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Director’s Commentary: Transitioning from Resident to Faculty

Adam Friedman, MD, shares his experiences transitioning from being a resident to becoming a faculty member at GW.

Dr Gonzalez Lopez is a first-year dermatology resident with the department of dermatology at George Washington School of Medicine in Washington, DC.

Dr Qureshi is a first-year dermatology resident with the department of dermatology at George Washington School of Medicine in Washington, DC.

Dr Friedman is the director of the residency program at George Washington School of Medicine in Washington, DC.


Dr Azam Qureshi: All right, Dr Friedman. Adriana and I today have discussed a little bit about transitioning to dermatology residency, particularly in the age of COVID. As we look forward to a new transition in a few years, I wanted to ask you. What was the hardest part of transitioning to being a dermatology attending?

Dr Adam Friedman: Well, certainly, the hardest part was one day being a 30‑year resident, the next day being faculty, and not a whole lot changes in 24 hours. You’re still the same person, still the same fund of knowledge, same concerns, same fears.

I’ll say, for me, I was very fortunate because I stayed on this faculty where I trained. That really helped having that nurturing environment, having my teachers who are now my colleagues still helped me when I ran into trouble. I wasn’t sure about things. That made it a lot easier. Granted, that can’t be the reality for everyone.

But I certainly would recommend that as you transition from residency into whatever type of practice model that there is a nurturing environment that somebody should certainly ask about the number of physicians in the practice. They’re maybe 15, but there may be 20 practices. While there’s so many people, you may see them once every other month at a group meeting.

Certainly, as a newly practicing and independent dermatologist, it’s important to have some support network where it’s on the ground or ‑‑ and I see this a lot ‑‑ turning to your former teachers, your mentors, or even your mentors beyond where you trained to really make sure there’s just a text message or a direct message way.

I have former residents send me HPIs and photos all the time to pick my brain. I do that to my own mentors, even 10 years out or 11 years out. I don’t know. I forget some days, but having that access to someone you trust and make you feel comfortable that first year is honestly terrifying. It really is. It takes about a year to feel good.

This would be a great question. Some of our new faculty at GW, we’ve had several folks just right out of whether fellowship or residency start. I like to think that they felt better about it being, once again, in an academic setting, running cases by myself and other colleagues.

You mentioned CDC conferences. That’s a great place to pick everyone’s brain about a tough case and get the residents on board. I will say being on residence helps you elevate your game very quickly because however little you feel like you don’t know or how little you know, they know even less, but they expect you to know everything.

That does create a very positive pressure that makes you acclimate much faster, but I think it’s about having a network. That is almost ingrained in being in academics, but majority of dermatologists are not in academics. Having that established network ready to go before you graduate will make that transition so much easier.

Then of course, turned to resources, AD, there’s a committee for young physicians with a plenty of career development resources, everything and learning how to code, which nobody learns how to do in residency. I myself probably didn’t get paid for a single biopsy for the first six months. I didn’t know what a 25 Modifier was. Just know, 25 goes on the actual visit code, and then you will charge for the biopsy separately. You get paid for both if you have more than one diagnosis, a little pearl that cost me so much money because I didn’t know it.


Dr Friedman: I think it’s about knowing what resources are out there creating your cabinet of experts to help guide you. Then what you’ll realize one day is you will be in someone else’s cabinet, and it feels really good when you’re the person that they turn to. You can pay it forward like others did for you.

Dr Qureshi: I guess now would be a bad time too. I admit that I haven’t billed for any of our visits yet. Sorry about that.

Dr Friedman: It’s OK. You’ve lost your credentialing at the hospital.


Dr Friedman: Awkward.

Dr Qureshi: In all seriousness, I’m glad that you touched on the value of mentorship because I know that that’s helped me a lot up until this point, so I’ll be texting you for many years.


Dr Friedman: That’s absolutely fine. If one message gets across, get as many mentors as humanly possible. “Momentous, less problems” is my saying. That’s going to be a hashtag or maybe a T‑shirt. I just stop talking. [laughs]

Thank you for those wonderful and hopefully insightful questions for everyone tuning in. Check out this series next month for more fun and career development.

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