How to Become a Dermatologist

By: Andrew Colucci, MD

Last Updated: Jun 29, 2021

Dermatologists provide life-changing medical diagnoses and treatments that restore health, prevent illness, improve quality of life, and bring relief for people who suffer from a variety of conditions that often cause severe mental and physical impairment. Dermatologists are physician specialists who diagnose and treat disorders of the skin, hair, nails, and mucous membranes in both adults and children. The services provided are broad, ranging from acne, infections, genetic disorders, and skin cancer to cosmetic issues such as scars, hair loss, tattoo removal, and aging.

Like most medical doctors, the day-to-day duties of dermatologists are as varied as the patients with whom they work. To diagnose infections or other skin conditions, they perform physical examinations, occasionally with the assistance of black light. Some disorders, such as systemic diseases, are treated with prescribed antibiotics or other types of medicine. These professionals also perform several types of minor surgical procedures, including the excision of moles and techniques like Mohs surgery – a specialized procedure that removes skin cancer from sensitive regions (such as the face) with minimal scarring and physical disruption.

Given that the high visibility of skin conditions can greatly impact a patient’s quality of life, dermatologists will often focus on cosmetic issues. Many are trained in techniques like Botox injections, as well as laser therapy to improve the appearance of birthmarks. Some dermatologists also perform vitiligo surgery or skin grafting, which is used to treat burn victims or patients with large scars.

Dermatologists also provide education and preventative care for skin and other health-related issues. For example, they perform skin surveys to locate lesions that may be precancerous, especially among patients who are at high risk for skin cancer. In these ways, a dermatologist is able to alleviate pain and suffering and can vastly improve the lives of those stricken with physical disfigurement and other debilitating conditions of the skin.

Workplace Details

While the majority of dermatologists work in outpatient individual or group practice clinics, some choose to work in hospitals or in more academic settings. Generally speaking, dermatologists enjoy a less demanding schedule as compared to many other medical specialties. According to a 2012 Medscape poll of thousands of U.S. dermatologists, the majority of dermatologists spend 30 to 40 hours per week treating patients, with one-quarter of dermatologists spending fewer than 30 hours per week.

Office-based dermatologists typically enjoy comfortable working conditions, as they spend less time on their feet than other medical professionals such as surgeons or hospitalists. Dermatologists who work in research or academia may have additional responsibilities that require longer hours, although occasionally cutting their clinical responsibilities in turn.

Hover over any state to explore local income and job growth data.

Relative to the overall number of hours worked, dermatology remains one of the highest paid medical specialties. For example, a 2019 Medscape poll reports that the average income for dermatologists in the United States is $419,000.

The Bureau of Labor Statistics states that the median salary for physicians and surgeons is $218,000 – a figure that includes all physicians and surgeons, from internal medicine and pediatrics to much higher paying specialties such as radiology and dermatology.

In general, dermatologists who work in hospitals or academic settings earn less than those working in private practices. The highest paid dermatologists work in Western states such as California and Hawaii, while the lowest paid are those in the south-central United States.

The U.S. Bureau of Labor Statistics projects job growth of 4% for all physicians and surgeons from 2019 to 2029, which is average. The medical field is considered an essential service industry, resulting in a typically steady demand for physicians, even as careers in other sectors decline. As highly trained medical specialists who provide important quality-of-life services, dermatologists in particular are in constant, high demand and likely will remain so for the foreseeable future.

Dermatology is one of the most highly competitive medical fields, and requires many years of education and training. The first step is an undergraduate degree from a four-year college, including pre-medical courses in biology, organic chemistry, physics, and general chemistry. Some candidates must also complete math and biochemistry coursework, depending on the medical school they plan to attend.

Students must also take and perform well on the Medical College Admissions Test (MCAT) during junior year of college in order to be accepted to medical school.

Following the undergraduate program, aspiring dermatologists must attend a four-year accredited medical school. Admission to medical school is extremely competitive, so a high undergraduate GPA is mandatory. Following acceptance, it remains essential to maintain academic momentum and high performance throughout medical school.

Students take the U.S. Medical Licensing Exam (USMLE) – part one following their second year of study, and part two just before their final year – and must earn a high score in order to obtain a dermatology residency.

Having determined that dermatology is your chosen specialty, in medical school you must apply for residency. The competition for securing a dermatology residency is among the most intense of all medical fields, with an estimated one-third of applicants failing to be accepted.

Once matched to a program, you will begin your residency after graduating from medical school. A residency in dermatology involves one year as an intern in either general surgery or internal medicine, followed by three years of clinical residency in dermatology.

At the end of residency, you must pass the final part of this exam in order to be a practicing physician in the United States.

Medical doctors must obtain and keep a current license from their state in order to practice.

After the successful completion of residency, many dermatologists elect to become “board-certified” and also to pursue further training through a one- or two-year fellowship in subspecialized fields such as cosmetic surgery, laser medicine, dermatopathology, phototherapy, immunodermatology, or Mohs micrographic surgery.

Dermatologists can obtain greater influence and responsibility within their field by pursuing positions in research or academics. Beyond their clinical responsibilities, these positions also require efforts to secure research funding, publish in scientific journals, present at professional conferences, and teach medical students and residents.

Finally, it should be noted that dermatologists can further advance their career, responsibilities, and income by engaging in subspecialty training and additional training in surgical techniques, thereby making themselves even more uniquely qualified to perform subspecialty procedures.

The long pathway to becoming a dermatologist typically combines the following steps:

• Bachelor’s (undergraduate) degree (4 years)
• Medical school (4 years)
• Dermatology residency (4 years)

A few schools offer an accelerated option that combines the bachelor’s and medical degrees into a single 6- or 7-year program.

As a pre-med undergraduate, you can major in any subject. Be aware that many medical schools have prerequisites in math, English, and the sciences you’ll need to fulfill to qualify for admission. The American Association of Medical Colleges (AAMC) lists prerequisites by school on its website.

Admission to medical school is competitive. Before applying, you’ll need to take that Medical College Admissions Test (MCAT). Having great scores will give you an edge, as will strong recommendations and work and volunteer experience in healthcare.

If your academic record or test scores aren’t as strong as you’d like, you might benefit from a postbaccaulaureate program before medical school. These range from 1 to 3 years in length. Some grant master’s degrees upon completion. If the program is linked to a medical school, good performance may lead to a conditional acceptance.

Next, let’s talk about medical school. There are basically two types. Both can prepare you to become a fully qualified dermatologist, but they have slightly different approaches:

• Allopathic schools - These are usually what we think of when we say “medical school.” Emphasis is on treating conditions with medications, radiation, or surgery. These programs award Doctor of Medicine (MD) degrees.
• Osteopathic schools - These take a more holistic approach to medicine that emphasizes prevention and wellness. Osteopathic medical schools award Doctor of Osteopathic Medicine (DO) degrees.

The admissions process for medical school is rigorous. Expect to fill out applications, provide personal recommendations, and interview with the admissions committee.

Once accepted, medical school students spend the first two years in lab, lecture, and practicum courses. The curriculum usually covers:

During Years 3 and 4, medical students practice diagnosing and treating patients under the supervision of qualified physicians during clinical rotations. Expect to spend several weeks each in emergency medicine, psychiatry, obstetrics, internal medicine, and many more clinical areas.

Then there’s residency. It’s theoretically possible to practice dermatology after graduating from medical school and passing your licensing exams. However, if you want to find an employed position, gain medical staff privileges at a hospital, and inspire the confidence of many patients, you’ll need to complete a residency accredited by the Accreditation Council for Graduate Medical Education (ACGME). This typically takes 4 years - one in general medicine and three in the specialty.

Residents practice under the supervision of an attending physician. Activities include rounding on patients, working with nurses, ordering and interpreting tests, presenting cases, treating patients, and supervising medical students. You’ll also attend classroom sessions led by the clinical faculty and participate in educational activities like journal club.

Licensed physicians who have completed a dermatology residency can become board-certified by sitting for the dermatology board examination, which is administered by the American Board of Dermatology (ABD). Board certification is not required to practice, but is preferred by many hospitals, employers, and patients.

To maintain board certification, a dermatologist must complete continuing medical education (CME) requirements throughout his career, and must retake and pass the board examination every ten years.

Three organizations offer primary certification in dermatology. Most (but not all) states recognize certification by all three organizations.

• American Board of Medical Specialties (ABMS)
• American Board of Physician Specialties (ABPS)
• American Osteopathic Association (AOA) - certifies DOs only

Some dermatologists also complete a fellowship in a dermatologic subspecialty. Organizations that offer board certification are indicated in parentheses:

• Pediatric dermatology (ABMS, AOA)
• Dermatopathology (ABMS, AOA)
• Micrographic surgery (AOA)
• Dermatologic oncology
• Procedural dermatology