How to become a dermatologist

1. 1Complete college and the premed science sequence

   Time: 4 yearsCost: Undergraduate tuitionSources 1

   Any major works if you complete biology, general and organic chemistry, physics and biochemistry, and medical schools weigh grades heavily. Because dermatology is so competitive later, it helps to build habits early: research experience, a strong science GPA and clinical exposure. Shadowing a dermatologist shows you the clinic pace and the mix of medical, surgical and cosmetic work before you commit years to the path.

2. 2Take the MCAT and get into medical school

   Time: About 1 year (application cycle)Cost: $360 MCAT; AMCAS $180 + $48 per extra schoolSources 2, 3

   Nearly all US medical schools require the Medical College Admission Test, which costs $360 for 2027 test dates or $145 with AAMC fee assistance. MD applications go through AMCAS at $180 for the first school and $48 for each additional one. Expect secondary applications, essays and interviews. Both MD and DO graduates can become dermatologists.

3. 3Finish medical school with a strong record

   Time: 4 yearsCost: Median federal debt $208,644Sources 4, 5, 9

   The first two years are classroom science; the last two are clinical rotations. MD students take USMLE Step 1 and Step 2 CK ($695 each in 2026), and DO students take COMLEX Level 1 and Level 2-CE ($745 each). Because dermatology residencies are hard to get, students aiming for the field usually build a record of strong clinical grades and exam scores, dermatology research and letters from dermatologists. Some take an extra research year.

4. 4Complete a clinical internship year

   Time: 1 yearCost: Paid as a residentSources 6, 4, 5

   ACGME requires dermatology residents to complete a broad clinical first year (PGY-1) before starting dermatology. Accepted options include internal medicine, pediatrics, family medicine, general surgery, emergency medicine, obstetrics and gynecology, or a transitional year. Plan for this year when you apply, since dermatology training cannot start without it. You usually take USMLE Step 3 ($955) or COMLEX Level 3 ($950) around this time.

5. 5Finish a 3-year dermatology residency and get licensed

   Time: 3 yearsCost: Paid as a resident; state license feeSources 6, 7, 10

   ACGME dermatology residencies last 36 months and cover general medical dermatology, inpatient consultations, dermatologic surgery, dermatopathology and a continuity clinic where you follow your own patients. During residency you may take the ABD BASIC exam, a first-year assessment that does not count toward certification, and from the second year you can take the four CORE modules. Apply for a full state medical license through your state's medical board; the CareerOneStop License Finder links to each board.

6. 6Pass the ABD APPLIED exam for board certification

   Time: Offered each July after residencyCost: Exam fee paid by candidateSources 7, 8, 11, 12

   The APPLIED exam is the last step to American Board of Dermatology certification. It has 200 questions in four 50-question sections over an 8-hour day at Pearson test centers, with about 55% medical, 15% pediatric, 15% surgical dermatology and 15% dermatopathology. You must have passed all CORE modules, completed residency and hold a full, unrestricted license or show a license application in progress, and you have five years after residency to pass. Optional fellowships, such as 12 months of Mohs surgery, come next.

Programs, tuition and graduates’ earnings

U.S. Department of Education, College Scorecard (most recent cohorts, released 2026-10-15). Scorecard groups programs by 4-digit field, so a row can include related programs. Tuition is the median published undergraduate tuition and fees of the colleges offering the program (shown only for undergraduate credentials); debt is the median of programs’ median federal loan debt at completion; earnings are the national median for the field and credential four years after completion.

Requirements differ by state. Check your state’s rules in the CareerOneStop License Finder (U.S. Department of Labor) before you enroll.

Visual pattern recognition

Much of dermatology is telling one rash or spot from another by sight, and missing an early melanoma can be fatal.

Fine surgical technique

Biopsies, excisions and Mohs reconstruction on the face demand precise, steady hands and good cosmetic results.

Efficiency

Clinics see many patients a day, so dermatologists need to examine, decide and document quickly without cutting corners.

Patient communication

Explaining a cancer diagnosis, or why a costly cream is worth using every day, determines whether patients follow through.

Knowledge of systemic medicine

Skin signs can point to lupus, diabetes or drug reactions, and treatments like biologics and isotretinoin need careful lab monitoring.

O*NET 31.0 rates these skills as most important for the occupation: critical thinking, active listening, reading comprehension, speaking, active learning.

Training cost

$212K–$213K

Before financial aid

Time

12-13 years

Typical path

Median pay

$328,730

All US jobs: $50,980

Payback once qualified

Under 1 year

Pay above the all-jobs median vs. cost

This range counts only what a typical future dermatologist borrows for medical school and the fixed fees to apply and get licensed. Base: $208,644, the College Scorecard median federal loan debt for medicine graduates. Low: plus the MCAT ($360), AMCAS applications to 15 schools ($180 + 14 x $48 = $852) and USMLE Steps 1-3 ($695 + $695 + $955). High: plus the MCAT, AMCAS to 30 schools ($1,572) and COMLEX Levels 1-3 ($745 + $745 + $950). Not included: undergraduate costs, interest, residency application and interview costs, American Board of Dermatology exam fees, state license fees and living costs. Many students borrow far more; residents earn a salary during training.

Rough guide only: ignores taxes, aid, interest and earnings given up during training. How we calculate it.

• Mohs surgeon

  A 12-month ACGME fellowship in Micrographic Surgery and Dermatologic Oncology, followed by ABD subspecialty certification.

• Dermatopathologist

  A dermatopathology fellowship after a dermatology or pathology residency, then subspecialty certification.

• Pathologist$312,400 median

  A dermatologist would need a separate pathology residency; dermatopathology is the usual overlap between the two fields.

• Pediatrician$210,040 median

  Switching to general pediatrics takes a full pediatrics residency; dermatologists who want to focus on children usually pursue pediatric dermatology instead.

• Practice owner or medical director

  Experienced dermatologists often lead group practices or clinic networks, which adds business and management responsibilities.