JAMA Author Takes Dig at Dermatology Resident Selection Practices

“A Piece of My Mind” is a feature of each issue of JAMA that has wide worldwide readership and high potential impact on public and professional perceptions of medical practice. In the May 23/30, 2012 issue, the author of “Considering Life Before Lifestyle” includes a jab at dermatology. During the author’s interactions with a MS3, the medical student told this him that he “…knew classmates who had hoped to become primary care physicians but who abruptly switched their focus to dermatology when they scored astronomically high on the USMLE Step 1 exam…” The author wrote that this medical student “…sensed that they had not developed a sudden passion for the immunotherapy of psoriasis, but rather an urgency to maximize their lifestyle now that their probability of matching had improved.” Obviously, this author’s perception is incorrect, and high Step 1 scores are not an automatic entry into a dermatology residency. Although important, dermatology is more than psoriasis. Likewise, the relatively few dermatology residency positions offered each year do not explain the national shortage of primary care physicians.