BONUS: From Pediatrics to Dermatologist & Practice Owner: Navigating a Career Shift and Balancing Life with Dr. Jeffrey Scales

Have you ever wondered about the journey behind a successful dermatologist? We're thrilled to introduce Dr. Jeffrey Scales, an esteemed dermatologist and founder of the North Carolina Center for Dermatology. 🩺👨🏾‍⚕️ In this bonus episode of the B-MED podcast, Dr. Scales takes us from his early interests in medicine to his flourishing career.

Our discussion also dives into the adventure of transitioning from one medical specialty to another as  Dr. Scales delves into his transition from pediatrics to dermatology. He shares nuggets of wisdom about the interview process for trainees, encouraging them to align their interests with their chosen specialty and urging them to consider the culture and location of the programs they are considering. He shares how he balanced his family time, with his spouse also being a physician!  Join us for this insightful and inspiring BONUS episode as we navigate with Dr. Scales!🎙️

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Transcript

Speaker 1: 0:00

Have you ever considered owning your own practice? Or what about transitioning from one career field to another? On today's episode of the BlackMed Connect podcast, I had the fantastic opportunity to interview Dr Jeffrey Scales, a dermatologist and the founder of the North Carolina Center for dermatology in Durham, north Carolina. We had an amazing conversation talking about his journey through medicine and as a founder of a practice and owner of a practice, and so much more. Let's jump right into the episode. Roll the music. Hi everyone. Welcome back to the BlackMed Connect podcast, affectionately known as the Be man podcast, where we share inspiring stories of black physicians and physicians in training at the intersection of medicine, culture and innovation. We're excited to be here this evening. I have an amazing guest with me. His name is Dr Jeffrey Scales and we want to welcome you on to the podcast.

Speaker 2: 1:09

Thank you for having me, Dr Weiss. It's a real pleasure.

Speaker 1: 1:11

Absolutely so, dr Scales, if you could share a little bit more about what inspired you to pursue medicine, and will work our way all the way up to you being the owner and founder of the North Carolina Center for Dermatology. Does that sound okay?

Speaker 2: 1:25

Yes, sounds great.

Speaker 1: 1:27

Excellent, excellent.

Speaker 2: 1:28

Well, I was born in North Carolina, I was raised in the Washington DC area and my mother was a nurse, an RN, that worked in several hospitals, but I remember her most fondly working at Howard University Hospital and in that role she worked with a lot of black physicians, including her boss, who was a pediatrician. And it turns out that her, the boss's husband, was the first black pediatric surgeon in the world. As far as I know, he was trained at Children's Hospital. But anyway, I got to know him, got to know his son who was one of my best friends, chuck Rosser, and his mother, and I really enjoyed the conversation they had about medicine. I enjoyed the stories my mother would come home with and there was a certain deference in reverence she had about the doctors and the work that they did in the hospital and I remember thinking this is really sounds like a great profession, sounds like something I'd be very interested in. The odd thing was well, I'm one of those people I was growing up where if someone was sick I wouldn't stay away from them. You know, if they had some cut in your arm, I'm trying to stay away. If you had ever told me I would end up as a physician, I would have said no, that would not be what I'd end up. I wouldn't be a race car driver or an architect. But it turns out that medicine was my calling. So I was fortunate enough to finish high school there in Bethesda, maryland.

Speaker 2: 2:44

I went to Morehouse College in Atlanta many years ago More than I'd like to remember at this point and I had the opportunity there to get exposed to some really sharp people, some really motivated and intelligent and focused men in ways that black men in particular had not been in a setting like that before. It really was a very inspirational time for me during my life. It really helped forge me and it worked hard. I did well and made Phi Beta Kappa and I was able to go to medical school. I was accepted to a number of medical schools, but I chose to go to an Ivy League medical school Mainly because I wanted to see the challenge.

Speaker 2: 3:24

People asked me why I should choose a medical school. You could have gone to Howard or some other place. I was admitted to all those places, but I decided I wanted to try the challenge. So I went and it was really a big change. It was quite a cultural change from Morehouse College in Atlanta to the Ivy League there in Philadelphia, pennsylvania. But it was good learning experience. I went on to train in pediatrics and practice that for a while and then finally dermatology. It was the inspiration of those people around me, particularly my mother, that took me down the path to medicine.

Speaker 1: 3:56

That's fantastic. It's interesting and it's always exciting to hear how people get started along the journey. So when you mentioned you weren't interested before, didn't really want to be around sick people, was it your time at Morehouse that really solidified that you wanted to do medicine or did you start leaning towards it? What really led you to go from not really thinking medicine to maybe? This is for me.

Speaker 2: 4:19

Actually it's probably more when I was in middle school that I decided I wanted to do. That had to do with the fact that my mother took me into the hospital and exposed me to some of the other doctors. I always found them to be very disciplined and honorable men, very professional. I really like the way they carry themselves, the work they were doing helping children and helping many people there in the area. It's a predominantly black institution and I really appreciate seeing so many people doing such positive things. So at that point I decided I wanted to be a doctor. There were a few things along the way that perhaps got my attention a bit. There's some things now that I think is very interesting. If these fields had been available then I might have considered the things like supply chain management and big data analysis and cybersecurity. Those things didn't exist at the time I was going through, but still I think I still would have chosen medicine and I've been very happy with it.

Speaker 1: 5:16

That's fantastic. So you mentioned your time at Morehouse and then getting into the Ivy Leagues. Right now we're in that season for trainees who are thinking about or either in their interview seasons or about to start, what advice would you possibly give? You went through it sounds like for a pediatric. So what advice would you give early on to a trainee who's working their way through the interview trail?

Speaker 2: 5:41

Is this a person that's finishing medical school and heading into a residency?

Speaker 1: 5:44

Yes.

Speaker 2: 5:46

Yes, okay, so I'll take it in two parts. Let's take it first. In decision making, people are interviewing and trying to decide what it is that they want to do. I think if you're interviewing, you're at the point you've already decided what specialty you want to be involved. I think it's important, when you're deciding where to go, that you consider a number of factors. Number one is that you want to make sure that they have some experience dealing with a diverse group of people who happen to be something other than the patients. There are many training institutions where you go to, and we are people of color, are the people that are used to teach the doctors how to be doctors most, but many of the people in the training programs are not represented in that regard, and so I think it's important to make sure that they are comfortable with that and they are prepared to train you and you're not in oddity.

Speaker 2: 6:34

Remember when I was in a warehouse it was a time when they were really pushing diversity and someone came to visit us from the University of Vermont and they promised a full ride for anyone that wanted to come to the University of Vermont, and medical school was expensive, and I did give us some consideration. But one of the things I thought about was that I would be one of only a few people like myself, if any others, and it would have been a very different training experience Would the patients have been comfortable with, would the doctors be comfortable with? So those are things that's one important question to ask while you're going through it. Secondly, is that always be early? I know it sounds like a very small point, but it is a very large point. Many times we take small things for granted. Well, I'm qualified. If I'm five minutes late, it's no big deal. When I was at Morehouse, they would say being there 10 minutes early is being on time. Being there on time is being late, and I thought that was a very important point.

Speaker 2: 7:29

You want to be ready when they are ready. You want to interview early in the cycle if possible. They have yet to have gone through a lot of other people before you. Many of the spots have already been filled in people's minds. They have their lists formed already and you might be someone trying to fill a final slot and you may be competing with a lot of other people. So it's important to try to be early, physically early to your interviews. You want to make sure that you apply early and then you want to be able to carry yourself in a confident manner. It doesn't mean being braggadocious, but people should feel like there's a certain confidence that you have when you speak. You're confident about the things that you've done and your accomplishments.

Speaker 2: 8:12

Everyone has small blemishes on their resume somewhere or maybe some experiences that didn't go quite as well. I mean, you just need to be honest about it. You need to be very good at having eye-to-eye contact that can be off-putting for people. You need to have erect posture. These things sound really small, like I'm talking about finishing school and I'm not my daughter, who's in medical school right now, in her first year at the University of Pennsylvania, and I've tried to discuss some of these things with her.

Speaker 2: 8:39

Your presence, your physical presence, your attire, making sure it's immaculate and appropriate for the circumstances that you're in. I heard someone say one time when I was in college that they had gone off to a corporate job. They had left Clark College in Atlanta and gone off to a corporate job. They were getting feedback from their bosses that their clothing was different, he says. The person said I like to wear brighter colors and these sorts of things. That's just me. I have to get used to it. That's not the impression you're trying to make. The impression you're trying to make is that I think of it, that you want to go in there and all these things want to be in place such that they're not distractions. Being late is a distraction. Not being dressed appropriately is a distraction. Coming at the end of a session is a distraction. Not holding eye contact Not that you want to stare down, but you should have the ability to hold eye contact and to be confident. It doesn't mean that you are trying to intimidate someone, but you want to be sure that you don't feel like there's anything that they are bringing to the table that intimidates you. Those are some of the things I would recommend.

Speaker 2: 9:45

Have a range of places you're applying. Sometimes people are applying to just a very limited number of places. Apply to 10, 12. Spread them out regionally. Yes, you may want to be in Washington DC, you may want to be in Los Angeles, but it may not be possible that you can be in those places during that particular time of your life. Be prepared to live in places that may not be the final place you're living. You're not choosing your final destination. You're choosing a place for training. The most important thing is that you get there and you get good training and then you can make a decision at that point. For others, it's important that you have to be around family and things like that. If you're planning to be a physician, you have to be prepared to move around and be in places that may not be as comfortable to you as you might want them to be.

Speaker 2: 10:27

I went to Chicago for my first residency in pediatrics. I've never lived in a place that cold before. Frankly, it was an amazing experience. I loved it. I loved Chicago. I literally cry when I love Chicago. I enjoy it there that much. It was a very cold place. It was cold most of the year. I hadn't been in sub-zero temperatures before. I didn't have clothing for that. Learning to be indoors a lot it was something that was a very pleasurable time. I enjoyed it. It was hard work. I worked very hard. Those days when you were resident you could easily be there. It was nothing to be there 30 to 34 hours. I don't think they do that quite anymore, which is a good thing. I wish they hadn't done it then. But yes, you are going to be prepared to work hard.

Speaker 2: 11:09

The other thing I'll say for people too and I was having this conversation with my daughter and she's having a little FOMO about her friends and the things they're doing who are not in medicine You're making a decision about a career that's very demanding but very rewarding. As I was reminding her, she will never want for a job. She will always have employment. She's desired everywhere that they have need, in whatever specialty she chooses. That's something that's very important to people who can't imagine what it's like.

Speaker 2: 11:38

No matter what the economy is, you're going to have jobs. You will have a good income, not an average income a very good income. You'll be able to do things and afford things in ways that others could only dream of. So, yes, it is a hard thing. It's supposed to be hard. It's supposed to be arduous and grueling, because you're going to be making decisions about people's lives that literally can cause people their lives, depending on what your special is. So the idea that it might be hard, you might be working more than you think you should that's part of the process, and you would expect your doctor to do the same thing when you showed up at someplace If you found this person hit and trained as well as everyone else who trained. That's not the doctor you want.

Speaker 1: 12:18

Absolutely. You said so many great things there about timeliness and confidence and I think, even in this era where there are virtual interviews still happening I think people may often take that for granted that you still need to come through the screen with confidence, you still need to be attentive, you still need to seem like you're interested and engaged in what's happening. So that's great advice about timeliness, confidence, knowing that you're going to make some sacrifices along the way, whether that be your location that you live in, or missing out on some things with your friends or family. I do think, like you said, when you lived in Chicago, I did my residency in Atlanta right, so you do have the opportunity to move around and it is exciting, which is definitely a journey that everyone else isn't necessarily familiar with. They may go to college and then they may go one other place, but we truly do move every few years for the time we're in training. So thank you for sharing what your experience was like during your journey.

Speaker 1: 13:22

Hello everyone, are you enjoying the episode so far this week? Well, I'm excited to announce that this week's episode is sponsored by the BeMed app that's right, you heard it the BlackMed Connect app. This app will be for any Black or Brown pre-medical students, medical students, residents, fellows and attendings, even for institutions. We're in the process of developing our app and we wanted to share it with you now, so if you're interested in receiving updates on when the BeMed app will be available to the world, then head on over to bemedconnectcom slash app APP and join the waitlist. Let's jump right back into the episode. I wanted to ask kind of to follow up. You said you did pediatrics for a while, but now you're a dermatologist. I'd love to hear what encouraged you or what things were going on to make you want to pursue dermatology when you were already a pediatrician, and what was that transition like for you?

Speaker 2: 14:22

I think it's a very good question. I'm going to say one thing and follow up to it. I forgot to add one more thing. When you go for the interviews, be sure you read about the people who are going to be in the department. Make sure you know a little bit about their research, they're a little bit about their publications, so that when they ask a question such as what questions can I answer for you, which comes up inevitably, they'll ask a few and then they want to see if you have some interest. Every program should. You will not say it directly, but you should show an interest in every place that you go, because you could end up in any of those places. So be sure that you've done some research on some of the people and just how.

Speaker 2: 15:00

I went from pediatric dermatology. So when I was in medical school, I went through a number of specialty during my training and I liked some of them, but I had to be honest, I really enjoy pediatrics. It was the thing I enjoyed the most. And subsequently I trained in Chicago and I went on to become a general pediatric doctor. I practice in an underserved area there in Chicago and I practice in underserved area in Cincinnati, ohio, and one of the things I realized is that I probably have more of a specialist personality than a generalist. There are many topics that you deal with in the primary care fields which can be challenging. I think one of the more difficult things I found was dealing with children and child abuse. You would see perpetrators, you'd see beaten children, you'd see all sorts of circumstances that I had to admit was something that I didn't think I could spend an entire career doing. Secondly, I think I enjoyed the idea of dermatology more than I realized.

Speaker 2: 15:58

My last month of training in pediatrics I had an opportunity to go and train with a wonderful or at least learn from a wonderful woman in Chicago who was one of the premier pediatric dermatologists in the country, named Amy Paller, and so I trained that last month. My wife was a doctor, she was at that hospital and she had told me about this woman and I really enjoyed the month I spent there. I thought to myself that's something really I could do and thought about it. So, as my wife was training in her subspecialty, pediatric emergency medicine, I was helping to raise a child and working in general pediatrics and I decided on a lark at the encouragement of one of our local doctors here who since retired, named Neil prose. He suggested I apply. So I applied to a number of places and I got a few interviews. It's harder to go back to training, especially after you've already started in medicine, so they were taking me as one of the older applicants, but I applied to a number of programs. I had some interviews, I was signaled that I had the possibility of going to three different places and I ranked back places and came to Wake Forest Baptist Hospital and trained with some wonderful people there and I really enjoyed your methodology.

Speaker 2: 17:08

I am a very visual person. I like the arts, I like sports, I like things I can see. My vision is my strongest sense and so I have a pretty good memory for memorizing things in regards to pictures and patterns, far better than I expected, better than most of the residents. So I really enjoyed that part. So practicing medicine to me is very much fun. I enjoyed a great deal, but I transitioned and afterwards I decided that we were here in North Carolina and I could have chosen many places to go. We decided to stay. My wife at the time was working at Duke hospital and we had two children at that point and one of them was in school, I decided just to stay here in North Carolina, but I was prepared to move to another place if we needed, and I've been here now. Practiced 26 plus years.

Speaker 1: 17:57

Fantastic, fantastic, I mean. You said so much. I want to kind of ask a few follow up questions and one thing that came to mind for me was you mentioned that you knew that your strength was being a visual learner, and I think people may take that for granted, like if you know that you are good with your hands, if you know that you enjoy being around a certain population, like athletes or the elderly, like those are things that should go into consideration when you consider what specialties you pursue, because those strengths will only help you throughout your career. So thank you for sharing even that insight into what you were good at, really even kind of help you transition into dermatology. And another thing you brought up that I love that you've said multiple times. You've talked about family a lot. You've talked about your daughter in medicine now and your wife was also a physician. How did you balance being a husband and a father during your time in training and even beyond once you started in practice?

Speaker 2: 18:55

That's a great point. I think you really hit upon something that I was hoping to be able to mention. So, as a general pediatrician, when it was just my wife and I, we could keep any sort of hours we wanted. At that time there were no hospitalists and so you went round on your own patients in the hospital, so that meant Saturday mornings. I was getting up Sunday morning, so I was getting up and going to see people in the hospital and that was great. Well, it was just the wife and I, and then we had a baby and then it became more challenging. So there were times I would, my wife would be working in the ER and I would be taking care of a child and I would bring the child and leave them at the nurses station while I went in and rounded on some patients and that come back and take the baby and we had back home and I realized that for the life I wanted, I needed to probably do something slightly different.

Speaker 2: 19:43

I think one of the most important points I've been talking to this with my daughter is that when you go through medical school, you are going through it at a time, for the most part, that you're about. You have about as much independence and lack of responsibility as you will ever have in your life ever. And you make decisions based sometimes upon the moment you are. Now. People say I really enjoy working with the surgeon. Wait, that was so much fun. Yes, the question is not so much what do you like? You can like a lot of things. The question is, how do you want to live? What do you see your life like? You mentioned the family. It's important for me to be able to provide 9 to 5 type of care for my children as we were growing up.

Speaker 2: 20:22

My wife is a pediatric nursing nurse. She's very smart, very accomplished and her hours are different. There's no hour that's sacred. There's no day that's sacred that she couldn't work. During the time that we were going through our career I had no problems being married to another professional person. It is difficult. Sometimes we have two doctors in the house where people have demands on their careers Sorry enough. Sometimes with one doctor, but we have two, sometimes as a surgeon. So I decided I wanted to choose a career after I had been in pediatrics and decided I needed to do something that was going to make me the more stable person at home. I'm home after five and I'm not home on week. I'm not away on weekends and I'm home during holidays, so I was the more stable person in terms of the hours, but I thought we made a great team together, contributing to things that they did.

Speaker 2: 21:10

I have a certain way about me and my wife has a certain way, until we both brought something to the table and we raised three children. But yes, those are very important things. You have to be honest about what it is. You say look, I want to have three children, I want to be a cardiothoracic surgeon or a cardiologist. Be clear what that life is really like. It's fun and interesting.

Speaker 2: 21:29

When you're the medical student and you're sitting there watching someone else do something, it seems very interesting. What is it like when you're there 21 straight days? You're rounding on patients all the time? I remember watching one of the pediatric surgeons train at Children's Hospital in Philadelphia. In fact, he's in practice here locally and he would see his children awake once every morning between the hours of about nine to 10, when his wife excuse me would bring the children in to see him. Otherwise he would go very early in the morning. He'd come home very late. On the nights he didn't stay in the hospital and that was a debt. He was doing that for months, years, and that was not a life I could imagine.

Speaker 2: 22:06

Now, granted, it is a tremendous feel and very necessary, but you have to be prepared to make some decisions like that and all your family's going to be at the beach and you have to work, not just in training, but like that for the rest of your life. That has great impact upon you and has an impact on the people around you and the families that you haven't even formed yet. You have to be very honest about what it is that you want. Just liking something as a specialty should not be enough for you to decide to go into it. You're going to decide.

Speaker 2: 22:32

Can you live that type of life? There are some specialties that have nearly 100% divorce rate, cardiology being one and somebody other surgical specialties. That's something that you have to be very clear about. If you plan to be single for the rest of your life, it really doesn't matter. If you plan to have a significant other, perhaps some children, maybe you have some responsibilities, like taking care of an elderly parent That'd be clear about what your feel will allow you to do. Otherwise, your torn and live directions in. It makes you unhappy at work and unhappy at home.

Speaker 1: 23:00

That's such great advice and I really think students need to hear that in trainees and even early career faculty like myself, because I think we are making decisions a lot of time based on being very career focused, being very driven individuals, thinking about what we can accomplish and not always taking into account when life will happen. So you really really appreciate you sharing that advice with our audience as well. We hope you enjoyed part one of the episode with Dr Jeffrey Scales, dermatologist and founder of the North Carolina Center for Dermatology. We had an amazing conversation about his journey through medicine, the importance of family and so much more. Stick around for our episode next week, part two, where we'll learn a little more about what it takes to run a practice, as well as explore what skin cancer is all about.

Speaker 1: 23:54

Don't forget to like this video. If you haven't done so already, go ahead and hit that thumbs up. Also, don't forget to subscribe to our channel if you're watching us on YouTube, or follow us and listen on all podcast platforms. We appreciate Dr Scales taking time to have this discussion and stick around and come back next week for part two of the episode. Until next time, always remember to dream without limits. Bye.