The myth of dermatology as a “dubious” choice of doctors: “The gains are not immediate. You don't do it from the first line at the office”

Diana Nastasă, president of the Multidisciplinary Society of Resident Doctors in Romania, says that she has colleagues who wanted to become dermatologists because “they saw how much it helps patients when the treatment gives results.”

• Dermatology has become, for several years, the most “coveted” medical specialty among the best resident doctors in Romania. In the first part of the article, HotNews analyzed how different the situation in Romania is compared to that in other European countries.
• The article is part of the Pulse project, an international journalistic consortium of which HotNews is a part, which provides the public with documented and diverse perspectives, with information from several countries, on issues of great public interest. The article is written by Alina Neagu (HotNews – Romania), Andrea Muñoz (El Confidencial – Spain), Francesca Barca (Voxeurop – France), Lorenzo Ferrari (OBCT – Italy), Martina Bozukova (Mediapool – Bulgaria), Noel Baker (The Journal – Ireland) and Justė Anceviciute (Delfi – Lithuania).

In Romania, says Diana Nastasă, “this is not really recognized, but some pathologies that also affect the patient's appearance – acne in young people, for example – can greatly affect their self-esteem and mental health. And dermatologists help patients a lot in this regard.”

In addition, although it is perceived as a “suspicious” specialty due to the diversity of procedures, including in the area of ​​cosmetic medicine, “earnings are not immediate, because it takes until you become a well-known doctor in this area. Over time you end up earning well. But you don't do it from the front row at the office”, says the president of the Society of Resident Doctors.

“Dermatologists are wanted all over the world”

Diana Savu confesses that she has met, over time, dermatologists from other countries, who told her that it is a very sought-after specialty there as well: “I have met dermatologists from other European countries – from France, Belgium, but also from the United States – and they told me that in their country this specialty is in great demand and there are not enough dermatologists.”

“It is a specialty that is also in short supply, because dermatologists are wanted all over the world. Many of our colleagues have gone to work in France or other European countries,” says Dr. Alin Nicolescu.

Not only in Romania

At the residency exam last November, which is given at the end of the Faculty of Medicine, the first specialty that was taken up, in order of averages, was dermatology, the statistics provided by the organizers of the national competition for HotNews showed.

33 of the first 200 future resident doctors opted for dermatovenerology and plastic surgery – specialties also practiced in the area of ​​cosmetic medicine. One in six. They are surpassed only by cardiology, which was chosen by 47 residents among the graduates with the highest marks.

Only one candidate out of the top 200 opted for general surgery, but there were candidates who opted for other surgical specialties, such as obstetrics-gynecology (5 out of the top 200), ophthalmology (4), neurosurgery (2) and otorhinolaryngology (ENT – 2 candidates).

However, this does not only happen in Romania, data from several European countries show.

Lina Kocienė, Faculty of Medicine in Vilnius: “Among the most popular was dermatology“

For the first time in recent years, at the Medical University of Vilnius, the capital of Lithuania, the most popular residency programs were dermatology and cardiology, according to faculty representative Lina Kocienė. Urology and psychiatry have also attracted much interest.

And in Italy, dermatology is the fourth specialty preferred by resident doctors, after cardiology, ophthalmology and gastroenterology, according to public data.

The situation in France

In France, the medical specialties most sought after by residents in 2024 and 2025 were plastic, reconstructive and cosmetic surgery, ophthalmology, dermatology, maxillofacial surgery and cardiology, according to public information.

Although the “popularity” of medical specialties among residents fluctuates over the years, in France the choices are considered to depend mainly on the personal aspirations of young doctors, who mainly take into account factors such as flexibility and remuneration received.

20 years ago, gynecology was “taken first” in residency

More than 20 years ago, gynecology was the specialty that was “taken first” at the residency, recalls, in a dialogue with HotNews, Cătălina Poiană, vice-rector at the “Carol Davila” University of Medicine and Pharmacy and coordinator of the residency committee last fall.

“In my generation, the head of graduation took obstetrics-gynecology. The best students then went to surgical specialties,” says Cătălina Poiană, who is an endocrinologist and the president of the Romanian College of Physicians.

Dr. Poiană also knows that today, not only in Romania, but also in more economically developed European countries, there is a tendency for young doctors to focus on specialties that can also be worked with in the private system or on their own, in individual medical offices.

“In these countries there seems to be a trend among young people, who avoid specialties that involve a high level of stress, high occupational risks, increased fatigue and, above all, an unpredictable schedule,” she says.

New generations value “work-life balance”

“I think, in fact, it's the way the new generations now look at the balance between professional and personal life. And I don't think young people should be judged for that,” believes Dr. Poiana, who is also the president of the College of Physicians.

This, while specialties such as Intensive Care, infectious diseases or emergency medicine “presuppose great complexity, great availability, and a service where you are 100% available all the time.”

“He can earn, for 4-5 private consultations in the afternoon, the money he would earn in a guard”

In addition, “one thing that scares more and more are the guards”, admits Cătălina Poiană. “The workload is absolutely killer on certain shifts – the sheer number of patients, the complexity of the cases, the lack of ability to go and rest the day after shift – the legislation provides for it, but you have to make up that day.”

Another problem, says Cătălina Poiană, is that “a doctor can earn, for 4-5 private consultations, in the afternoon, the money he would earn in an emergency room.” This is how it came to be that, in recent years, some of the doctors prefer to offer consultations in private, instead of guarding in specialties considered difficult, admits the president of the College of Doctors.

“The system must change and motivate young doctors”

The tendency of young doctors to choose medical specialties that they consider more “offering” is a phenomenon that will not be able to be completely stopped in the coming years, believes Cătălina Poiană. But it could be reduced, if measures are taken “to make other medical specialties more attractive”.

“On the one hand, you need to have some human resources policies that are adapted to the realities we are experiencing now – the way of working, the guard system, the responsibilities need to be rethought. And some incentives are needed that reflect exactly the level of risk and demand of the doctor in that specialty.”

“The system must change and motivate young doctors”, believes the president of the College of Doctors. “What they want is to be recognized for their professional effort, to have some decent working conditions, where they can practice what they learned in college and have some clear prospects for development. Without that, it will be very difficult to ensure the distribution of doctors by specialty and a health system that is really functional.”

Countries where the situation is different: “classic” specialties are still preferred

But in Europe there are also countries where medical specialties considered “heavy”, especially surgical ones, are still preferred.

Ireland is another country where future doctors “classically” choose preferred specialties in the public health system, not in the private one: general medicine – the equivalent of family medicine in Romania – is a highly sought-after specialty, according to public information. This is especially due to the fact that such medical personnel are needed in the extensive rural areas of this country.

And emergency medicine and surgical specialties – such as general surgery, orthopedics, neurosurgery, urology – remain at the top in Ireland.

Bulgaria prioritizes and pays better for other specialties

One of them is the neighboring country Bulgaria, which, like Romania, has faced, for many years, an exodus of young doctors abroad, due to the financing problems of the health system.

In Bulgaria, traditionally, the highest paid and preferred medical specialties are cardiology, surgical specialties, gastroenterology, as well as obstetrics and gynecology.

In recent years, there has been increased interest among medical graduates in pediatrics as well, which is largely due to the fact that new children's hospitals are being built in the neighboring country.

A new National Children's Hospital is under construction in Sofia, to be ready in 2029.

A regional pediatric hospital has also been built in Burgas, and its opening is expected later this year.

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