Should medical residents pursue cosmetic dermatology?

As medical students complete their residency training, decisions remain - including whether or not to offer cosmetic treatments to patients. Murad Alam, M.D., spoke yesterday about why he thinks it is a rewarding part of his practice, as well as reasons a dermatologist might not want to pursue cosmetic dermatology.

Doctors may pursue cosmetic dermatology as an opportunity to be creative, according to Dr. Alam, chief of the section of cutaneous and aesthetic surgery, department of dermatology, Northwestern University, Evanston, Illinois. Even though many of these procedures are simple to do, it is an opportunity to be creative in tailoring the treatments to individuals, he adds.

"For those interested in a kind of jet-set existence, you get to rub shoulders with the rich and beautiful," he says, citing the kind of patient that requests cosmetic work tends to be a more affluent, educated consumer.

He says patients are often especially grateful for these procedures, as they make patients feel confident and better about their appearances -- an empowering, enriching feeling for physicians.

Autonomy was another plus, as those doctors who choose to do this work and decide which specific treatments they like to administer. "There are few emergencies and you only offer the services that you want to," he says.

On the other hand, the equipment that is necessary for cosmetic procedures is quickly outmoded with the changing tide of treatments in this arena, he says.

"You'll need to buy new equipment - lasers, instruments -- Patients want and expect these new things," Dr. Alam says.

In the same spirit, doctors need to train themselves and their staffs by taking courses buying books, attending national meetings offering specialized training for nurses, he says.

There is also the patient that is hard to please, with very high expectations, who looks for perfection.

"When you do this work, it's possible to inadvertently treat patients with body dysmorphic disorder," he cautions. "Also you might have some sleepless nights because of some patients, but it comes with the territory."