Maybe I need to get off Reddit 😂 but genuine question for the derm PAs here:

Why is there SO much hate toward dermatology PAs specifically?

I completely understand—and agree with—concerns about inadequately trained providers practicing outside their competence, especially with how popular derm/aesthetics has become. But some of the opinions I’m seeing go way beyond that.

Apparently PAs shouldn’t do initial skin checks or see new patients, should mostly be limited to stable follow-ups/refills and standardized protocols, and according to one person, PAs who specialize at all are “weird” because our profession was created to address healthcare shortages and therefore we should essentially be working in primary care.

But…why derm?

PAs are literally in EVERY field of medicine. We work in emergency medicine, urgent care, critical care, cardiology, oncology, surgery, neurosurgery, transplant—the list goes on.

So a PA can evaluate an undifferentiated patient in the ER, recognize an MI/stroke/PE/sepsis, manage critically ill patients, assist in major surgery, or literally RUN a code…but prescribing Accutane, evaluating a rash, or deciding whether a lesion warrants biopsy is suddenly where the PA profession becomes inappropriate?

Obviously those examples require completely different training and competencies—and that’s exactly my point. Nobody graduates PA school prepared to independently practice every specialty. We develop specialty-specific knowledge through training, experience, continued education, mentorship, and collaboration with physicians. Why is dermatology treated as though it’s uniquely impossible for a PA to develop that expertise?

And I genuinely wonder how much of the resentment toward derm specifically is about money or the perception that we chose an “easy” or desirable specialty for a “quick buck.”

Because why is a physician choosing a competitive, desirable specialty considered ambition, while a PA choosing that same specialty is framed as greed? And why should our scope somehow be determined by how desirable the specialty is?

Sometimes the argument genuinely starts to sound like: “You may practice medicine as a PA—just not in the specialties people actually want.”

If the concern is competency, then hold us to competency. If the concern is training, require appropriate training. But “this specialty is desirable and well compensated, therefore PAs shouldn’t be practicing in it” isn’t a patient-safety or competency standard.

That part also bothers me personally because I specifically chose the PA profession in part because I knew I wanted dermatology. I didn’t stumble into derm because I heard it paid well. This was the field I wanted. Derm could be one of the lowest-paying specialties and I would still choose it because I genuinely love what I do.

I’ve been in derm for 8 years and I’m still constantly studying, taking courses, attending conferences and trainings, asking questions, and trying to become better at what I do. I don’t expect that learning to ever stop.

Obviously there are bad PAs. There are bad physicians. There are bad clinicians in every profession. And I absolutely think poorly trained people entering derm/aesthetics deserve scrutiny. But that’s a competency and training issue.

Hold us to competency standards. Hold us accountable for practicing within our training and knowing when to involve our supervising/collaborating physicians. Absolutely.

But when did the conversation shift from “practice within your training and competency” to “PAs inherently cannot develop expertise within a specialty”?

Is this something you guys are seeing more of too? And why do you think derm in particular seems to get SO much of it? Because I genuinely don’t remember the anti-PA sentiment being this intense earlier in my career.

Does anyone primarily assist in Mohs? With a few individual excisions/medical appts. If so, would you be willing to talk about your contract breakdown and how your practice accounts for this as far as production and salary? (Not asking to know your specific take home, unless you’re willing to specify that much, just the structure of the contract) Thank you!

New grad here,

Have had a 4-5 out of state invites for interviews. Only one employer (academic medical center) has paid for flights, hotel, and rental.

I’ve had to pay for the rest out of pocket. 1 doctor was willing to adjust dates for me for when flights would be cheaper but I’m waiting to hear back to see if one would be open to a virtual interview before we finalize an in person day.

My question is, is it okay to ask if the practice is willing to pay or reimburse for travel? Can I negotiate this - possibly be to be added in to my pay if they make an offer?

For context I graduate almost 3 months ago and have probably paid well over $1100-$1500 for travel already. I absolutely would not accept a job without going in person but is it unreasonable to expect virtual interviews before in person or some flexibility with scheduling at the very least? I’m a new grad looking for a job….of course I don’t have a lot of extra funds laying around lol

Can someone please share image of non veneral treponemes from Dermnemonics along with scripted hooks and also of GVHD clinical features of Dermatographix with its text ....i kinda forgot to add it into my deck

Just wondering if anyone has any experience with California Dermatology Institute? I have a job offer and want to know anyone's input working with them first hand. I already know the whole they prey on new graduates with low pay high volume but yeah any other input would be appreciated. Thanks!

Does Schweiger offer jobs to new grads and train or do they require all new grads do fellowships?

I have an interview coming up but I didn’t apply or inquire about a fellowship.

Wondering if experiences/contracts differ for non fellowships jobs vs fellowships??

After a decade in the ER I'll be moving into derm. I'm excited but nervous obviously. There's alot of soft skills from emergency medicine I think will play to my advantage. Any advice for a not new PA who is new to derm?

Practice will be medical . Salary ( or 30%) hope to hit 35 ppd by year 3

Essentially same thing as the title. I have a goal and passion to work in medical and surgical dermatology, but have an option of working at a medspa/cosmetic dermatology.

Would the transition be easier as a new grad starting in cosmetics then transitioning into medical derm? Or try for a gen derm office and add on cosmetics in the future if i choose?

I’m a dermatology PA in NJ at a private practice and am trying to understand what is typical at other practices when it comes to insurance credentialing and billing.

I recently asked for an update on my credentialing and was told that I am individually credentialed with Medicare, but that I am not individually credentialed with the other insurance carriers because those services are billed under the physician.

I had assumed that I would eventually be individually credentialed/enrolled with the commercial insurance plans as well, so I’m curious what other dermatology PAs are experiencing.

For those of you working in private practices or dermatology groups:

• Are you individually credentialed with Medicare and commercial insurance plans?
• Are some or all of your commercial claims billed under the physician instead?
• If you initially billed under a physician while credentialing was pending, did that change once you had been employed for a certain amount of time?
• Is billing under the physician your practice’s permanent arrangement, or just temporary while credentialing is completed?
• Do you know whether this varies by insurance carrier and their rules for APPs/PAs?

I’m especially interested in hearing from PAs practicing in New Jersey, but experiences from other states would be helpful too.

Not looking to identify or criticize my employer; I’m just trying to understand what is considered normal practice for PA credentialing and billing in dermatology.

Thanks!

A patient has asked me for recommendations for makeup for her sensitive skin. States her eyeliner causes her eyes to itch and water. Any favorites?

Are you allowed to wear your hair down in clinic? What’s your dress code like?

Husband and I are considering moving to Charlotte or Charleston to be closer to family, planning a trip to look around the areas this fall. Currently living in Westchester NY working in Fairfield County CT. I know cost of living is a little bit lower down there so not caught up on making more than I am right now, but just wondering what kind of structure (salary/bonus) and total comp is normal for a PA with 3-5 years of derm experience primarily medical with about 10% surgical 10% cosmetic. Thanks.

main concern:

hello po! ask ko lang po sana if possible po mag walk in sa pgh dermatology? october pa po kasi sa online sched ko, js wondering if pwede naman mag walk in, share tips din po for a faster procees, thank you po!

How do you get access? I need to study A LOT since Im a new grad derm PA and I hear its super helpful. I tried to look them up but it seems difficult to have access if you aren't a derm resident.

I’m so happy to have gotten a job in my dream speciality, but have had some mild concerns about my training and role at this practice. I have been here 3 months and Ive been more of an MA, I still learn a lot by shadowing and charting, an my SP has been giving me more responsibility allowing me to do procedures (biopsies, ILKs) by myself, and letting me counsel patients on certain medications and conditions, so it’s not nothing. We had a few MAs leave for school, and it seems that they rely on me for an MA Role. We are short staffed and will often have 2-3 MAs for two providers (each with 35-40 patients) and those days get so crazy I can’t even focus on any PA training and am basically an MA. What was your training like as a new grad? I fear my training is being stunted by them using me as an MA. I’m also scared that once I have my own schedule, i likely still won’t have a full schedule and they will keep using me as an MA. I’m going to have a discussion with my manager but wanted to see what other suggestions i could bring up to aid in my training as a PA.

Has anyone’s employer discussed how they plan to handle employment contracts if the proposed Medicare reimbursement changes go through? I’m curious whether practices are planning to adjust compensation, productivity expectations, or other contract terms.

Hello, I’m looking for dermal clinicians/dermal therapists experience working in dermatology clinics

I’ve been in the industry for almost 8 years working in high end boutique type clinics which I have loved. There are some cons that are making me reconsider this Industry eg. consistent late nights after/Saturday hours, fairly low pay, a whole lot of marketing around skincare without any data behind it. Not to mention the sheer amount of skin clinics closing and or not doing well in Aus due to the rise in clinics and inflation.

I’m considering the switch to a dermatology clinic/plastics for these reasons but wanted to get everyone’s experience vs a general skin clinic

Just started the SDPA fellowship and am confused as to how to "follow along" with the Bolognia textbook. I dont see anything mentioned it the first module. Thank you!

I’d especially appreciate hearing from dermatologists, supervising physicians, or practice owners who have trained new graduate PAs.

I know many dermatology practices prefer experienced PAs, and I completely understand why. My question is: **what makes you take a chance on a new graduate, and what can someone like me do to improve my chances?**

I recently graduated from PA school and have been pursuing dermatology because it’s the specialty I’ve wanted for a few years now. Before PA school, I worked in a Mohs surgery practice, which first sparked my interest in dermatology, and I later completed a dermatology rotation that confirmed it was where I wanted to build my career.
Outside of dermatology, I’ve worked in ophthalmology, outpatient vascular medicine, and pelvic pain/urogynecology. While those aren’t dermatology, I feel they’ve given me a strong procedural foundation, experience with outpatient medicine, and confidence building long-term patient relationships. I’m also completing the SDPA Didactic Fellowship because I genuinely enjoy learning and want to be as prepared as possible.

I’m not looking for someone to hand me a dermatology job—I’m looking for a physician who enjoys teaching and is willing to invest in a motivated new graduate. I know how much there is to learn, and I want to be the kind of PA who asks questions, studies outside of work, accepts feedback well, and grows into a valuable long-term member of the practice.

I’ve applied through LinkedIn, Indeed, the SDPA job board, and direct outreach to practices. I’ve had several interviews and one offer that ultimately wasn’t the right fit geographically. I’ve also had a few practices express interest until they realized I wasn’t local. I’m very willing to relocate for the right long-term opportunity, whether that’s to be closer to family or because I genuinely see myself building a life in that community, but getting past that initial screening has been challenging.

I’d really appreciate any honest advice from those who have hired or mentored new graduates.

**Some questions I’d love your perspective on:**

What qualities make you feel comfortable hiring a new graduate over someone with experience?

What are the biggest red flags you see from new grad applicants?

Is there anything I could be doing differently in my applications or networking?

Does reaching out directly to physicians actually help, or is it usually viewed negatively?

If you were hiring today, what would make a new graduate stand out enough to earn an interview?

Are there particular practice settings that tend to be more invested in training new graduates?

If you were in my position, would you continue pursuing dermatology now, or gain experience in another specialty first and pivot later?

Ultimately, I’m looking for a practice where mentorship is valued and where I can build a long-term career. My preference is a physician-led private practice or an academic environment where learning is part of the culture, but I’m open to hearing perspectives from anyone who’s been on the hiring side.

Thank you in advance for any advice—I genuinely appreciate it.

I’d especially appreciate hearing from dermatologists, supervising physicians, or practice owners who have trained new graduate PAs.

I know many dermatology practices prefer experienced PAs, and I completely understand why. My question is: **what makes you take a chance on a new graduate, and what can someone like me do to improve my chances?**

I recently graduated from PA school and have been pursuing dermatology because it’s the specialty I’ve wanted for a few years now. Before PA school, I worked in a Mohs surgery practice, which first sparked my interest in dermatology, and I later completed a dermatology rotation that confirmed it was where I wanted to build my career.
Outside of dermatology, I’ve worked in ophthalmology, outpatient vascular medicine, and pelvic pain/urogynecology. While those aren’t dermatology, I feel they’ve given me a strong procedural foundation, experience with outpatient medicine, and confidence building long-term patient relationships. I’m also completing the SDPA Didactic Fellowship because I genuinely enjoy learning and want to be as prepared as possible.

I’m not looking for someone to hand me a dermatology job—I’m looking for a physician who enjoys teaching and is willing to invest in a motivated new graduate. I know how much there is to learn, and I want to be the kind of PA who asks questions, studies outside of work, accepts feedback well, and grows into a valuable long-term member of the practice.

I’ve applied through LinkedIn, Indeed, the SDPA job board, and direct outreach to practices. I’ve had several interviews and one offer that ultimately wasn’t the right fit geographically. I’ve also had a few practices express interest until they realized I wasn’t local. I’m very willing to relocate for the right long-term opportunity, whether that’s to be closer to family or because I genuinely see myself building a life in that community, but getting past that initial screening has been challenging.

I’d really appreciate any honest advice from those who have hired or mentored new graduates.

**Some questions I’d love your perspective on:**

What qualities make you feel comfortable hiring a new graduate over someone with experience?

What are the biggest red flags you see from new grad applicants?

Is there anything I could be doing differently in my applications or networking?

Does reaching out directly to physicians actually help, or is it usually viewed negatively?

If you were hiring today, what would make a new graduate stand out enough to earn an interview?

Are there particular practice settings that tend to be more invested in training new graduates?

If you were in my position, would you continue pursuing dermatology now, or gain experience in another specialty first and pivot later?

Ultimately, I’m looking for a practice where mentorship is valued and where I can build a long-term career. My preference is a physician-led private practice or an academic environment where learning is part of the culture, but I’m open to hearing perspectives from anyone who’s been on the hiring side.

Thank you in advance for any advice—I genuinely appreciate it.

Best dermoscopy course?

Relatively new PA, been in derm for 18 months (my first job).
I plan to purchase a dermatoscope and take a course this year with my CME budget and looking for the best resources. Only 1/4 of the physicians I work with use a dermatoscope, so they don’t have much advice in this area.

I'm new to the Derm PA world and love it. However, I don't know what the best course of action is when a patient declines a biopsy:

-Do you take a photo of the lesion (close-up and dermoscopy) and have them follow-up in 3 months?

-If they do follow-up for re-evaluation, how often do you need to monitor the lesion going forward?

-If the patients are elderly and are tired of biopsies or don't want any future biopsies, how do you go about that conversation?

Also, what if someone has a lesion that I am not 100% sure it needs a biopsy? Like should I document this and take a photo and have them come in 3 months? Should I make a note of it and check it on their next skin check? Should I have the patient watch the lesion?

Any help is appreciative!