-Is there diversity among the faculty, or did they mostly come from the same institution? Do you think the attendings eacheach unique approaches to dermatology, or does everyone use the same cookie cutter approach?
-How does your program rate on the annual ACGME survey? Are there any issues with this?
-Has your program had any known ACGME violations or known citations recently? If so, what has been done to fix them?
-How much time is dedicated to lectures? Do you have to miss lectures frequently for any reasons?
-Have any residents left your program that you know of? If so, why?
-How is the faculty retention rate? Is there high turnover?
-Does your program have any prominent faculty members, or ones that are well known for their ability to teach? If so, how many and who? How often do they contribute to your education?
-Does the department rely heavily on any one individual to carry the educational "burden", or are a lot of attendings involved in teaching?
-Tell me who the best teacher is in your program and why.
-Do your attendings use dermoscopy? If so, how many and do they teach you the specifics in clinic?
-About how many hours a week do you work? Do you feel like you have enough time to study?
-How do residents in general perform on the mock board exam?
Hopefully, this gives you a better idea of how to gather some important information about a program. Just because residents "seem happy" somewhere, doesn't mean the quality of the education is good. Just because people tell you their program isn't malignant, doesn't mean the program is going to train them well. On the same note, perceived reputation doesn't always mean a good education either. I found places many people would consider a "top" program to have absolutely abysmal training. I think it also says a lot about a program when residents tell you how much they love their program and how great it is only to find out minutes later how many deficiencies they "mistakenly" failed to mention.
The program you go to plays a large part in your career, so don't take it lightly. Ask tough questions, get real answers, and make an educated decision, not a decision just based on how you felt after your interview day or whether you think the residents you talked to seemed happy. Doctors like making decisions based on evidence, so try and bring some of that into the application process. Best of luck!
Last edited:
