The physician shortage plaguing our profession across the nation is impacting specialties in every area, and it will soon impact the field of dermatology especially hard. The American Academy of Dermatology estimates a shortage ranging from 3,800 to 13,400 dermatologists in the coming decades.

In fact, you are very likely witnessing the effects of this shortage with increased wait times for patients seeking medical care. From 2004 to 2017, the average wait time to see a dermatologist increased 33% (from 24.3 days to 32.3 days). In 2022, the trend continued with an average wait time of 34.5 days. This raises concerns about the future of patient care and creates an urgent need to ensure that we have a consistent pipeline of skilled dermatologists entering the profession.

Availability of residency positionsOne reason for the shortage of incoming dermatologists is due in large part to the lack of residency programs. Demand for the specialty remains high, yet finding a dermatological residency program can be difficult. According to the National Resident Matching Program, there were 864 applicants (including both MD and DO applicants) for the 499 dermatology residency positions offered this year. Those who are accepted into dermatology residency programs are traditionally among the most academically accomplished of their peers. As such, it is extremely competitive to be accepted for a dermatology residency training position.  

More residency training opportunities

In my Dallas-based dermatopathology practice, we are working to bridge the gap with a new dermatology residency program offered through The University of North Texas Health Science Center at Fort Worth’s Texas College of Osteopathic Medicine (TCOM). This year, TCOM was ranked as the top medical school in Texas by the U.S. News & World Report. It has also been ranked No. 1 by the publication among osteopathic schools nationwide for two consecutive years.

Launching the program amidst a global pandemic was no small feat and is a true testament to the faculty’s commitment to seeing the project across the finish line. The process of setting up the residency program in 2018. It typically takes six months to a year of planning and preparation for the application, followed by two more years for a residency program to receive accreditation from the Accreditation Council for Graduate Medical Education. While COVID-19 slowed the process down even further, our team persevered, and we received initial accreditation for the program on April 21, 2023.

Although we did not go through the match process this year, 25 individuals who learned that the program was approved reached out and went through the interview process. We found three excellent candidates who began their training in July. The program is accredited for three positions per year and will ultimately have nine trainees when fully enrolled.

Enhanced training for residents

There have been many changes in the field of dermatology since I entered the medical profession. We have seen huge advancements in treatments and therapeutic agents, as well as a number of sub-specialties added under the broader dermatology umbrella. At the same time, it is heartening to recognize there are some things that remain the same, such as the reasons that motivate some of these young physicians to pursue the specialty.

“I chose dermatology because I love how you can see everything – the disease, the histology and the patient’s improvement,” said resident Ciaran Symthe, DO. “The skin is our interface with the external world, offering a fascinating perspective on health and disease and a rewarding way to improve patients’ psychosocial wellbeing.”  

The residents in our program can expect to receive a classical style of training that prepares them for this dynamic and ever-changing field, including opportunities to learn about surgery, pathology, pediatric dermatology, cosmetic dermatology and other sub-specialties.

“I can’t imagine a better residency program. We have a positive working environment with great clinical and didactic experiences in both private practice and academic settings. We also have numerous opportunities to get involved in dermatology via networking events, industry relationships, research and conferences. What sets our program apart is the positive environment and rockstar attendings, who can open up doors and support/encourage us to be influential contributors to the field of dermatology,” said Dr. Symthe.

The residents spend time in the clinic seeing patients as well as at our dermatopathology practice, Cockerell Dermatopathology, where they will analyze many biopsy specimens, including the ones they take from their own patients.

“I chose to pursue dermatology because I get a mix of medicine and surgery. In addition to their skin pathologies, many patients suffer from adverse psychosocial issues because of these conditions, so I appreciate the opportunity to treat them holistically,” said resident Susuana Adjei, DO. “This program provides comprehensive training in the field of dermatology, so I know I’ll be prepared for my future. Our faculty is also made up of dermatologists who are very successful in their careers, so I know we’ll be able to learn how to navigate the field well.”

In addition, our residents will have the opportunity to attend conferences at the local, regional and national level, as well as receive training on the business, financial and legal aspects of operating a medical practice.

“The residency program is laying a strong foundation for my future career in dermatology, aligning seamlessly with my goals of becoming an excellent dermatologist and a leader in the field. Through its comprehensive curriculum, hands-on experiences and exposure to a wide range of pathologies, I'm gaining practical skills and in-depth knowledge essential for success. Furthermore, the mentorship and guidance from my faculty are shaping my clinical approach and facilitating the growth of a robust professional network, said resident Marissa Ceresnie, DO. “What truly sets dermatology apart for me is the ability to profoundly impact people's quality of life by addressing their skin, hair and nail concerns. Beyond combining my affinity for visual diagnosis and performing hands-on procedures, I'm passionate about providing care that not only enhances health but also contributes to overall well-being.”

  

Final thoughts

My esteemed colleagues and I are committed to training the next generation of dermatologists to be highly skilled, well-rounded physicians with extensive expertise in the field. We are excited about the outstanding residents we have in our program and take pride in knowing they are part of the solution to ensuring that patients will continue to receive quality dermatological care for years to come.

About Clay J. Cockerell, MD, JD, MBA

Dr. Clay J. Cockerell is a world-renowned specialist in treating and diagnosing skin disorders and has diagnosed over three million biopsies.

An internationally recognized pioneer in his field and double board-certified in dermatology and dermatopathology, Dr. Cockerell has been practicing medicine since 1986.  He is currently the Founder & President of Cockerell Dermatopathology and the Program Director of the Health Education Services dermatology residency program sponsored by the Lake Granbury Medical Center.  Also, Dr. Cockerell sees patients a few days per month to assist with resident training and to keep his clinicopathological skills sharp.

Dr. Cockerell has held numerous leadership positions within several highly regarded medical associations.  Most notably, he served as the President, Secretary & Treasurer and a member of the Board of Directors of the American Academy of Dermatology, President of the Texas Dermatological Society, and President of the Dallas Dermatological Society.  Also, Dr. Cockerell holds leadership roles as Founder and President of Cockerell Dermatopathology and a former AmeriPath Board of Directors member.

Dr. Cockerell and his wife, Brenda, had a lifelong dream of producing wine and, in 2005, purchased a vineyard in Calistoga, California.  They now produce wine under the Coquerel Family Wine Estates label.  Dr. Cockerel and Brenda have two children, Charles and Lillian, and they have been married for forty-six years.  In addition, Dr. Cockerell and Brenda enjoy traveling, golf, and winter sports.

About Cockerell Dermatopathology

The Cockerell Dermatopathology story begins with Dr. Clay J. Cockerell's vision to establish a practice whose mission is to treat each specimen as if it came from one of own family members.  Family!  At Cockerell Dermatopathology, every employee is driven by a relentless pursuit of diagnostic excellence.  We specialize in evaluating dermatologic disorders, tackling cases ranging from the routine to the most challenging.

Our practice continuously invests in cutting-edge technologies to best serve each referring clinician and their patients.  These innovations result in higher-quality diagnostic slides, quicker turnaround times for routine cases, and seamless deployment of EMR interfaces.

From an educational perspective, Cockerell Dermatopathology is more than a dermatopathology practice.  We host numerous in-person and internet-based education events and boast a state-of-the-art 14-headed microscope for dermatology resident training sessions.

Our services extend beyond borders, serving hundreds of clinicians in Texas, throughout the United States, and globally.  With a highly accessible team of board-certified dermatopathologists and a dedicated support staff, our vision is simple yet profound.  Family, we treat every specimen as if it were from one of our own family members.