Reflections on My Dermatology Rotation in the United States

The one-month rotation I completed at Premier Dermatology in Virginia in March 2025 provided an invaluable experience regarding the U.S. healthcare system, while offering the opportunity to observe the differences between Turkish and American practices. I deepened my clinical understanding by participating in Mohs surgery, general dermatology clinics, and diagnostic procedures.

Key Takeaways Under the guidance of Dr. Khachemoune, I learned Mohs surgery techniques; I learned to recognize histological patterns such as basaloid islands in basal cell carcinoma and keratin pearls in squamous cell carcinoma. Alongside Dr. Zahir, I performed biopsies and cryotherapy applications in conditions like molluscum contagiosum and tinea unguium. Unlike the supervised training in Turkey, the rotation emphasized autonomy, teamwork, and patient-centered care.

Challenges and Growth I overcame initial issues such as suturing mistakes and inadequate lidocaine injections through practice and feedback. Although adapting to the U.S. electronic medical record (EMR) system was challenging at first, I increased my documentation efficiency by using checklists.

Comparison of U.S. and Turkish Healthcare Systems While the U.S. system prioritizes preventive healthcare, advanced technology, and collaboration, cost barriers exist. Turkey's universal system reduces the financial burden, but wait times are long. In the U.S., patient pre-evaluation (by medical assistants) increases efficiency, whereas in Turkey, integrated electronic records reduce unnecessary tests. Prescription flexibility in Turkey (nationwide pharmacy access) is more user-friendly than the pharmacy-dependent system in the U.S.

Cultural Observations While American patients are more proactive and independent, family support stands out in Turkey. The rotation strengthened my ability to adapt to a fast-paced environment and take initiative.

Impact on My Career My exposure to dermatopathology reshaped my career goals. Dr. Khachemoune's mentorship ignited my interest in pathology, leading to my decision to pursue a pathology residency and a dermatopathology fellowship in the U.S. My passion for diagnostic precision and interdisciplinary collaboration was reinforced by this rotation.

Conclusion This experience improved my clinical skills, demonstrated the strengths of both systems, and clarified my career path. By blending the innovation of the U.S. with the practicality of Turkey, I aim for excellence in patient care.