News|Videos|August 12, 2026

Training Dermatology NPs: Building Confidence From New Fellow to Graduate

Author(s)Victoria Garcia-Albea, NP, Shannon Heaning, Content Associate

Victoria Garcia-Albea, NP, discussed the learning curve dermatology NP fellows experience and the need for greater dermatology education for APPs.

Victoria Garcia-Albea, NP, directs the dermatology nurse practitioner training program at Lahey Clinic in Burlington, Massachusetts, where she also serves as lead nurse practitioner in the Hansen's disease clinic. Garcia-Albea has practiced medical dermatology since 2006, after completing the same dermatology NP training program she now leads.

Garcia-Albea also serves on the Elevate Derm leadership board and is co-medical director of the organization's upcoming fall meeting in Austin, Texas. In a recent interview with Dermatology Times, she discussed the progression she sees among fellows entering dermatology with limited specialty experience and the need for greater dermatology education and clinical exposure for advanced practice providers (APPs).

MORE RESOURCES FOR APPs

A Stairstep Learning Curve for New Fellows

New fellows typically enter the program from primary care or urgent care backgrounds with limited dermatology experience, creating a steep initial learning curve, Garcia-Albea explained. As fellows become more comfortable, that curve begins to level off, until an unfamiliar disease, side effect, or clinical scenario challenges what they know and sends the learning curve upward again.

Garcia-Albea described this repeating pattern of growth and plateau as a small-scale reflection of dermatology itself. Even experienced clinicians must continually learn as new treatment options, approaches to patient monitoring, disease severity assessment tools, and considerations around patient experience enter clinical practice.

She said fellows' understanding of the scope of dermatology also changes substantially during training. Many arrive expecting the specialty to revolve primarily around a handful of familiar conditions.

They think dermatology is all acne, warts, and fungus, Garcia-Albea said, It's a very, very vast specialty, which is what is so fun about it.

Exposure to a wider range of dermatologic diseases expands that perspective while giving fellows experience managing increasingly complex patients and conditions.

From New Fellow to Confident Graduate

The training program spans two years, allowing Garcia-Albea to see a marked transformation in fellows' clinical knowledge and confidence.

That transformation becomes especially apparent when incoming and outgoing fellows overlap. Garcia-Albea said new fellows may arrive nervous and unfamiliar not only with dermatology but also with their colleagues, the practice, and basic systems such as the electronic medical record.

Outgoing fellows, meanwhile, demonstrate the confidence, clinical experience, and depth of knowledge they have accumulated throughout the program.

“It's kind of shocking how much they grow,” Garcia-Albea said

The contrast illustrates how much learning occurs during the two-year program, from navigating a dermatology practice to developing the clinical judgment necessary to evaluate and manage patients across a broad range of disease states.

Expanding Dermatology Education for APPs

Garcia-Albea's own path into dermatology also informs how she views current gaps in APP education. When she completed her nurse practitioner education before entering the specialty in 2006, she received little formal dermatology instruction.

Although interest in dermatology among APP students remains high, Garcia-Albea said opportunities to gain hands-on experience can be difficult to find.

"It's hard to get precepting in dermatology. There's a shortage of derm providers, and so I think a lot of people in APP school want more dermatology education. It's just hard to come by," she said.

Get Involved With Dermatology Times

For APPs early in their dermatology careers, opportunities to connect, learn, and share experiences can be an important part of professional growth. Dermatology Times invites early-career nurse practitioners and physician assistants who have been in the field for 10 years or less to share their perspectives through NP/PA Connect. APPs can contribute clinical reflections, career challenges, advocacy efforts, lessons learned, and insights on emerging treatments while connecting with others across the dermatology community.

Interested in getting involved? Learn more about how to share your journey as a dermatology APP with Dermatology Times.

The challenge creates a disconnect between APP students interested in dermatology and the availability of specialty-specific training opportunities. Garcia-Albea pointed to greater access to dermatology lectures and clinical experiences during APP education as areas that could better prepare clinicians interested in entering the specialty.

Her experience training fellows also demonstrates the depth of dermatology knowledge that develops over time. For clinicians entering the field with limited exposure, that education does not happen all at once but through repeated cycles of learning, experience, and reassessment as both the clinician and the specialty continue to evolve.

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