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Dermatology Training Pathway

How to become a dermatologist in Australia — the Australasian College of Dermatologists' four-year training program, how national selection works through the state Faculties, the exams, and why it's one of the hardest specialties to enter and one of the most heavily private.

Dermatology is one of the most competitive specialties in the country, with a small workforce and very few training positions. There's no formal research requirement, but in practice successful applicants spend several post-internship years building a CV — often including a higher research degree — before they're selected.

Why dermatology

You diagnose and manage the full range of skin, hair and nail disease — inflammatory conditions like eczema and psoriasis, skin cancer and pigmented lesions, autoimmune and genetic skin disease, paediatric dermatology — blending clinic-based medicine with procedural work (biopsies, excisions, cryotherapy, phototherapy) and, for many, a cosmetic and laser component. Work is overwhelmingly outpatient, largely office hours, with very little after-hours or on-call burden. It suits people who like visual diagnosis and pattern recognition, want a mix of medicine and minor procedures with a strongly office-hours lifestyle, and are prepared for a long and very competitive entry that usually rewards research and sustained dermatology experience.

Draws: Largely office-hours work with minimal on-call for a procedural field, A mix of medical diagnosis and minor procedural / surgical work, Strong, growing demand driven by skin cancer and an ageing population, An overwhelmingly private specialty with an uncapped cosmetic niche.
Trade-offs: One of the hardest specialties to enter — a tiny number of training places, Years of CV-building, commonly including a higher research degree, first, A demanding multi-part Fellowship Examination across written and viva work, Heavily metropolitan — very few dermatologists work rurally.
Subspecialties: Medical / general dermatology, Skin cancer & dermatologic surgery (Mohs), Paediatric dermatology, Dermatopathology, Cosmetic, laser & procedural dermatology, Immunodermatology & autoimmune skin disease, Contact & occupational dermatitis, Phototherapy & photomedicine.

The training pathway

The same fellowship, two very different timelines. The fast route assumes everything goes right; most people land on the realistic one.

Fastest route

4 years

Selected at the minimum, every assessment and the Fellowship Examination passed first go — the shortest the program allows.

Internship & residency

PGY1–2

General registration plus at least two years of postgraduate hospital experience — the entry minimum. Applications are usually lodged during PGY2.

National selection into ACD training

from PGY3

One centralised ACD process — CV scored centrally in Sydney (double-marked), then multiple mini-interviews — delivered through the five state Faculties.

Basic training (Years 1–2)

Years 1–2

Years 1–2 of the four-year program: CSOM online modules in Year 1 and a continuous run of work-based assessments.

Advanced training (Years 3–4)

Years 3–4

Years 3–4, consolidating clinical and procedural practice and sitting the multi-part Fellowship Examination.

Fellowship — FACD

Qualified · ~PGY7

Specialist dermatology registration.

Realistic route

7–10 years

Typical — several post-internship years building a competitive CV (successful applicants commonly average around four years of experience, often with a higher research degree) before selection.

Internship & residency

PGY1–2

General registration and at least two years of postgraduate hospital experience.

CV-building years (service registrar / research)

2–4+ years

Most spend several years in dermatology-relevant terms, service-registrar roles and research — a higher research degree (MPhil/PhD) has become close to expected — before applying. Up to four applications are allowed.

National selection into ACD training

the hardest step

A tiny number of places nationally (around 114 total training positions across the four years, roughly 15–25 new entrants a year on the AMC's historical figures). The national applicant-to-place ratio isn't published.

Basic training

Years 1–2

CSOM online modules (Year 1, covering pharmacology and clinical sciences) plus ongoing work-based assessments — SITAs, case-based discussions, Derm-CEX and procedural assessments.

Advanced training + Fellowship Examination

Years 3–4

The Fellowship Examination runs across written papers (June), vivas including a histopathology viva (July) and clinical vivas (August). Up to four attempts are allowed.

Fellowship — FACD

Qualified · ~PGY9–11

Specialist registration; many add subspecialty experience in dermatologic surgery, paediatric dermatology or dermatopathology.

How competitive is it?

Dermatology is consistently one of the hardest specialties to enter, driven less by exam attrition than by sheer scarcity of training places. The Australasian College of Dermatologists' workforce snapshot recorded about 686 Fellows and 136 trainees across Australia at December 2024, with roughly 114 accredited training positions in total across the four-year program (a standing number, not an annual intake). On the AMC's published historical figures, the program filled in the order of 15–25 new training places a year between 2010 and 2016; no national applicant-to-place ratio is published, so the precise odds aren't known — but the small number of places, set against strong demand, makes entry very competitive. As a labelled state example, Western Australia's prevocational service reports that only around a quarter of applicants succeed on their first application there. The workforce is also heavily metropolitan: more than 90% of dermatologists work in major cities and fewer than 40 work in rural Australia. The practical effect is a long pre-selection build-up — successful applicants commonly have several years of dermatology-relevant experience and increasingly a higher research degree before they're taken on.

Unaccredited time: In practice, usually — there's no formal research or service-registrar requirement, but the workforce is tiny and places are few, so most successful applicants spend several post-internship years (commonly including a higher research degree) building a CV before selection.

Sources: ACD — Australian Dermatologist Workforce Snapshot (Dec 2024), AMC — Australasian College of Dermatologists accreditation reports (training places), PMCWA — dermatology careers (WA first-application figure).

Selection criteria & how to apply

Selection is national. The Australasian College of Dermatologists runs one centralised process — a structured CV scored centrally in Sydney (double-marked) and then multiple mini-interviews — operationalised through five state Faculties (NSW, Victoria, Queensland, South Australia and Western Australia), each with a Director of Training. You may apply up to four times. The AMC's accreditation report discloses that the CV is scored with weighting multipliers rather than flat percentages — for example clinical experience and demonstrated interest in dermatology carry the most weight, with research and academic achievement and presentations also counted — but the exact CV-versus-interview split is not published. Because only multipliers (not a complete percentage rubric) are disclosed, the steps below are shown qualitatively rather than as a points bar. The assessed steps:

EligibilityGate

Full registration plus at least two years' postgraduate hospital experience; applications are usually lodged during PGY2 for a PGY3 start. Up to four applications are permitted.

CV — clinical experience & interest in dermatologyAssessed

The most heavily weighted CV elements. The AMC report describes employment/clinical experience and demonstrated interest in dermatology as carrying the largest scoring multipliers — sustained, recent dermatology-relevant terms count most.

CV — research, academic record & publicationsAssessed

Academic achievement and presentations/publications are scored. A higher research degree (MPhil/PhD) is not formally required but has become close to expected among successful applicants.

CV — community, leadership & referencesAssessed

Community involvement, leadership and structured references contribute to the centrally scored CV, at a lower weighting than clinical experience and interest.

Multiple mini-interviewsAssessed

Shortlisted applicants attend MMIs run through the College. The interview is a major part of the final ranking, but its exact weight relative to the CV isn't published.

Key documents: ACD — Training program & selection, ACD — How to apply for training, AMC — accreditation of the ACD specialist program.

How it works, Faculty by Faculty

Selection is national, but training is delivered by the College's state Faculties. You apply through the ACD's central process and are trained through one of five Faculties (NSW, VIC, QLD, SA, WA), each with a Director of Training. Smaller jurisdictions don't have their own Faculty — Tasmania and the ACT sit with the larger eastern Faculties, and the Northern Territory with South Australia. Pick your state below.

NSW

Who runs selection: The ACD's NSW Faculty, with a Director of Training, rotating accredited posts across Sydney and regional NSW teaching hospitals and clinics. Selection is national; the Faculty is where you're trained.