Interview with Dr. Jennifer Huang - Part I: Advice for Dermatology Residents

Today we have the pleasure of featuring Dr. Jennifer Huang, the Residency Program Director of the esteemed Harvard Combined Residency Program in Dermatology.  Our article will focus on advice for dermatology residents.

dermRounds: Dr. Huang, learning dermatology is a complex process with many dermatologic conditions to master.  What advice do you have for a resident who is early on in her/his career in approaching the vast body of knowledge and skills needed?

Dr. Huang:  Dermatology is both challenging and stimulating because it is a specialty of rare diseases.  Aside from the most common conditions we see (e.g. psoriasis, acne, eczema), most skin diseases we encounter are recognizable because we have read about them or we have seen them once before.  As a dermatology resident, reading on a regular basis is just as important as bedside learning.  I recommend reading about every interesting patient you see at the end of the day…combining book and experiential learning is the best way to retain information.  I also recommend creating a reasonable schedule for yourself over the year so that you can get through an adequate amount of information over the year.  Find time to study regularly with your co-residents.  Learning dermatopathology, especially with glass slides, is often best as a group effort.

The management of dermatologic conditions is an art refined by practice.  There are many ways to cook an egg, and most ways will lead to a delicious outcome!  If you can acknowledge and accept that there is often no one right way to manage a condition, you will become a better dermatologist.  Keep a journal/notebook in your white coat, and jot down any clinical pearls you are taught at the bedside.  Refer to these notes when you are reading. Synthesizing what you have learned at the bedside and in a textbook in this way will help you better understand and remember how to manage your patients.

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dermRounds:  How should the approach to learning change as a dermatology resident moves from being a first-year resident to a second-year resident to a third-year resident?

Dr. Huang:  First-year dermatology residents should focus on being outstanding observers.  Getting into the habit of taking the time to notice and describe all aspects of the skin exam will allow you to be more thorough and complete when evaluating the challenging patient.  Dermatology clinic can feel very rushed!  Don’t let the pace of clinic rush your exam…this is the time to slow down.  Second year is the best time to start practicing independence.  With each patient, pretend that the buck stops at you, and be confident with proposing a diagnosis and management plan to your attending.  They will appreciate this (even if they adjust your assessment and plan!) and reward you with more teaching and independence.  As a third-year resident, you may be feeling restless!  Remain humble and work hard at continuing to learn and ask questions.  Also use this time to teach and guide your junior residents.  Teaching often is the best way to identify your own knowledge gaps.

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dermRounds: There are many parts of dermatology residency -- general medical dermatology along with its subdivisions (e.g. rheumatology-dermatology), pediatric dermatology, surgical dermatology/MOHS, cosmetic/laser dermatology, dermatopathology, etc.  What has your advice been to residents who are trying to figure out whether they want to further sub specialize after residency?

Dr. Huang:  We invest a lot of time and money into becoming a doctor.  So by the time we are residents, we are anxious to be done!  I strongly encourage residents to think twice if they find a lot of joy in a particular aspect of dermatology.  Fellowship training can be beneficial in many ways; it provides job flexibility, expertise that can facilitate job negotiations, and personal reward in contributing unique to a practice or department.  Think about it early and rule it out late.  And don’t worry if you are considering more than one fellowship…that means you definitely chose the right field!  And if it comes down to it, you won’t be the first person to have done more than one fellowship!

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dermRounds: Residency may be the first time the resident has had a real job outside of being a student.  What attitudes and characteristics are important in approaching this job?

Dr. Huang:  For some of you, this may be the first time you have received a real pay check.  Congratulations!!!  Be frugal and save as much as you can.  This is a good habit for life.  One of the biggest transitions from student to resident is the shift toward service obligations.  It is extremely important to hone your skills in teamwork, adaptability, and resiliency.  There will be many patient care responsibilities, and you may feel pulled in many different directions.  Remember that we are all here to 1) take the best care of patients, and 2) learn as much dermatology as possible.  In that order.  You are on the same team as your fellow residents, attendings, staff and patients.  You will get the most out of your training by contributing as much of yourself to that team as possible.

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dermRounds: Any last words of advice for our dermatology residents?

Dr. Huang:  Remain humble.  Remember the extraordinary privilege of being a doctor.  Give more to others than you receive.

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Dr. Huang is a pediatric dermatologist at Boston Children’s Hospital and an Assistant Professor of Dermatology at Harvard Medical School.  She currently serves as the program director of the Harvard Combined Dermatology Residency Program.  She also has a special interest in pediatric oncodermatology, the focus of her clinical and research expertise.