New York Times Examines ‘Migration’ of Top Medical Students to Dermatology, Plastic Surgery

The New York Times on Wednesday examined a "migration" of "top tier" medical students from "branches of health care that manage major diseases toward specialties that improve the life of patients," such as dermatology and plastic surgery, and that improve the "lives of physicians, with better pay, more autonomy and more-controllable hours."

According to the Times, dermatology and plastic surgery are "among the most competitive" residency programs. Dermatology, plastic surgery and otolaryngology had the highest median medical board scores and the largest percentage of medical honor society members among 18 specialties, according to a report by the Association of American Medical Colleges and the National Resident Matching Program.

Internists in 2006 worked an average of 50 hours weekly, compared with about 40 hours weekly for dermatologists, according to an annual survey by the magazine Medical Economics. A recent survey conducted by the Medical Group Management Association found that internists have average annual incomes of $191,525, compared with $390,274 for dermatologists. In addition, dermatology "offers more independence from the bureaucracy of managed care because patients pay up front for cosmetic procedures not covered by health insurance," the Times reports.

"Medical school professors and administrators say such discrepancies are dissuading some top students at American medical schools from entering fields, like family medicine, that manage the most prevalent serious illnesses," according to the Times. Such students are "being replaced in part by graduates of foreign medical schools, some of whom return to their home countries to practice," the Times reports.

Joel Felner, a cardiology professor and associate dean for clinical education at the Emory University School of Medicine, said, "We have a shortage in America of primary care or family type doctors," adding, "We do need dermatologists, but I am more worried about the really sick people, and dermatologists aren't taking care of them" (Singer, New York Times, 3/19).

A Times video that examines issues related to the article is available online (Harris/Singer, nytimes.com, 3/19).