How Much Training Does My Dermatologist Have? And the Importance of Scope of Practice
By: Paul Massey, MD, MPH, FAAD
As residents of Wyoming, it's crucial for dermatology patients to be aware of who is providing their skin care services and the varying levels of training among healthcare professionals. Understanding the scope of practice between physicians, nurse practitioners (NPs), and physician assistants (PAs) can impact the quality and safety of your skin care.
Physicians, including dermatologists, undergo extensive medical training, typically completing four years of undergraduate education, followed by four years of medical school. Board-certified dermatologists then undergo residency training specific to dermatology, lasting three to four years. Fellowship-trained dermatologists (such as pediatric dermatologists or Mohs surgeons) then undergo an additional one to two years of subspecialized training. This comprehensive education equips dermatologists with the knowledge and skills needed to diagnose and treat various skin conditions, ranging from common acne to complex skin disorders to advanced skin cancer care.
Nurse practitioners and physician assistants play vital roles in our healthcare system, and are a valued part of the patient care teams in Wyoming dermatology practices. However, as patients, it is important to understand that their training pathways differ from that of physicians. Nurse practitioners are registered nurses who have pursued advanced education, often completing a master's or doctoral degree in nursing. Similarly, physician assistants obtain a master's degree from an accredited PA program following an undergraduate education. While both NPs and PAs undergo rigorous training, their education is much shorter in duration compared to that of physicians. For example, the formal clinical training of nurse practitioners and physician assistants is estimated to span 500-900 hours, compared to the approximately 10,000 hours of dedicated clinical experience dermatologists receive in their training.
The Wyoming Academy of Dermatology (WAD) supports our Wyoming-based nurse practitioners and physician assistants as they provide care for our patients and expand access to dermatologic care in our state. It does so by providing year-round continuing education and provides a network of dermatology experts that all members can call on when needed. However, WAD also believes that board-certified dermatologists should be the leaders of dermatology care teams in Wyoming and that dermatologists should be available to provide oversight of nurse practitioners and physician assistants. WAD does not support unsupervised non-physicians performing medical procedures independently. We further believe in transparency of care teams, such that Wyoming dermatology patients can effectively identify the level of training of those caring for them.
Understanding the differences in training and scope of practice among healthcare providers is vital for dermatology patients in Wyoming. By being informed and proactive about who is taking care of your skin, you can confidently navigate your dermatologic healthcare journey.
1 Jalian, H.R., C.A. Jalian, and M.M. Avram. Increased risk of litigation associated with laser surgery by nonphysician operators. JAMA Dermatol, 2014. 150(4): p. 407-11. 2 Position on Delegation. American Society of Dermatologic Surgery Association. https://www.asds.net/Portals/0/PDF/asdsa/asdsa-position-statement-delegation.pdf