Physician workforce economics in the United States have changed substantially over the past few years as a result of oversupply in many specialties and the emergence of managed care as the predominant health care delivery system. Some newly graduating residents have reported difficulty in finding jobs, unsatisfactory compensation levels, and low job satisfaction. However, dermatology as a specialty has experienced surprisingly prosperous employment opportunities. Recent studies have affirmed that recent dermatology residency graduates have had less difficulty than their colleagues in securing desirable positions. This article examines 4 different factors that may have set dermatology apart from the rest of the medical specialties: the supply of new dermatologists, the impact of managed care and shifting health care systems, the impact of changing professional demographics, and the changing scope of practice. Trends in these 4 areas have tightened the supply and increased the demand for dermatologists. Whether future residents will enjoy a similarly open market remains to be seen as the US health care system evolves. (J Am Acad Dermatol 2003;48:265-70.)