by: Terri Nagy, MPAS, PA-C

It is a great profession, so I don’t blame you, honestly. In 1994, when the Society of Dermatology Physician Assistants was ‘born’, there were only 49 members. By 2014, there were close to 3,000 and that number continues to increase yearly. This is a simple reflection of the fact others share your desire, yet at the same time, more employment opportunities are becoming available.  I will admit, it is not uncommon for me to be speaking at a conference only to be approached by an attendee, seeking advice on how to break into the specialty. In addition, I am frequently contacted to serve as a mentor to a new NP/PA graduate who is interested in pursuing a career in Dermatology. I honestly do not consider myself the Dermatology Guru. However, recently, I was attending a dinner program for Dermatology NP/PAs and was recognized as the individual who had been in practice the longest. So, I guess it is safe to assume, I may have some wisdom to share with you on this topic.

I will also admit, Dermatology was never my passion when I was in PA school or while completing my residency. One of my colleagues, Mark, had this deep desire to work in Dermatology, which I couldn’t understand at the time.  I mean seriously, how fun could it be to look at rashes all day? But Mark saw the skin as the ‘window into the body’, which was a beautiful metaphor, but still not enough to pull me in.

I started my career working in Internal/Family Medicine, which gave me a great foundation in understanding and caring for that body to which the skin was the window.  I work in the state of Ohio and during that time, PAs were not only fighting for prescription privileges, we were also struggling to be recognized. I spent much of my day explaining to patients/friends/colleagues the exact role of a PA. It had been 30 plus years since the first PAs started at Duke University and the climb up that hill was certainly a long, slow one!

Five years after graduating from PA school, four years after completing my residency, believe it or not, I hit the income ceiling for my current specialty. As a single mom, I had a decision to make. A position opened with a local dermatologist and in 2003, I started to understand why Mark believed the skin to be a ‘window into the body’.

There were only two of us who applied for the position of which I eventually landed. My competition had far more years of experience in Dermatology and would have been the logical choice.  Yet, I was chosen.

I had a few things on my side:

  1. Desire to learn. Being new to the field, my supervising physician could train me to practice dermatology his way.
  2. I had actually seen quite a bit of dermatology during my time in Internal/Family Medicine. I made a list and brought it to my interview.
  3. My understanding of how systemic diseases can be expressed cutaneously ~ Mark’s window.

The Bureau of Labor and Statistics predicts that the job market for PAs and NPs will grow ‘much faster than average’. US News and World Reports list PAs and NPs as one of the top three best health care jobs. When I graduated PA school, there were 3 PA programs in the state of Ohio. Now there are 12. Which means, four times as many graduates each and every year in a very fast-growing profession.

Dermatology, historically, has been a tough field for PAs and NPs to break into. There are a multitude of reasons. However, I have noticed, each year, more and more of my local dermatologists are adding PAs/NPs. Which means, our value and worth in regard to our impact on patient care is certainly acknowledged and appreciated.

But how does one make the leap into this field in 2019? Employment requirements are much more stringent. Most positions today require at least 2 years of dermatology experience in order to even be awarded an interview.  With more programs popping up, and more candidates, the competition can be tough.

As I have mentored PAs/NPs seeking a position in dermatology through the years, my advice has remained unchanged.  I will offer you the same:

  1. Don’t give up your desire to work in Dermatology. It may not happen right away, but that’s ok. It’s amazing sometimes how being patient, and letting life unfold, can actually lead us to where we want to be.
  2. Don’t rule out the idea of working in Internal Medicine/Family Medicine for a couple years.  Dermatology does provide a window to what may be happening internally.  Having a strong basis in medicine not only can help make you a better Dermatology PA/NP, it’s also a great selling point to perspective employers.
  3. You have probably seen more dermatology than you realize. Grab a copy of ‘Fitzpatrick’s Color Atlas and Synopsis of Clinical Dermatology’.  It’s a great resource for one thing! But take a look in the index and peruse the topics.  Make a list of what you know you have seen and learned about in class, clinicals, and clinic. It’s a great list to have available when you interview.
  4. Get training. The Society of Dermatology Physician Assistants (SDPA) has an online training program which is considered a fellowship in Dermatology. Their website is: www.dermpa.org. It is called the Diplomate Fellowship. It is roughly 60-70 hours of continuing medical education in Dermatology. A great selling point for potential employers.  The SDPA also hosts two conferences yearly and offers online CME, all which are great educational resources for those new to Dermatology.
  5. Sign up for Mentor Match through the AAPA. Get linked to providers in your area who are practicing in the specialty of your dreams. Sometimes it is not just what you know, but it is also who you know.
  6. Organizations to consider joining and/or attending their conferences:

It also goes without saying, I am certainly available to offer further guidance and support. Feel free to reach out. My bio is on the website. We can also chat at the Skin, Bones, Hearts and Private Parts CME Conference. I will be lecturing in Destin, Virginia Beach, San Antonio, and Las Vegas. Hope to see you there!

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