As a medical student, do you ever wonder what it’s like to specialize in dermatology? Meet Amit Pandya, MD, a featured physician in the AMA Wire® “Shadow Me” Specialty Series, which offers advice directly from physicians about life in their specialties. Check out his insights to help determine whether a career in dermatology might be a good fit for you.
“Shadowing” Dr. Pandya
Practice setting: Academic university medical center.
Employment type: University employee.
Years in practice: 26.
A typical day and week in my practice: Each day is different for me. I have a unique job because I specialize in pigmentary disorders and conduct research and see patients with these disorders. On Mondays, I see 12 patients in the morning and 12 in the afternoon with an autoimmune pigmentary disorder called vitiligo. Patients come from the local area as well as the rest of Texas, other states and even other countries, due to the fact there are very few doctors who specialize in this disease.
I work with a team of research fellows and students who see patients with me. On Tuesday mornings, I perform various transplant procedures on patients with vitiligo. On Tuesday afternoons, I supervise dermatology residents and medical students in a dermatology clinic in a large public hospital at which time I see about 20 patients with these trainees.
On Wednesdays, I spend my time meeting with other faculty members, research fellows, medical students and college students to work on research protocols, analyze results and write manuscripts for publication. Because I’m a member of the admissions committee in my medical school and am a faculty advisor for various student groups, I mentor a large number of students and residents who meet with me throughout the week.
On Thursday mornings, I attend grand rounds for our dermatology department during which time interesting patients are presented for educational purposes, diagnostic help and suggestions on therapy. This is followed by a lecture from an invited guest on some aspect of dermatology. Thursday afternoons are spent seeing about 18 patients with two dermatology residents. Patients typically have a variety of hyper and hypopigmented skin disorders, but we also see some general dermatology patients. This clinic is repeated on Friday afternoons.
The remainder of Thursday morning and Friday morning are spent working on research, preparing lectures, answering patient questions and administrative tasks. Because of my research and resultant publications, I am often asked to give lectures and frequently travel as a visiting professor to give lectures for dermatology societies and universities throughout the world. I usually have evenings and weekends off, but I spend at least a few hours per week working from home during this time.
The most challenging aspects of dermatology: Because pigmentary disorders are not life-threatening, I often have to deal with denial of care by insurance companies for treatment I have prescribed for my patient. I work hard as an advocate for my patients because I see the psychological impact of these disorders on them.
The tears and frustration expressed by these patients are part of what motivated me to specialize in this field in the first place, and I try my best to help them get the care they need. Performing research to show the tremendous impact on quality of life on patients with pigmentary disorders, writing letters to insurance companies to appeal denials and speaking with insurance company staff take a lot of my time but I’m willing to do it for the benefit of my patients.
The most rewarding aspects of dermatology: Every day I go to work, patients thank me for helping them or changing their lives and students learn from me and become better doctors. While this would be rewarding enough for anyone, I love the fact the research I’m performing is on the cutting edge of dermatology and moving our specialty forward for dermatologists worldwide. Every day, I get to work on diagnostic methods and treatments that will be available to dermatologists two or three years from now.
Three adjectives to describe the typical dermatologist: Outgoing, happy and compassionate.
How my lifestyle matches, or differs from, what I had envisioned: I initially went into internal medicine and while I was in medical school, I thought I would be practicing an internal medicine specialty, such as infectious disease or gastroenterology. Dermatology and research were not in my plans and I have been pleasantly surprised by how my career has progressed.
Work-life balance is important for all human beings. Because the amount of work for a doctor can be overwhelming, it’s important to put limits on the amount of income one desires and work one has to perform on a daily basis. Although I work hard, I take time off every day for myself to pursue time with family and friends, exercise or hobbies that help bring balance into my life. Raising children was a unique challenge and affected my productivity as a faculty physician, but now that my sons are grown and I look back at their years at home, I don’t regret the time I poured into them. It was well worth it for the satisfaction of knowing I gave it my best and for the warm relationship I have with them now.
One of the most gratifying parts of my career is my opportunity to help the undeserved in our world. Once a month for the past 15 years, I have spent a Saturday morning at a free clinic in our community to giving free dermatologic care to 15–20 patients. I work with a dermatology resident, four medical students, four college students and translators at this clinic. I’m happy that my fellow faculty members and residents cover the remaining Saturdays every month to provide year-round free dermatology care to the people of North Texas who drive to this clinic from an eight-county region.
In addition, once year I go on a medical mission trip for one week to give care in another country, usually Mexico or India. I have performed these activities with my family for many years and consider these trips the highlight of my family life. By making community service part of my life, it’s easy to incorporate it into my other activities. This work helps to reframe my priorities, give back to the community in return for the many blessings I have received in my life and helps me appreciate all that I have. I’m glad I work with so many students and colleagues who want to do the same. They inspire me every week.
Skills every physician in training should have for dermatology but won’t be tested for on the board exam: Dermatologists should be good at visual learning. They should be able to appreciate color, texture, shape, hues, patterns and other aspects of art appreciation. This skill helps them recognize diseases and monitor lesions and rashes for improvement or worsening. They should also have very good people skills, with the ability to make patients feel welcome and cared for despite short, 10–15 minute visits. Empathy, respect, cultural competence, compassion and curiosity are all important traits that should be possessed by a dermatologist.
One question physicians in training should ask themselves before pursuing Dermatology: Do you like a fast-paced, outpatient specialty that combines diagnosis of various diseases, surgical procedures, laser procedures, caring for patients of both genders and all ages, looking at pathology specimens under the microscope and scraping the skin to make a bedside diagnosis under the microscope? Are you energized by people or drained by human interaction? If it’s the latter then maybe dermatology is not for you.
One online resource every medical student interested in dermatology should follow: The American Academy of Dermatology has a basic dermatology curriculum for medical students.
Quick insights I would give students who are considering dermatology: Study hard in medical school and make good grades; shadow dermatologists in academic and private practice to make sure it is the right field for you.
Song to describe life in dermatology: “Livin’ the Dream.”
Editor's note: An earlier version of this story incorrectly identified Dr. Pandya as a woman. AMA Wire® regrets the error.