The perception that dermatologists in practice have substantially higher incomes than in academics is often cited as the primary reason people choose to practice outside academic institutions.

We sought to compare the incomes of dermatologists in academics versus various practice settings.

Data from various surveys of dermatologists from 2002 to 2004 were adjusted for annual inflation to the year 2004 and compared. Benefits and bonuses were not included. The income level of clinical instructors, who are 7.0% of all academic dermatology faculty, were not available for inclusion.

Median dermatology faculty income (combined average of assistant, associate, and professor levels) was $192,267, 12.0% less than the median practice income of $215,303. There was substantial variation across regions, institutions, and types of nonacademic practice. Median starting incomes for dermatology residency graduates were comparable in practice across multiple data sources ($182,116-$200,000) and private universities ($189,336); however, both were significantly higher than median starting incomes in public universities ($83,349).

This study relied on self-reported data. Although all attempts were made to use comparable information, variances in how data were collected and classified may exist.

Initial income for those entering practice is equivalent to those entering academia in private universities; however, incomes for both of these groups are 2- to 3-fold higher than those entering academia in public universities. This discrepancy may discourage some recent trainees, some of whom have high debt and high expenses, from entering the field of academic dermatology. Because incomes in academia increase predictably with increasing rank, overall self-reported incomes for established dermatologists in practice and senior academia are comparable.