A doctor for skin, hair and nails. Very well paid, and one of the hardest residencies to get.
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Pay, the path, pros and cons and the facts on one printable page. Counsellors: send it to a student from your own email in one click.
The median pay is about $328,730 a year. Across everyone in the job it runs from about $102,810 at the lower end to about $578,560 at the upper end. The source is listed under Sources at the end of this page.
12 to 13 years after high school, on the usual route.
$155,000 to $335,000 all in for tuition, fees, exams and kit. Living costs are not counted.
Yes. It is a regulated job, so you need a license or registration before you can work.
Very high demand nationally, from government outlook data. Demand varies by region, so check your area.
Or read the whole thing here
What you earn and what it costs to get there.
Median
$328,730
Bottom tenth
$102,810
Top tenth
$578,560
The national median is $328,730 a year, the bottom tenth earn $102,810 or less and the top tenth $578,560 or more (2025 federal wage survey). One caution: the federal survey counts physicians who are employed and paid a wage. Dermatologists who own or part-own a practice are not in it, and the bottom tenth mostly reflects part-time and academic work rather than a normal full-time job.
$91,211 to $100,382
Resident pay in years 1 to 4 at UC San Diego (University of California San Diego), 2025 to 2026
You are paid from the start of residency, but that is four years on a fixed salary while your student loan interest keeps running. Each hospital sets its own scale, and this one is in a high cost city. Nationally, the AAMC (Association of American Medical Colleges) survey of 345 teaching hospitals puts the average first-year stipend at $68,166 as of July 1, 2025, and about $81,807 in the fifth year. Read from the AAMC's data, downloaded in a browser with Claude in Chrome on 6 November 2026, because aamc.org refuses our checker.
$452,450 or more
The best paid quarter of dermatologists on a wage, 2025. Practice owners are not in the survey
Insurance pays for medical dermatology. Cosmetic treatments are paid for directly by patients, with no insurer deciding the price, which is a large part of why the top of this field earns what it does.
Roughly, all in
$155,000 to $335,000
Tuition, fees, exams and kit. Not rent, food or travel
The low end is a community college transfer into an in-state public bachelor's degree, then an in-state public medical school, plus the MCAT (Medical College Admission Test), applications and the licensing exam steps. The high end is full price public undergraduate tuition followed by a private medical school, with board certification fees at the end. Residency, which is another four years, is paid work, so it adds no tuition of its own. Most graduates borrow, and the debt is large, so apply for the admission test fee assistance program before you spend anything on testing, and fill in the FAFSA (Free Application for Federal Student Aid) every year.
Most graduates borrow, and the debt is large. Fill in the FAFSA (Free Application for Federal Student Aid) every year, and apply for the fee assistance program before you spend money on the admission test.
Employed salary
A base from a hospital or large group, plus a bonus tied to how many patients you see.
Practice ownership
You keep the profits of the clinic. Invisible in government wage data.
Procedure income
Biopsies, excisions and skin cancer surgery are billed as procedures, separately from the visit.
Cosmetic services
Paid directly by patients. Steady, predictable, and not dependent on any insurer.
The exact path from high school to qualified.
Twelve years after high school, and the competition is fierce the entire way.
Bachelor's degree
4 years
Any major, but finish the pre-medicine sciences with a very high grade average and sit the admission test.
Medical school
4 years
An MD (doctor of medicine) or DO (doctor of osteopathic medicine) degree, with clinical rotations in the last two years.
Intern year
1 year
A general year of hospital medicine or surgery before dermatology training starts.
Dermatology residency
3 years
Skin clinic, dermatopathology under the microscope, and surgery. Paid, and very hard to get into.
Board certification and license
After training
Certify with the American Board of Dermatology and hold a license from your state medical board.
Biology and chemistry
Required for every pre-medicine track.
Physics
On the medical school admission exam, and it explains how lasers and light treatments work.
Statistics
Reading studies is a daily part of medicine, and studies are statistics.
Art
Dermatology is pattern recognition by eye. Being able to describe exactly what you see is the core skill.
Each state licenses physicians through its own medical board, so there is no single national license. The examination is national: three steps of the United States Medical Licensing Examination, or the osteopathic equivalent. After residency you certify with the American Board of Dermatology, one of the twenty four member boards of the American Board of Medical Specialties. Certification is not the same thing as a license, but hospitals and insurers expect both.
There are only a few hundred dermatology residency places in the country each year, and far more applicants than that. Programs look at exam scores, research output, the reputation of your medical school and who wrote your letters. Students who want this typically take a research year to strengthen an application, and many strong candidates still do not match. If you are planning for it, build a backup specialty you would genuinely be happy in.
Things you don't need, but that help.
Micrographic dermatologic surgery
One to two more years. Removing skin cancer layer by layer, checking each one under the microscope while the patient waits.
Dermatopathology
One more year. Reading skin biopsies under a microscope all day, with no clinic.
Pediatric dermatology
One more year. Birthmarks, eczema and genetic skin conditions in children.
Cosmetic and laser dermatology
Learned mostly through courses and practice rather than a formal fellowship.
Research
It carries more weight in this specialty than almost any other. Start early and stick with one project.
A very high grade average
There is no gentle route into dermatology. The filtering starts in your first year of college.
Shadowing
Spend a day in a skin clinic and a day in a surgery suite. They are very different jobs.
A backup you would enjoy
Most pre-medicine students never reach medical school, and most medical students never match into dermatology.
Dermatology is famous among medical students for a reason that has nothing to do with skin. Clinic hours are predictable, almost nobody is admitted to hospital overnight, and true emergencies are rare. That combination of high pay and a schedule you can plan a life around is what turns it into one of the hardest specialties to enter. Be honest with yourself about whether you want the field or the schedule.
Day to day, pros and cons, where you'd work.
Clinic from eight, often 30 or more patients in a day, many of them short. Full skin checks looking for anything that has changed, acne in teenagers, eczema, psoriasis, rashes nobody else could name. Several biopsies, done in a few minutes each. One afternoon a week might be surgery, removing skin cancers and closing the wound. Then reading pathology reports and calling the patients whose results were not what anyone hoped. Home by six.
The good
The hard parts
Things people don't tell you.
About 9,500 Americans are diagnosed with skin cancer every day, says the American Academy of Dermatology. Melanoma found before it spreads to the lymph nodes has a 99% five year survival rate.
The American Academy of Dermatology says one in five Americans will develop skin cancer in their lifetime. It expects 8,510 melanoma deaths in 2026.
An adult's skin covers roughly 20 square feet and weighs more than the brain and liver. It is also the only organ a doctor can examine completely without any equipment at all.
Dermatology is the one field of medicine where a clear photograph is often enough to make a diagnosis. That has made virtual consultations genuinely useful here, and it is how many rural patients now reach a skin doctor at all.
Every list is built from the same numbers shown above, so you can see where this career sits next to the others.
Doctors first, then the rest of the field. See every career in health.
Last checked November 2026. Pay figures are typical full-time annual amounts in United States dollars, based on Bureau of Labor Statistics wage data and published pay scales. They vary by state, employer and experience. Tuition is for in-state students at public schools unless the card says otherwise. How every figure on this site is sourced and checked.
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