Q&A: Wall Street Journal article may leave ‘concerning’ impression of dermatologists

Key takeaways:

• The Wall Street Journal has claimed dermatology is a glamorous, laid-back and lucrative specialty.
• Seemal R. Desai, MD, FAAD, president of the AAD, tackled these claims.

The Wall Street Journal has published an article labeling dermatology as the “it” job in medicine due to seemingly glamorous perks, prompting a defense from the American Academy of Dermatology.

“Four-day workweeks, double the salary of some colleagues and no emails at night. If those perks sound like they belong to a few vaunted tech jobs, think again. Dermatologists boast some of medicine’s most enviable work lives, and more aspiring doctors are vying for residency spots in the specialty.”

So began an article published by the Wall Street Journal entitled “$500,000 pay, easy hours: How dermatology became the ‘it’ job in medicine,” where dermatology is portrayed as a glamorous, lucrative and easy-going job pursued by many but achieved by few.

The article claims that these supposed perks of the specialty have contributed to its popularity among residents, causing a 50% uptick in applications, according to data from the Association of American Medical colleges.

A source in the article calls residency slots within the specialty “ungodly competitive,” crediting this competition to offerings of a better work-life balance, free weekends and a median $541,000 annual salary — a figure the publication compared with pediatricians’ annual median salary of $258,000.

With the subtitle “Americans’ newfound obsession with skin care has medical students flocking to this specialty,” the article insists that dermatology’s “allure” is, in part, due to the boom in skin care’s popularity on social media, with dermatologists receiving as much as $30,000 for sponsored posts from skincare brands.

The approval of Botox for frown lines in 2002 and the pandemic-induced necessity of Zoom offices have also caused rates of cosmetic consultations and procedures to skyrocket, with one source in the article saying the residents she has worked with in recent years have been “more interested in how much I charge for Botox.”

In response to this article, the AAD released a letter to the Wall Street Journal’s editor, calling the impression of the article on readers “extremely concerning,” stating that the content “completely overlooks the primary reason why dermatologists choose this career: a lifelong commitment to helping their patients and the public by providing critical medical care for diseases affecting the body’s largest organ.”

The Wall Street Journal declined Healio Dermatology’s request for comment.

Healio Dermatology spoke with Seemal R. Desai, MD, FAAD, president of the AAD, about some of the claims made in the article and their negative repercussions as well as what residents can truly expect in this demanding field.

Healio: Why is the article’s impression on readers “extremely concerning” for the dermatology field?

Desai: The narrative portrayed in the article completely misrepresents the specialty, diminishing the vital contributions dermatologists make to medicine. By framing dermatology as a superficial or overly simplistic field, such accounts undermine the profound and life-changing work dermatologists perform — we play an essential role in improving patients’ health and quality of life.

This misrepresentation also overlooks the rigorous training required to become a dermatologist. Aspiring dermatologists undergo years of intense education, clinical experience and competitive residency placements to master the complexities of skin health, disease and treatment.

Simplifying the specialty not only devalues the expertise required but also minimizes the significant impact dermatologists have on their patients’ physical and emotional well-being. Recognizing the true scope and depth of dermatology is essential to appreciating the specialty’s indispensable role in health care.

Healio: Why are dermatology residencies so competitive?

Desai: Dermatology is one of the most competitive medical specialties, attracting a high number of qualified applicants. Yet the limited availability of residency positions restricts the number of new dermatologists entering the field. Expanding residency opportunities is crucial to addressing the growing need for equitable access to dermatologic care and would ensure more specialists are available to provide comprehensive care for a wide range of patient needs.

Healio: Can you speak to the article’s claims about dermatologists’ high salaries and the comparison made to pediatricians’ pay?

Desai: The differences in salaries between specialties such as dermatology and pediatrics stem from a variety of factors that are rooted in how health care services are valued and reimbursed. The truth is that we have an overly complex health care payment system that is systemically flawed.

Addressing these issues requires sweeping reforms to ensure fair compensation that reflects the critical contributions of all medical specialties and the realities and costs of practicing medicine today. Addressing these issues is critical in order to provide all Americans with the care they need and deserve.

Healio: Do you believe the increase in skin care’s popularity on social media and the demand for cosmetic procedures following Zoom dysmorphia are the main contributors to the rise in dermatology applications?

Desai: Absolutely not! I think awareness of dermatology has increased for many reasons —including new medical treatments that have been approved and the subsequent advertising of them, as well as social media coverage.

However, dermatology is one of the most competitive medical specialties. I can’t imagine that a person would make the decision to pursue dermatology based on social media, and if they did, I can’t imagine them succeeding in the specialty.

To be a dermatologist, you have to have a deep commitment to continuous medical education to stay abreast of scientific discovery, new treatments and changes in the understanding of human biology, while making an immediate impact on patients’ lives, and restoring confidence and capabilities. I don’t think the true rigors of ourspecialty come across on social media.

Healio: What myths about the dermatology field do you believe drive many to apply for residency in the specialty?

Desai: Dermatology is often surrounded by misconceptions, with articles and discussions sometimes perpetuating myths about the specialty. While some dermatologists may enjoy the flexibility to set their own schedules or earn high salaries, there are many of us, like myself, that work long hours seeing patients and then spend our time away from the office completing patient charts, negotiating with insurers to get patients the treatments they need and volunteering to help others in our communities.

The portrayal of dermatology as an “easy” or “lifestyle-focused” field overlooks the intense competition, rigorous training and demanding nature of the specialty. Despite the challenges, dermatology remains incredibly rewarding for those who commit to the demands of this specialty.

Healio: What are some reasonable expectations that residency applicants interested in dermatology should know before applying?

Desai: Before they can begin practicing, dermatologists receive more than a decade of training, including 8 years of school, a year-long internship in medicine and 3 years of residency in dermatology, where they work alongside experienced doctors and complete 12,000 to 16,000 hours of treating patients.

Dermatology applicants are among the most driven individuals, often inspired by personal experiences with skin disease or the diverse branches of the field.

Healio: As a dermatologist yourself, what motivated you to pursue a career in this field and what should motivate residents considering applications to the specialty?

Desai: Skin diseases have a profound impact on a patient’s life both from a medical but also very importantly from a psychological perspective. My own family’s experience with skin disease, particularly a devastating diagnosis of vitiligo, made a huge impact on my future career trajectory.

By the time dermatologists have completed 3 of the total 4 years of traditional medical school and are considering additional training in residency, they are choosing a career in dermatology because it’s an opportunity to help patients and practice at the crossroads of medicine.

Dermatology is a diverse specialty that combines medical, surgical and research skills with the curiosity and visual acumen of a detective. For many of us it’s that diversity that drew us.

We treat over 3,000 diseases of the skin which range from skin cancers to life-threatening drug reactions to life-impacting conditions such as acne, alopecia, cutaneous infections, eczema and psoriasis, along with skin changes associated with aging. Our training uniquely prepares us to help improve the quality of life and save the lives of patients from birth to old age.

Reducing dermatology to lifestyle benefits or social media appeal trivializes its critical role in patient care and dismisses the dedication, intellect and compassion that define the field.

Healio: What last piece of advice would you give to aspiring dermatologists?

Desai: Dermatology is an amazing field! I often tell medical students that as the body’s largest organ, the skin is the window into the entire body. By working in dermatology you can save lives, improve lives and have a profound impact not only on someone’s health, but also on their overall well-being both physically and emotionally.

References:

• $500,000 pay, predictable hours: How dermatology became the ‘it’ job in medicine. https://www.wsj.com/lifestyle/careers/dermatology-jobs-salary-young-doctors-174cfe53. Published Nov. 18, 2024. Accessed Jan. 10, 2025.
• AAD letter to the Wall Street Journal in response to “$500,000 pay, predictable hours: How dermatology became the ‘it’ job in medicine.” https://www.aad.org/news/aad-letter-wsj-response. Published Dec. 2, 2024. Accessed Jan. 10, 2025.