October Career Corner

WDS Career Corner: Applying for Pediatric Dermatology Fellowship 

Thank you to Dr. Lloyd-McLennan and Dr. Deeti Pithadia for their contributions to this issue. 

Allison Lloyd-McLennan, MD, is a pediatric dermatology fellow at Stanford University. She earned her medical degree from the University of California, Davis, and completed her dermatology residency at the University of Nebraska Medical Center, where she served as chief resident. She also is a board certified pediatrician, having trained at UCSF Benioff Children's Hospital Oakland. 

Dr. Deeti Pithadia is a board-certified pediatric dermatologist at the Cleveland Clinic Foundation. She earned her medical degree at the Medical College of Georgia School of Medicine, followed by her dermatology residency at the University of California Los Angeles where she served as chief resident. She completed her pediatric dermatology fellowship at the University of California San Francisco.

Dr. Deeti Pithadia

1. What is the biggest piece of advice you would give someone considering applying for a pediatric dermatology fellowship?

My biggest piece of advice for those who are considering pediatric dermatology fellowship but aren’t quite sure if they should take this step is to think about what you want the “bread and butter” of your future practice to look like. If you envision a practice focused primarily on skin checks, skin cancer, and common rashes, general dermatology may be a great fit. If you find yourself drawn to conditions such as eczema, acne, hemangiomas, birthmarks, and the unique medical and surgical needs of children, pediatric dermatology fellowship may be especially rewarding. Fellowship provides the opportunity to deepen your expertise in the full spectrum of pediatric skin disease, gain experience managing complex and rare conditions, and develop procedural skills specific to caring for children. You do not need to commit to a career devoted exclusively to pediatric dermatology to benefit from this additional training; the knowledge and skills can enrich a general dermatology practice as well.

This is advice I received as a resident, and taking it to heart and pursuing fellowship really shaped my career trajectory. It has brought me so much professional satisfaction early in my career, and looking back, I would make the same decision a million times over. I would encourage applicants to keep an open mind, seek mentorship, and consider not only which patients they enjoy caring for today, but also the breadth of expertise they want to bring to their future practice.

2. What is something about the pediatric dermatology application or interview process that tends to surprise applicants?

One of the most wonderful surprises is how warm, welcoming, and collegial the pediatric dermatology community is. It is a relatively small field, and there is a genuine sense of connection among pediatric dermatologists across the country. Program faculty are enthusiastic about training the next generation of pediatric dermatologists, and there is a shared recognition of the need to grow our workforce and expand access to care for children.

Applicants may also be pleasantly surprised by the range of opportunities available to them. With many so many excellent fellowship programs and, currently, a relatively small applicant pool, applicants typically have plenty of flexibility to explore different training environments and choose programs that align with their interests. I would encourage applicants to approach interviews not only as an opportunity to demonstrate what they bring to a program, but also as a chance to identify where they will feel supported, thrive, and develop the skills they need for their future practice. The field is small enough that the relationships you build during this process can continue to enrich your career long after fellowship ends.

3. How should applicants think about choosing programs—what differences between pediatric dermatology fellowships aren't obvious from program websites?

I would encourage applicants to look beyond the program website and ask questions about the specific clinical, procedural, and practical experiences that will shape their training.

For those interested in procedural dermatology, ask about opportunities to perform lasers and excisions, including both sedated and nonsedated procedures. Learning how to approach procedures in a developmentally appropriate way, partner effectively with children and their families, and develop technical surgical skills tailored to the skin of pediatric patients is particularly valuable.

It is also important to understand the depth of exposure to complex pediatric dermatology. Ask how much time fellows spend in multidisciplinary and subspecialty clinics, such as vascular anomalies and rheumatology-dermatology clinics, and about experience managing genetic conditions, managing biologics and other systemic therapies, and inpatient consultations. Even if you do not plan to specialize in these areas, you will likely encounter patients with conditions relevant to these skills throughout your career. Broad exposure during fellowship helps prepare you to recognize and manage complex disease and know when to collaborate with other specialists.

Another important consideration is the degree of graduated autonomy fellows receive throughout training. Look for programs that provide increasing opportunities to develop independent clinical judgment and confidence while maintaining appropriate faculty supervision. This may come through continuity clinics, opportunities to supervise residents, and increasing responsibility for evaluating complex patients and developing management plans. These experiences help fellows transition from observing and learning to taking ownership of clinical decision-making, preparing them to practice independently with confidence after fellowship.

I would also encourage applicants to ask about opportunities for structured teaching, including dedicated faculty-led lectures/didactic sessions, and board review. These experiences can vary considerably from program to program. While most of fellowship training happens through hands-on patient care, having protected time for formal teaching can help reinforce clinical knowledge, fill gaps in exposure, and provide a more comprehensive foundation for independent practice.

Finally, understanding the practical aspects of clinical workflow is important. Ask about administrative responsibilities, including the management of patient portal messages, and the level of nursing and staff support available to fellows. These details can vary substantially between programs and have a meaningful impact on your daily experience, efficiency, and ability to focus on clinical learning.

Ultimately, the goal is to find a program that will provide the breadth of experience, mentorship, and support you need to become a confident and well-rounded pediatric dermatologist.

4. If you were applying again today, what would you do differently?

If I were applying again today, I would consider applying to a broader range of programs to gain a better understanding of the range of training environments and opportunities available. Exploring a wide variety of programs can help you appreciate their individual strengths, identify differences that may not be obvious at first, and better understand which environments best align with your professional goals.

I would also prioritize connecting with current and former fellows to hear about their experiences firsthand. They can often provide valuable insight into the day-to-day realities of a program, the quality of mentorship, procedural opportunities, and how well the training prepares fellows for independent practice. Given that many interviews are now conducted virtually, I would also consider in-person second looks or short visiting rotations at programs of particular interest whenever feasible. Spending time in a clinical environment can offer a much clearer sense of its culture, workflow, and learning opportunities than a virtual interview alone.

Most importantly, I would approach the process with an open mind. Every program has its own strengths, and taking the time to understand those differences can help you make a more informed decision about where you will grow most as a clinician.

Dr. Lloyd-McLennan

1. What is the biggest piece of advice you would give someone considering applying for a pediatric dermatology fellowship?

When considering applying to a pediatric dermatology fellowship, it is important to think about which aspects of pediatric dermatology bring you the most joy, what motivates you on a daily basis, and how your fellowship year can help you reach your career goals. Considering these aspects will help you determine if fellowship is the best fit for you and which programs can offer both the clinical and non-clinical opportunities that inspire you. It is also important to consider personal factors such as location, family support, and work-life balance.

2. What is something about the pediatric dermatology application or interview process that tends to surprise applicants?

Pediatric dermatology interviews tend to feel more relaxed and personal. Pediatric dermatology is a close-knit community, and interviews are often more about getting to know you as a person and future colleague than they are about discussing academic accomplishments.

Programs want to understand what draws you to pediatric dermatology, how you approach challenges, and what you're hoping to gain from fellowship. I think it's important to remember that the interview process goes both ways. It's an opportunity for you to get a sense of the people you'll be working with, the culture of the program, and whether you can envision yourself thriving there.

3. How should applicants think about choosing programs—what differences between pediatric dermatology fellowships aren't obvious from program websites?

Websites do a great job of presenting the clinical and research responsibilities and can give insight into the typical daily or weekly schedule. However, it can be difficult to assess aspects like mentorship style, program culture, clinical autonomy, and opportunities to pursue their individual interests.

Depending on your clinical interests, it can be important to understand the balance between general pediatric dermatology and more complex or multi-specialty care. It is also worthwhile to consider how you can personalize your fellowship experience to support your career goals. Examples include opportunities to shape your fellow continuity clinic, gain exposure to procedures, pursue leadership opportunities, and participate in formal teaching opportunities with residents or medical students. Understanding how academic time is structured is also worth exploring. I would also encourage applicants to connect with current fellows and faculty early, ask thoughtful questions, and be honest with themselves about what matters most to them. 

4. If you were applying again today, what would you do differently?

Looking back, I don't think I would change much about my application process. I was intentional about considering programs that aligned with both my professional goals and my family's needs, and I'm grateful that this approach led me to my current fellowship program. Finding a place where you can thrive both inside and outside of medicine is incredibly valuable.