After more than a decade of education and training, you may be more than ready to start your dermatology career. Yet a fellowship – and particularly a cosmetic fellowship – may provide invaluable training with career-long implications. I made the decision to pursue a cosmetic fellowship after completing a pediatric dermatology fellowship because I saw the opportunity to also meet the cosmetic needs of my patients’ parents. My cosmetic training wasn’t a cake walk by any means, but it made me the practitioner I am today. A cosmetics fellowship may be right for you if:
You didn’t receive adequate cosmetic training during residency.
It’s very common for dermatologists to complete their residencies without sufficient training in even the basics of cosmetics: injectables and lasers. Unfortunately, there is a paucity of cosmetic dermatologists in academic positions at residency programs even though dermatologists are experts in injectables and lasers. A cosmetics fellowship can help you provide safter and more adequate care.
You want to build on your residency training and become a cosmetics expert.
Even if you had a good amount of cosmetics training, you may want to build on what you learned in residency with the goal of becoming an expert who speaks at conferences and does research in the field.
Here are some thoughts to keep in mind:
- No cosmetic fellowship will result in a job that provides only cosmetic care.
Sometimes people think that they are going to only do cosmetics after completing a cosmetics residency. One hundred percent cosmetic jobs simply don’t exist. People will promise a lot of things, but in the real world you will see medical dermatology patients. It’s your responsibility to learn how to convert a medical patient into a cosmetic patient, and a cosmetics fellowship can teach you how to do that.
- You don’t necessarily need a cosmetic fellowship to do basic cosmetic procedures.
Neurotoxins and basic fillers are the most common cosmetic procedures along with chemical peels and basic laser procedures. Both the ASLMS and ASDS offer education and training where you can learn the basics for real world practice.
- Research is a strong component of cosmetic fellowships.
Some programs are 50 percent research. If research isn’t your jam, then perhaps a cosmetic fellowship isn’t the best fit.
- A cosmetic fellowship may be your most challenging experience yet.
Be prepared to work long hours and travel to multiple locations. I probably worked harder in my cosmetic fellowship than in my previous fellowship and residency. Not only did I work in the office but also at home with a lot of outside reading and research.
- Consider financial ramifications.
It may seem hard to fathom, but cosmetic fellowships pay less than residencies. If financial constraints are an issue, a cosmetics fellowship may not be right for you.
- Consider the patient safety and legal ramifications.
Could I have gone without a cosmetics fellowship? Probably. Would things be ok? Probably. Yet one bad outcome in a cosmetic patient is even worse than in a medical patient because cosmetic procedures are elective. No matter the consent, patients can still sue you. A cosmetics fellowship teaches you how to recognize red flag patients, how to manage complications, and what decisions to make both ethically and legally.
If you’re interested in applying for a cosmetics fellowship:
- Reach out to current and past fellows to ask about their experiences.
- Visit programs and spend some time to make sure you get along with the people.
One year can be a long time when you are working closely together.
- Make sure it’s the right educational philosophy for you.
Some programs offer a lot of autonomy while others provide more opportunities for observation.
- Plan your future before pursuing a fellowship.
Where do you want to practice? Some programs include non-compete clauses that may inhibit your ability to practice in that market in the future.
My cosmetics fellowship allowed me to learn technology not yet released in the market and research new technology. Since my fellowship was with a dermatologist who is both a cosmetics and legal expert, I learned skills and lessons that I could not learn on my own. Cosmetics fellowships are competitive, so seek them out early in your dermatology residency and put yourself out there. It may be the best career decision you’ve ever made.
