Unlike the achievement of becoming a board-certified dermatologist, a dermatology career does not develop in a straight line, and rarely at a steady pace. It seems to me that a shift from a single-minded focus during residency to the fifth-grade strategy of doing our personal best at the main tasks of everyday work as well as participating in a variety of other experiences successfully develops a career that encompasses excellence, enthusiasm, and the fulfillment of personal needs along with those of our practice or institution. When we do our personal best on the day-to-day matters, people will be beating down the doors to offer other valuable experiences. To paraphrase an old truism, if you want something done well, find a busy person who does other things well. Some of the experiences presented to us may question our basic assumptions and redirect our careers; others will fizzle out, but not before they garner self-confidence or even indirectly lead to something more substantial in our careers. Sometimes all that an experience teaches us is that we do not want to continue down that path.
Career development is a dynamic process. Strive for excellence in everything that you do, keep your eyes open for broadening experiences, and maintain your fifth-grade enthusiasm! I am not sure what I will be doing in 5 years, but I hope it will be fresh, varied, and exciting. Do dermatology careers develop through a focused plan or serendipity? At my mature age, with a well-developed career, my answer is mostly serendipity.