Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes!
A dermatology program coordinator, Christina Iwanik, discusses the KevinMD article, “Ways that one can succeed in dermatology residency: words of wisdom from a program coordinator.” She explores the importance of efficiently managing administrative tasks, staying proactive with surgical logs, and seeking supportive mentorship throughout residency. Christina also emphasizes building positive relationships with co-residents, using institutional resources to one’s advantage, and maintaining resilience when faced with challenges. By integrating these strategies and staying dedicated to continuous learning, residents can thrive in their training and lay the groundwork for a successful dermatology career.
Our presenting sponsor is DAX Copilot by Microsoft.
DAX Copilot, by Microsoft, is your AI assistant for automated clinical documentation and workflows. DAX Copilot allows physicians to do more with less and turn their words into a powerful productivity tool. DAX Copilot automates clinical documentation—making it available in the EHR within minutes—and clinical workflows, including referral letters, after-visit summaries, style and formatting customizations, and more.
70 percent of physicians who use DAX Copilot say it improves their work-life balance while reducing feelings of burnout and fatigue. Patients love it too! 93 percent of patients say their physician is more personable and conversational, and 75 percent of physicians say it improves patient experiences.
Discover AI-powered solutions for clinical documentation and workflows. Click here to see a 12-minute DAX Copilot demo.
VISIT SPONSOR → https://aka.ms/kevinmd
SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast
RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
GET CME FOR THIS EPISODE → https://www.kevinmd.com/cme
I’m partnering with Learner+ to offer clinicians access to an AI-powered reflective portfolio that rewards CME/CE credits from meaningful reflections. Find out more: https://www.kevinmd.com/learnerplus
Transcript
Kevin Pho: Hi and welcome to the show. Subscribe at KevinMD.com/podcast. Today, we welcome Christina Iwanik. She’s a dermatology program coordinator at the University of Connecticut School of Medicine. Today’s KevinMD article, which she co-wrote, is “Ways one can succeed in a dermatology residency, words of wisdom from a program coordinator.” Christina, welcome to the show.
Christina Iwanik: Thank you, Kevin. Thank you for having me today.
Kevin Pho: All right. So, before talking about the article itself, what led you to write this in the first place and submit it to KevinMD?
Christina Iwanik: OK. So one day I was having lunch with Dr. Albert Zhao—he’s our PGY-3 resident in dermatology. When we met at the time, he was a brand-new resident, and we just had lunch trying to get to know each other. He said to me, “You know, tell me about yourself and how’s work going.” Soup to nuts, I told him everything that I do as a coordinator, and he just sat back and said, “You have to write all this down. You have such a knowledge base and experience—you need to share it with others.” And I said, “OK, how am I going to do that?” And he said, “Let’s write an article.” So I sat down and I started writing and writing. He took a look at it and said, “Mhm. I don’t think I need to change anything. We’re going to submit this somewhere.” I said, “OK.” So we sat and we waited. Next thing you know, I’m here.
Kevin Pho: All right. Excellent. So tell us about the article for those who didn’t get a chance to read it.
Christina Iwanik: The article is from the perspective of a coordinator. We as coordinators manage the program, and so every day we’re held to task from higher entities such as ACGME, our institution, our DIO, our program director, our chair, and a lot of the information we require has to come directly from the residents. When I meet with them during orientation, there’s a lot of information there that kind of goes over the resident’s head. I tell them all the time, “Take notes, don’t worry about it. I’m here for you, it’s only the first day.”
Basically, the article itself is just about different tips and tricks on how to get through residency, how to be a good resident, how to be compliant, how to come off as someone who is going to be a good team player and work well with other residents, work well with the faculty, and just, you know, get through residency without any issues on the administrative side.
Kevin Pho: So dermatology residency famously is one of the most competitive residencies to go into. Presumably, you’re getting the best of the medical student class. What are some characteristics that you’ve seen that help them succeed in a dermatology residency?
Christina Iwanik: It’s very interesting you ask that, because I also manage the student and resident rotators that come through. So when fourth-year medical students—whether they’re inside UConn or outside—apply for their VSLO applications, they come and rotate with us for four weeks, and those students are constantly asking me, “What do I need to do? How do I get into derm? I know what I have to do, but do you have any tips and tricks?”
I always tell them: Make sure you have a mentor—someone in dermatology who’s going to be there and guide you the right way. The other thing is publish, publish, publish. Keep on publishing. Do some research; find a faculty member—even, and you know, there are some locations around the country where institutions don’t have a home derm program, so they have to go seek someone at another institution or private practice. Either way, collaborating with them, getting those papers in, articles, research.
And, you know, I just tell them to be themselves, but also know to be humble, and take constructive criticism when you’re on these rotations. Take it, learn from it, and do better the next day.
Kevin Pho: Any tips for these medical students to find a dermatology mentor?
Christina Iwanik: Yes. I think if you’re lucky enough to have dermatology in your institution, you should start from year one. There’s a derm interest group, which is called DIG. They can start joining that, and through that they can find a mentor—perhaps even a resident mentor and a faculty mentor. It’s pretty much just approaching them and asking, “Hey, you know, I’d like to work with you on a paper,” and the next thing you know, that relationship evolves.
Now, if you’re in a program that doesn’t have derm in your institution, it’s a little harder. But again, it’s finding someone by going on these rotations. It’s a lot of legwork as far as finding the right dermatologist to be a mentor with. Once you establish that relationship and have that collaboration with that faculty member, it pretty much drives itself.
I’ve always said that for the students who don’t have a home program: call the derm coordinator and just find out how they can help you, and they’ll find someone for you. I have a lot of students who just reach out to me with cold emails, and next thing you know, I’m forwarding them to Dr. Jean Grant Kills—who’s world-renowned, and we’re lucky to have her in our department; she’s the one who started UConn Derm—and I’m sending that email to other faculty members and saying, “Hey, can any of you, you know, talk to this student?” And more times than not, they’re collaborating with them, and they start with their derm journey.
Kevin Pho: Now, what makes a dermatology resident unique, in contrast to other medical residencies or surgical residencies for that matter? What makes a dermatology residency special?
Christina Iwanik: So, the derm residents are, I feel, no different than any other resident in other specialties—they all have to pass medical school, pass their exams, and graduate. But a derm resident, I feel, is special in that they do need to know not only skin but autoimmune diseases as well. I’ve had residents come to me who were very upset when there’s a patient they just can’t figure out how to help. They’ve worked with the faculty, they’ve worked with colleagues, and, you know, it’s very hard. It’s not just clean-cut, where some people feel dermatology is just acne and pimples. It’s not; it is far beyond that.
So a dermatology resident—there’s a lot of studying that has to be done. One thing I do tell my residents when they match here: They have to do an intern year somewhere. Their PGY-1 year has to be done in either surgery, pediatrics, internal medicine, or transitional. And I say, take that time during that year and just start reading in derm; keep yourself educated. Keep on studying, keep on reading, keep on asking questions, because it is one of those specialties where you’re doing a full-body check on someone, from their scalp to their tippy toes. And, you know, you hope that your patient comes out nice and clean and everything’s great, but in that one office visit, your dermatology resident could find three things wrong with you. Whereas if you’re someone who just deals with OB/GYN, then you’re just dealing with OB/GYN issues.
Kevin Pho: One of the things that we talk about on this show is physician burnout and, of course, burnout in residents and medical students as well. From your experience seeing many cohorts of residents, what are your thoughts about burnout during residency, what trends are you seeing, and what kind of support services does a residency offer for residents who show symptoms of burnout?
Christina Iwanik: Right, so that’s a huge hot topic that’s been talked about the past couple of years through the ACGME. Our institution here at UConn does a very good job at addressing burnout. We have what’s called wellness funds, so our residents are given certain funds to do an activity or two—whatever they need to just break away. I’m in charge of making sure that the scheduling is done right and making sure that they get approved for where they want to go or where they need to go.
They also have counseling here at UConn, where if the resident does feel burnt out and stressed, they have a private hotline they can call, and that’s no cost to them. They’re meeting with a clinical physician and, again, privately meeting with them. There is an outlet here at UConn; we’re very supportive with our residents who do express stress and burnout. The program director meets with them. They sometimes meet with me privately and just tell me, “Hey, you know, this is what’s going on.” We do have a great support system here. Again, it’s not just for derm residents at UConn; it’s for all of our residents.
I think people feel sometimes that one specialty burns out quicker than another specialty. Again, it depends on the resident. Some residents can handle stress—no problem—with loads and loads of work thrown at them, and some of them not as much. I mean, we’re all human beings, so we’re all wired a little differently.
Kevin Pho: Now, as I said before, dermatology is a very competitive specialty. What are the character traits in medical students that would help them best succeed in a rotation? What kind of questions should medical students ask themselves to see whether they’re fit for a dermatology career?
Christina Iwanik: Again, when they sign up to do a VSLO rotation with us, or if they’re in-house and they want to do their continuity clinics and they’re set for derm—they know that derm is going to be their path—some of the characteristics would be, again, study up on derm. It’s a lot of reading, and I think most people don’t realize how much studying you have to do. There’s the “Bible book,” which we talk about—Bolognia. That’s a great book to start with, and just keep on reading.
One of the tips that Dr. Grant Kells said with residency: “Read the book, and you’ll read it the first time—you won’t know what’s going on—then read it again, and then keep on reading it, and not just that one but other publications.” Again, going back to having a mentor is huge, and that’s something that your mentor can work with you on: to advance you and help you make the right decisions and learn how to interact with people, because a lot of medical students, I find now, are having a hard time just having that one-on-one interaction. That could be a generational thing. I find, being Gen X, I’m not like that.
So I think learning how to have conversations with people—being more of a people person. Again, I constantly go back to saying, work on papers, do your research. A lot of medical students now are taking a year between their third and fourth year to do research and to beef up their application so that when they do go for their fourth-year rotations and then they do go for interviews, they have that experience in their application to make them a better applicant than someone else.
Kevin Pho: Now, on the flip side, from your experience, any pitfalls or red flags that would make residents or medical students less successful in a dermatology residency? Obviously, keep it anonymous, but what have you seen that would hinder someone’s success?
Christina Iwanik: Oh, I always say in a very loving way, “Know your place in the food chain.” If you don’t know it, just be quiet and be ready to learn. Sit there, listen to the faculty member. I think what happens sometimes with medical students is they’re so eager, and when they go to present a patient in clinic, they start telling the faculty provider everything about the patient before they write the notes and everything. Sometimes students are too fast; they’re missing information. Sometimes students are not as savvy with their explanation of the patient—they’re just not presenting the whole picture after they’ve seen the patient. Then when the faculty member goes into the back to see the patient, the faculty member is like, “Oh, you missed this, this, and this.”
So the students need to be more, how should I say, open to criticism. And I think what happens is sometimes students think, “Oh, how could they have said this to me? That’s wrong.” There are some students—and I say this lovingly—who can be a little cocky, and that happens. But then there are students who take the criticism in stride. They take the time to fix whatever criticism was given to them. Again, criticism is based on perspective, so you have to understand that whoever is telling you and trying to give you better advice—just take it and learn from it.
Kevin Pho: We’re talking to Christina Iwanik. She’s a dermatology program coordinator at the University of Connecticut School of Medicine. Today’s KevinMD article, which she co-wrote, is “Ways one can succeed in a dermatology residency, words of wisdom from a program coordinator.” Christina, let’s end with some take-home messages that you want to leave with the KevinMD audience.
Christina Iwanik: Oh, I think—I thought about how I was going to answer this. The coordinator is your friend. They’re the middleman. They’re there for you. They’re there to help you. Within residency, it’s hard enough to try to get through three years of derm with all the studying you have to do and making sure your case logs are in and making sure that you’re doing what’s expected of you and meeting your milestones. Really working with your coordinator—they have such experience, they have the knowledge base, they’re here to help you. The faculty is there to help you.
Again, it goes back to making sure that you are a resident who just works well with others, is ready to pitch in—let’s say resident clinic, when you have another resident who’s falling behind, you want to be the one who says, “Hey, I’ll grab your next patient.” Really, in the end, it’s just being a good human being and just knowing that you’ll do fine. Board-certified dermatology docs have been in the same place as you—everybody had to go through training—and in the end, you’ll be OK.
Kevin Pho: Christina, thank you so much for sharing your perspective and insight, and thanks again for coming on the show.
Christina Iwanik: Thank you for having me.