Thank you to all the helpful faculty for their time.

I have been diagnosed with a chronic medical condition that could possibly leave me physically limited in the future, especially with regards to fine motor control. I've decided to reevaluate my specialty choices in this light, and my advisors have recommended that I look in to dermatology.

My questions for you are:

1) Do you think that a dermatology practice (probably academic, but possibly private) can be tailored to avoid procedures?

2) Should I disclose my medical condition in my residency application? I am not *currently* functionally limited and, depending on how my treatment goes, it is possible that I may never deteriorate.
a) On the one hand, I am afraid of being overlooked, given the caliber of healthy candidates.
b) On the other hand, I wouldn't want my future program to think I had deceived them if I am unlucky and become symptomatic during my residency.
c) Someone even suggested that my condition may be to my advantage, as residencies sometimes want to find people who won't go over to the more lucrative cosmetic side of derm and I would be a sure bet in that regards. Is this true?

Thanks very much for any responses!

This is a very difficult question. I think it would be hard to avoid all procedures. You could develop a practice without large excisional procedures, but punch and shave biopsies will almost certainly be required for any type of practice. It is possible that you could have an assistant or resident help with these procedures, but it may be difficult to avoid them completely.
I do think honesty is the best policy. However, no one can guarantee that this would not affect your candidacy at some centers, so ultimately, you have to make this decision.
I hope you have a long, healthy and satisfying career.

Apply with full disclosure and let individual programs decide. If the application is misleading, and problems arise, the program could possibly terminate for cause. You should find out what are your rights under the Americans With Disabilities Act, as this would serve as the gold standard.

Its hard to imagine dermatology with no procedural component. But I suppose you could train a technician to do biopsies and liquid N2.

I don’t know if it’d be an advantage or not, but I think disclosing it would be the best choice.

1) A dermatology practice could be tailored to avoid procedures, although arrangements would need to be made for biopsies and excisions. Current residency requirements assume that residents are taught basic dermatologic surgery. If it seems likely that you could not perform these during your residency, you may need to consider another training program with less procedure orientation.
2) If you are not currently disabled, and may never be if treatment is successful, I believe it would be your option whether or not to disclose the information. Dermatology programs try to pick the best candidates for their program, and I don't think it would be a particular advantage or disadvantage to disclose the information. Your application should stand on it's own merit.

Every dermatologist needs to be able to perform basic procedural skills such as skin biopsies. Although some dermatologists focus more on the medical vs the surgical aspects of this specialty, I would suggest that if you feel your condition would prevent you from skillfully performing a biopsy on the face for example, then perhaps you might be better suited for another field of medicine.