Welcome to The Roadmap Series: Key Learnings by Residency Year. This first installment, PGY-2 Roadmap: What to Expect in Your First Year of Dermatology Residency, is a concise, practical guide to help new dermatology residents navigate the whirlwind of clinics, didactics, procedures, and consults. Inside you’ll find clear expectations from program directors, tips for mastering dermatologic terminology, efficient study strategies (including BASIC exam prep), and actionable advice for gaining procedural confidence. Think of this as a short, reliable playbook to help you build a strong foundation and move from overwhelmed to capable — faster.
Your first year in dermatology can feel like trying to take a sip from a firehose. Everything is new, and it’s all happening at once: clinics, didactics, procedures, and consults. This roadmap is designed to ease some of that weight and anxiety by giving you a clear sense of what lies ahead. You’ll find guidance on what program directors expect of you, how to master dermatology’s unique vocabulary, strategies for learning the material, preparing for the BASIC exam, and gaining hands-on procedural experience. The goal is simple: to help you build confidence and establish a strong foundation for the rest of residency.
What Program Directors Expect of You
Program directors know PGY-2 is a steep learning curve. They do not expect you to know everything. What they look for is reliability, effort, and progress. Show up prepared, on time (which means early), eager to learn, and willing to ask questions. Take ownership of your patients, be dependable, and begin to recognize the bread-and-butter conditions you’ll see every day like acne, atopic dermatitis, psoriasis, actinic keratoses, basal cell carcinoma, and squamous cell carcinoma. They want to see you engaged in didactics, practicing your procedural skills, and building good clinical habits.
No one expects mastery right away, in fact it will likely take most of the year before you have your “I know something” moment. It may be knowing the diagnoses at grand rounds, proposing a differential diagnosis during clinic that hits — something will click, and you will remember that moment as a pivotal turning point when you realize how much you actually know. Stick to keeping it consistent: learning from your mistakes, demonstrating curiosity, and steadily moving forward.
Mastering Dermatologic Jargon
A key part of PGY-2 is learning how to describe what you see. Dermatology has its own language, and using it precisely is critical. Kodachromes are invaluable for practicing this skill. The American Academy of Dermatology (AAD) offers image banks with standardized terminology you can review on your own or with co-residents. Another excellent option is Krazy Kodachromes, hosted by Dr. Adam Friedman and the George Washington University Dermatology Residency Program. These sessions walk through Kodachromes and differentials in real time, modeling how to create accurate descriptions and logical differentials.
The Full Spectrum of Dermatology: A Diverse and Inclusive Dermatology Atlas provides a free gallery of common dermatologic conditions displayed across a wide range of skin tones, making it a valuable tool for building inclusive diagnostic skills. VisualDx (a paid resource) and DermNet (free) are additional interactive, image-rich platforms that let you search by diagnosis or generate a differential based on clinical findings. Many times the images will have a description that allows you to cross-reference your own description. Additionally, documentation during clinic is a great time to practice describing your clinical and dermoscopic findings to home your skills.
Resources to Aid in Didactic Learning
Your main academic job in PGY-2 is to build a broad, sturdy foundation. These core resources will support what you’re learning in didactics and in clinic:
-
- Textbooks: Dermatology by Dr. Jean Bolognia is the most comprehensive and widely used reference in residency, offering in-depth explanations and clinical context. For shorter, high-yield overviews, Review of Dermatology by Drs. Ali Alikhan and Thomas Hocker, and the Derm-In-Review Study Guide are excellent for structured studying and quick reference. For dermatopathology, Dermatopathology by Dr. Dirk Elston is a concise, resident-friendly option that emphasizes patterns and high-yield associations. If you want more depth later on, Lever’s Dermatopathology: Histopathology of the Skin remains a classic resource.
- Study habits: Review topics before and after didactics to reinforce what you’re learning in real time. Same goes for what you seeing in clinic. Pick a handful of diagnoses and focus on those conditions for your late night study sesh, which will solidify the clinical translation. Layering knowledge like this helps it stick and makes didactics feel less overwhelming.
Creating Your Study Notes
While building your foundation of dermatology knowledge, another major goal of your PGY-2 year is creating your personal study guide. You’ll want to start with a reliable source, such as the Derm In-Review Study Guide. This guide will become your go-to resource when studying, containing all the high-yield information you need to review repeatedly. Here are some tips to optimize your study guide:
-
- Didactic preparation: Review your study guide content prior to reading your book club chapter or articles. It will help you recognize the high-yield information. As you read, add to your notes to create your complete guide.
- At conferences, take notes and write down the information you want to add to your study guide. This will help you retain the valuable information and easily find it when you’re studying in the future.
Learning on the Go
It’s not always easy to find the time to sit down and read, so podcasts and audio guides are a great way to keep learning during commutes, workouts, cooking, or even while doing your laundry.
-
- The Grenz Zone breaks down dermatology concepts into digestible, memorable segments. It’s especially useful for reviewing core material, reinforcing what you’ve heard in didactics, and making board prep feel less daunting.
- Dermasphere, hosted by dermatologists Drs. Luke Johnson and Michelle Tarbox, highlights recent research articles and explains why they matter for clinical practice. It’s essentially a portable journal club. You’ll walk away knowing not just the results of new studies, but also how they may influence patient care.
- Derm In-Review Audio Study Guide is the audio companion to the Derm In-Review Study Guide. It provides a structured overview of medical, pediatric, and surgical dermatology as well as dermatopathology, making it easy to cover high-yield material on the go.
Using Anki Wisely
Anki is becoming an increasingly common resource among dermatology residents because it uses spaced repetition and active recall to reinforce information in long-term memory. One growing favorite is Dermki, a pre-made deck based on Alikhan’s Review of Dermatology.
The sheer number of cards can feel overwhelming, so don’t feel pressured to get through everything right away. Start small during PGY-2 and let Anki become part of your steady study routine. Even reviewing 10–20 cards a day builds powerful retention over time and pays off later in residency.
Preparing for the BASIC Exam
Your first major exam in residency is the BASIC exam, usually taken in the spring of PGY-2. This one-day, computer-based test is administered nationwide on the same day for all residents. It isn’t pass/fail; instead, it provides a percentile score compared to your peers. The goal is to highlight strengths and identify areas where you need to build a stronger foundation.
To prepare, start incorporating question banks into your study schedule about 2–3 months before the exam, depending on how much allotted study time you have. High-yield options include:
-
- AAD’s Board Prep Plus
- Derm-In-Review (free to residents)
- DermQBank
Working through practice questions helps you test recall under pressure, reinforces didactic learning, and familiarizes you with the style of exam questions.
Growing Your Procedural Skills
PGY-2 is also when you begin to build confidence with procedural skills like biopsies, excisions, and even cosmetic procedures if your program allows. The best way to improve is simple: practice. Be ready to glove up and help at every opportunity because showing initiative not only gives you more practice but also demonstrates to your attendings that you’re eager and dependable.
You can read endlessly about procedures, but there’s no substitute for performing them. Early on, spend time shadowing and assisting medical assistants and nurses. You’ll pick up valuable lessons on how to set up trays, prepare patients, and bandage wounds properly. These details may seem small, but mastering them makes you smoother, safer, and more confident when it’s your turn.
Be proactive: When attendings see that you’re helpful, engaged, and ready to step in, they’ll be more likely to trust you with autonomy. Every biopsy you take and every excision you close or help with builds your skill set, so take advantage of every opportunity.
Dermoscopy: Your New Best Friend
Learning to use your dermatoscope consistently is another cornerstone of PGY-2. Use it at every opportunity as familiarity only comes with practice. Helpful resources include:
-
- Atlas of Dermoscopy by Dr. Ashfaq Marghoob, which include detailed images with explanations of key features.
- Dermoscopy: The Essentials by Dr. Peter Soyer introduces practical frameworks like the “three-point checklist.”
- Pigmented Lesions for Dermatology Residents is a free monthly webinar series by Dr. Kohen and Dr. Buchanan, which covers pigmented lesions, non-melanoma skin cancers, acral and nail disease, vascular lesions, and inflammatory dermatoses throughout the academic year.
Consider adding a phone attachment to your dermatoscope so you can capture images, build a personal image library, and compare your differentials with biopsy results. This is a powerful way to accelerate your learning.
Final Thoughts
PGY-2 is a whirlwind with new responsibilities, new knowledge, and new expectations. But remember: Your program directors aren’t looking for perfection. They want to see reliability, effort, curiosity, and steady progress. Give yourself permission to be a learner. With every clinic, every Kodachrome, every podcast episode, and every study session, you are building the foundation of your career.
Trust the process, lean on your co-residents and mentors, and take it one step at a time. You’ve made it this far, and you’ve got this.
Did you enjoy this article? Find more on Navigating Residency here.