Passing the Dermatology Boards: What Actually Matters
As dermatology residents begin preparing for board certification, it’s easy to feel overwhelmed by the sheer number of study resources available. Textbooks, question banks, pathology reviews, board courses, podcasts, flashcards, and online lectures all compete for your attention.
According to Elise Burger, MD, PhD, FAAD, one of the biggest mistakes residents make is trying to do everything.
“The surest way to succeed is by looking at Kodachromes, understanding the recent CMEs, and knowing treatment guidelines and management algorithms inside-out.”
The American Board of Dermatology (ABD) exam is designed to mirror real-world clinical decision making. While disease recognition remains essential, many questions require second- and third-order thinking, including:
- Determining the next best step in management
- Identifying appropriate referrals
- Selecting diagnostic workups
- Recognizing pathology and clinicopathologic correlations
- Selecting the best medication and monitoring for side effects
- Understanding treatment modifications for pregnancy, allergies, or special populations
Understanding the Exam
The ABD certification examination consists of 200 questions divided into four sections.
Approximate content distribution:
- Medical Dermatology: 55%
- Pediatric Dermatology: 15%
- Surgical Dermatology: 15%
- Dermatopathology: 15%
Although dermatopathology officially accounts for approximately 15% of the exam, many residents report that pathology concepts appear throughout the test and influence a much larger percentage of questions.
The exam heavily emphasizes:
- Clinical image recognition
- Dermatopathology
- Disease associations
- Treatment selection
- Patient management
The #1 Resource: Kodachromes
If there is one recurring message from recent test takers, it is this:
Look at more images.
Then look at more.
Then look at even more.
Board questions frequently present classic diseases in atypical distributions or unusual clinical settings. Success depends on pattern recognition developed through repeated image exposure.
Helpful image-based resources include:
- VisualDx
- NEJM Images in Clinical Medicine
- JAMA Images in Dermatology
- Dermatology Anki decks
- Board review slide collections
- Dermatology textbooks used primarily for image review
Residents should prioritize viewing as many clinical photographs as possible rather than spending excessive time reading textbook minutiae.
Dermatopathology: Do Not Neglect It
Pathology remains one of the highest-yield areas on the exam.
Residents should expect:
- Numerous dermatopathology questions
- Fixed pathology images
- Clinicopathologic correlation
- Management questions following pathologic diagnosis
For example, questions may require recognizing a pathology slide and then determining:
- Appropriate referrals
- Additional testing
- Imaging recommendations
- Treatment plans
Recommended Dermatopathology Resources
Anand Dermatopathology Review
Widely considered one of the most valuable board-review resources available. The course focuses on classic diagnoses, board pitfalls, and rapid image recognition.
Jerad Gardner’s 100 Classic Cases
A highly regarded collection of classic dermatopathology cases accompanied by high-yield teaching points and image review.
Jerad Gardner Board Review Lectures
Ideal for passive learning and strengthening weak areas.
Cockerell Dermpath On Demand
Includes pathology review sessions, practice examinations, and diagnostic walkthrough videos.
Ferringer and Ko Dermatopathology Textbooks
Excellent references for reinforcing foundational dermatopathology concepts and image recognition.
Best Question Banks
Question banks help identify knowledge gaps and improve test-taking endurance.
Important note: A common theme among recent graduates is that actual board questions are often more difficult than practice question banks. Use question banks to learn concepts rather than predict exact question style.
AAD Boards Prep Plus
The most commonly recommended resource among recent test takers.
Highlights:
- More than 2,000 questions
- Medical dermatology
- Pediatric dermatology
- Surgical dermatology
- Dermatopathology
Derm In-Review (ODAC)
Popular among residents for board preparation and longitudinal review.
DermQBank
Features:
- Large question volume
- Extensive clinical images
- Broad topic coverage
BoardVitals
Offers a free trial and can be useful for additional question exposure.
JAAD CME Articles: One of the Highest-Yield Resources Available
Many recent diplomates cite Journal of the American Academy of Dermatology (JAAD) CME articles as one of the most valuable study tools available.
Recommendations:
- Review the previous 3–4 years of JAAD CME articles
- Focus on key clinical takeaways
- Pay particular attention to management recommendations and treatment algorithms
Many residency programs have successfully divided CME articles among residents and held group teaching sessions to review the most important points.
Surgical Dermatology and Skin Cancer Management
Board questions frequently assess management rather than memorization.
The goal is not memorizing every NCCN flowchart but understanding how management decisions are made.
Residents should understand:
Melanoma
- When sentinel lymph node biopsy is indicated
- Appropriate staging workup
- Imaging recommendations
Cutaneous Squamous Cell Carcinoma
Know high-risk features including:
- Diameter greater than 2 cm
- Poor differentiation
- Perineural invasion
- Invasion beyond subcutaneous fat
Merkel Cell Carcinoma
Understand:
- Imaging recommendations
- Sentinel lymph node biopsy indications
- When radiation therapy should be considered
Free Video Resources
Boards University
A valuable collection of board review lectures and surgical dermatology content.
Particularly recommended:
- Mariwalla surgical dermatology lectures
- Board review video archives
- Skin cancer management reviews
Textbooks: Use Strategically
Textbooks remain useful but should not become the primary study method during board preparation.
Recommended references include:
- Alikhan Review of Dermatology
- Baby Bolognia
- Leventhal Self-Assessment in Dermatology
Rather than reading cover-to-cover, residents should focus on:
- Clinical photographs
- Management pearls
- Disease associations
- Treatment algorithms
High-Yield Topics to Know
Residents should be comfortable with:
Genetic Syndromes, such as:
- Basal Cell Nevus Syndrome
- Cowden Syndrome
- Gardner Syndrome
- Birt-Hogg-Dubé Syndrome
Know:
- Diagnostic criteria (including knowing multiple minor criteria)
- Associated malignancies
- Referral recommendations
- Extracutaneous manifestations
Connective Tissue Disease
Autoimmune Bullous Disease
Pregnancy-Specific Management
Medication Allergies and Alternative Therapies
Medication Monitoring and Side Effects
Questions often focus on how management changes when standard treatment is unavailable.
Final Takeaways
If you remember only three things from this article:
1. Look at More Images
Clinical image recognition remains one of the highest-yield activities for board preparation.
2. Do Not Neglect Dermatopathology
Pathology appears throughout the examination and often drives management questions.
3. Think Like a Practicing Dermatologist
The board exam rewards clinical reasoning. Focus on what you would do in real life to prevent morbidity and mortality.
The exam is challenging, but it is fair. Trust your preparation, trust your instincts, and remember that most successful test takers leave the exam feeling uncertain.
You’re probably more prepared than you think.
