Variety is an overarching theme when considering a day in the life of a dermatologist, says Jennifer Hsaio, MD. "Dermatology is one of the most versatile specialties out there," she says. "Dermatologists can specialize in medical, cosmetic or inpatient dermatology, but most of us do at least a little of each type."
Dr. Hsaio, who practices at UCLA Medical Center, Santa Monica, was initially drawn in by seeing patients with severe skin diseases improve quickly, and how this transformation affected them. "Skin problems can have a really negative effect on a patient's self-esteem," she observes. "We can often see improvement in a few visits, which is very gratifying for us and, more importantly, for our patients."
Dermatology also offers many opportunities to educate patients. "We spend time explaining the patient's disease or condition and what to expect from the proposed treatment, as well as doing a lot of preventive care," Dr. Hsaio explains. "For example, when a patient has eczema, we'll talk a lot about the importance of maintaining a good barrier and how to prevent or lessen flareups."
Dr. Hsaio also appreciates what skin can reveal about a patient's internal health. "We often see cutaneous clues as a manifestation of internal disease process." Referencing various skin lesions, she suggests xanthomas can be a sign of high cholesterol or purpura, which may indicate subcutaneous bleeding associated with vasculitis, hypertension or platelet disorders.
Typical day: clinic, procedures, teaching
Dr. Hsaio likes to see patients in the morning, treating such conditions as acne, eczema, psoriasis or skin cancer. Afternoons are devoted to resident teaching clinics, where she and two residents will see patients together. "I enjoy these visits because I teach on two fronts, both the residents and the patients," she says.
Although most residents are in dermatology, internal medicine residents sometimes enter the mix as well. "I think it's helpful for internal medicine residents to rotate with us to develop some background knowledge of dermatology," she says. "After all, many of our patients come to us via referrals from their internists."
As for procedures, such as the surgical excision of skin cancers, it's often rewarding for her to integrate them into her schedule throughout the week. "Many of my colleagues prefer to group procedures all on certain days, but I like having mine spread out throughout the week to keep things interesting," she says.
Collaborating with colleagues
Since completing her residency at UCLA in 2014, and then joining the faculty, Dr. Hsaio has shared a call schedule with her colleagues to provide coverage for UCLA Medical Center, Santa Monica. "We're each on call for one to two weeks at a time," she explains. "Our resident will go to the hospital to assess the patient, then the faculty member will arrive to discuss the case."
Relishing the challenges seen in a day in the life of a dermatologist, Dr. Hsaio advises students who might be interested in dermatology to enroll in a dermatology elective in medical school. "UCLA offers three elective choices: outpatient, surgical and inpatient dermatology. Seek one out because otherwise you can go through medical school without hands-on training in dermatology," she says. "Dermatology is covered in the curriculum, but that's very different from seeing actual patients."
By Darcy Lewis