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It takes 12 years to become a dermatologist, broken down into eight steps.
You can major in anything, but you need to complete your medical school prerequisites. Medical schools require at least one year each of biology, general chemistry, organic chemistry, physics, biochemistry, and English. Many also expect math or statistics coursework.
Beyond grades, start building your application early. Volunteer in clinical settings, shadow dermatologists specifically, and get involved in research. Medical schools want evidence that you understand what clinical medicine actually looks like, and dermatology residency programs later want proof that your interest in skin didn’t materialize overnight during your fourth year.
Competitive medical school applicants typically score 515 or above on the MCAT. If you’re already thinking about dermatology, aim for a higher MCAT score, as students who eventually match into derm tend to have been high performers from the start.
Apply broadly to allopathic (MD) and osteopathic (DO) programs through AMCAS or AACOMAS, respectively.
Medical school admissions committees evaluate your GPA, MCAT, personal statement, letters of recommendation, clinical experience, research, and extracurriculars. Make sure your application tells a coherent story about why you belong in medicine.
Medical school takes four years to complete, split into two distinct phases. Years one and two focus on classroom-based instruction in anatomy, physiology, pharmacology, pathology, and the basic sciences of medicine. Years three and four shift to clinical rotations (clerkships) where you work directly with patients in hospitals and clinics under attending physician supervision.
Required clerkships typically cover internal medicine, surgery, pediatrics, psychiatry, obstetrics and gynecology, and family medicine. Elective rotations give you the chance to explore dermatology firsthand. Take every dermatology elective available at your home institution, and plan audition (away) rotations at programs you’re interested in for residency.
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Start dermatology-focused research by your first or second year of medical school. Matched dermatology applicants average nearly 30 abstracts, presentations, and publications. You don’t need 30 to match, but research productivity signals commitment to the specialty and gives you something concrete to discuss in interviews.
Score well on USMLE Step 2 CK (or COMLEX Level 2 for DO students). After Step 1 moved to pass/fail, Step 2 CK became the primary screening metric for residency programs. According to the National Resident Matching Program (NRMP)’s 2024 Charting Outcomes, matched dermatology applicants report median Step 2 scores of 257, among the highest of any specialty.
The dermatology match is one of the tightest bottlenecks in all of medicine. In 2025, the U.S. senior MD match rate for dermatology was just 63%, according to the NRMP. Applicant numbers rose 33% between 2021 and 2025, while available positions increased only 9%. Roughly 574 dermatology residency positions were offered nationally.
Applications go through ERAS (Electronic Residency Application Service), and the match is coordinated by the NRMP. You’ll submit your CV, personal statement, medical school transcript, USMLE scores, research portfolio, and letters of recommendation from at least one dermatologist who has supervised your clinical work.
Away rotations are important in dermatology. Rotating at a program gives faculty a chance to evaluate you over weeks rather than minutes, and strong performance on an audition rotation is one of the most powerful predictors of landing an interview and matching. Plan two to three away rotations during the summer before your fourth year.
Dermatology residency lasts four years and comprises a preliminary internship year (typically in internal medicine, general surgery, or a transitional year) followed by three years of dedicated dermatology training.
During residency, you’ll diagnose and manage over 3,000 skin conditions, from common acne and eczema to complex autoimmune disorders and melanoma. You’ll learn procedural skills, including biopsies, excisions, cryotherapy, and cosmetic procedures like laser treatments and injectables. Dermatology is quite visual, so pattern recognition becomes second nature as you see thousands of patients.
Residency also prepares you for the business side of medicine. Many programs now include training on practice management, coding, and billing, which matters because a large percentage of dermatologists eventually work in private practice.
USMLE Step 3 is the final licensing exam, and most residents take it during their first or second year of residency. Passing all three Steps (or the COMLEX equivalents for DO graduates) is required for an unrestricted medical license in every state.
State medical license requirements vary, but the process generally involves submitting your exam scores, proof of completed training, and a licensing fee to your state’s medical board. Every state requires continuing medical education (CME) credits to maintain your license, and you’ll need to renew periodically.
Board certification is technically optional, but virtually every practicing dermatologist pursues it. The American Board of Dermatology (ABD) administers a comprehensive exam that covers medical, surgical, and cosmetic dermatology. Passing earns you the credential of Fellow of the American Academy of Dermatology (FAAD).
Maintaining certification requires ongoing CME participation and recertification every 10 years. Board certification signals to patients, employers, and insurance networks that you meet the highest professional standards in the field. Most hospital systems and group practices require it.
Fellowships add one to two years of focused training and open doors to niche careers within dermatology. The American Board of Dermatology currently certifies subspecialties, including dermatopathology, pediatric dermatology, and Mohs micrographic surgery (procedural dermatology).
Mohs surgery fellowships are particularly competitive and lucrative. Mohs surgeons treat skin cancers with a technique that preserves maximum healthy tissue, and the procedural volume drives strong earning potential. Cosmetic dermatology, immunodermatology, and laser medicine are other common fellowship tracks, though not all carry formal board certification.
A fellowship isn’t necessary to practice general dermatology. But if you want to specialize in cancer surgery, work in an academic medical center, or build expertise in a narrow clinical area, the additional training pays off.
Dermatology is one of the highest-compensated specialties in medicine. The average annual wage for dermatologists is currently $372,692. The lowest 75% earn $384,500, and the top 25% average $400,000 per year.
Dermatologists in private practice earn significantly more than those in hospital or academic settings. Cosmetic dermatology procedures (Botox, fillers, laser treatments) are often paid directly by patients, which adds revenue that insurance-based practices don’t capture.
The BLS projects 3% employment growth for physicians and surgeons overall from 2024 to 2034, with about 23,600 annual openings across all specialties.
Dermatology-specific demand remains strong due to rising skin cancer rates, an aging population needing more skin-related care, and growing consumer interest in cosmetic procedures. The specialty also benefits from relatively low physician turnover and high job satisfaction.
It takes 12 to 14 years of post-secondary education to become a dermatologist. This includes four years of college, four years of medical school, and four years of residency (including one intern year plus three years of dermatology). A fellowship adds one to two additional years.
Here’s a breakdown of the timeline:
A few accelerated BS/MD programs allow students to complete undergraduate and medical school in six or seven years instead of eight. These programs are extremely selective and typically require a commitment to medicine from day one of college.
It’s extremely hard to get into a dermatology residency. Dermatology consistently ranks among the most competitive specialties in the NRMP match. In 2025, only 63% of U.S. senior MD applicants matched into dermatology. Applicant numbers grew 33% over five years, while available positions expanded by just 9%. You need top board scores, a strong research portfolio, excellent letters from dermatologists, and successful audition rotations to be competitive.
No, a dermatologist must have an MD or DO degree. You cannot practice dermatology without completing medical school and a dermatology residency. However, if you’re interested in skin care without the full physician training path, physician assistants (PAs) and nurse practitioners (NPs) can work in dermatology clinics under physician supervision.
The American Board of Dermatology currently certifies three fellowship-trained subspecialties: dermatopathology (studying skin tissue under a microscope), pediatric dermatology (treating children and adolescents), and procedural dermatology/Mohs surgery (skin cancer surgery). Beyond these, dermatologists often develop expertise in cosmetic dermatology, immunodermatology, laser medicine, or teledermatology through practice experience and continuing education.
Dr. Jonathan Preminger was the original author of this article. Snippets of his work may remain.
Reviewed by:
Orthopaedic Surgery Resident Physician, Lewis Katz School of Medicine at Temple University
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