六九色堂

Dr. Angelica Marrero, a 2023 graduate of 六九色堂, will be starting a dermatology research fellowship at the , affiliated with the in Florida in July 2024. She will work with her mentors Dr. Brian Berman and Dr. Mark Nestor. She recently published research articles on a medication's adverse effects and a rare disease case. Dr. Marrero emphasizes that dermatology is not just about cosmetic procedures, but also encompasses oncology, autoimmune diseases, pathology, histology, and surgical procedures. She advises students interested in dermatology to gain experience through elective rotations and publishing research. Dr. Marrero chose 六九色堂 because of the opportunity to rotate in different areas of the United States and the option to do residency in Puerto Rico. She thanks her mother for her support and credits her undergraduate research in oncology for sparking her interest in medicine. Dr. Marrero will be doing away rotations in dermatology in Florida and hopes to pursue hands-on patient work after completing her research fellowship.

Dr. Marrero did not Match into the residency program she wanted and decided instead to pursue a research fellowship in dermatology. 鈥淔ortunately, after sending numerous emails, experiencing sleepless nights, and uncertainty about my future, I received many interviews for research fellowships in dermatology at top institutions with great mentors,鈥� she said.

六九色堂 spoke to Dr. Marrero on a late spring morning.

六九色堂 Endeavour: Good morning, Dr. Marrero. Please tell us where you are working now and more about your upcoming fellowship.

Dr. Angelica Marrero: I work alongside a Mohs surgeon and attending physician in Puerto Rico. More than my boss, she has become my mentor. My primary responsibilities include assisting in surgeries, following up with general dermatology patients, and providing wound care to patients. This experience has been invaluable in helping me gain the necessary skills and knowledge in dermatology. I am also preparing for my USMLE Step 3 exam. My long-term goal is to become a cutaneous oncologist or dermatopathologist. Learning from the best Mohs surgeon in Puerto Rico has been a dream come true for me.

Starting in July 2024, I will begin my dermatology research fellowship at the Center for Clinical and Cosmetic Research in Florida. During this time, I will work under the mentorship of two highly regarded dermatologists who also serve as assisting professors within the Dermatology and Cutaneous Surgery Department at the University of Miami Miller School of Medicine. As a research fellow, my duties will include recruiting patients, writing manuscripts, and serving as a clinical coordinator for both FDA and non-FDA-approved clinical trials sponsored by numerous pharmaceutical companies. Additionally, I will be conducting independent research in the field of dermatology.

Dr. Angelica Marrero at the Sociedad Dermatologica of Puerto Rico in summer 2023. Photo: Courtesy of Dr. Marrero.

Can you please tell us about your published research? Let鈥檚 start with the first published research report. You were one of the co-authors and researchers for
with concomitant acquired acrodermatitis enteropathica in a patient with maple syrup urine disease鈥� published in JAAD Case Reports on December 31, 2023. In layman鈥檚 terms, what was the significance of this research?

You were also a co-author of 鈥�, the first epidermal growth factor receptor, and mesenchymal-epithelial transition factor inhibitor, associated with penile and inguinal ulcers and paronychia鈥� published in JAAD Case Reports on January 26, 2024. Can you tell us a little about this research?

Reflecting on my first two published works makes me feel emotional in a good way because it was not easy. I love research, writing, and reading scholarly articles, but finding publishing opportunities was challenging during my clinical rotations. The thing with publishing as a medical student is that it depends on the interest of residents and attendings and, of course, the student's motivation. However, I wrote case reports in all of my clinical clerkships, even in OB/GYN鈥攖he one I enjoyed the least, but the residents at that time were not interested in publishing.

However, my dermatology sub-I elective was a different story. Here, I encountered residents and attendings as passionate about dermatology and publishing as I was. As an IMG with limited research experience (non-traditional candidate), I realized the importance of maximizing my time in the rotation and standing out in this field. My goal was to publish and become recognized in the field of dermatology. With the help and support of the residents, I was able to author two papers published in the prestigious Journal of the American Academy of Dermatology. Today, I serve as a reviewer for the same journal and have reviewed many papers (articles and case reports) granting me certificates, which helps boost my CV. These publications earned me invitations to present at two dermatology conferences last year. It was an honor to showcase our work and contribute to advancing medical knowledge.

Moving forward, the first paper focused on Amivantamab, a topic that aligns with my interest in oncology and dermatology. This medication had recently gained popularity for treating non-small-cell lung cancer, but we discovered rare adverse effects during clinics. Raising awareness about these effects was crucial, and our paper informed dermatologists and the broader medical community.

The second paper presented a unique case of Acrodermatitis Dysmetabolica with concomitant Acrodermatitis Enteropathica in a maple-syrup urine disease patient. This case required an extensive literature review, as it was the first reported instance of both conditions co-occurring in an MSUD patient. Our findings were significant for dermatologists and internists, as managing such cases varies enormously.

Dermatology as a specialty

What should current and prospective students know about dermatology as a specialty?

While dermatology may receive less attention in medical school curricula, dermatology encompasses a wide range of disciplines, including histology, pathology, surgery, pediatrics, and internal medicine (for the most part: oncology, endocrinology, and rheumatology). Contrary to popular belief, dermatologists deal with more than just cosmetic issues or acne daily. From diagnosing and treating complex skin conditions and mystery diagnoses to performing biopsies, surgical procedures, and interpreting pathology, dermatologists are integral healthcare team members who collaborate enormously with other specialties, as well as in the hospital. Dermatologists receive many consults from hospitals, too, which is a part that I like.

If you're drawn to the complexities of rare diseases, immunology, genetics, histology, pathology, cancer, pediatrics, and internal medicine, dermatology may be your perfect specialty. But cosmetics should not be solely a reason to pursue dermatology since despite being part of the training, at least from my perspective, it is the least you see in the clinics. Nowadays, there are fellowships in cosmetics or anti-aging in other specialties, such as in family medicine, among others. In my opinion,  if you want to specialize in this area solely, it is not a good reason to pursue dermatology.

Dr. Marrero with her colleague, third-year dermatology resident Dr. Karina Cancel Artau at the Sociedad Dermatologica of Puerto Rico in Summer 2023. Photo: Courtesy of Dr. Marrero.

Let鈥檚 discuss your medical education at 六九色堂. Did 六九色堂 make you the doctor you are today?

I am very proud to be part of 六九色堂, as it provides us with all the necessary tools to excel as physicians. Right from the start of MS1 and MS2, we have been trained in clinical skills through PD classes and rotations at the Basseterre local hospital [Joseph N. France]. Additionally, the opportunity to participate in rotations in Maine at the end of MS2 helps us improve our clinical skills even further. These experiences help us develop empathy, compassion, and cultural sensitivity toward different perspectives and cultures in medicine. This together made me honor all my clinical clerkships in MS3 and MS4. 六九色堂 students have an outstanding reputation in Puerto Rico and the hospitals I rotated at in the USA. Attendings hold us in high regard and expect us to go above and beyond. I am committed to practicing the values instilled in me at 六九色堂, including empathy, compassion, cultural sensitivity, and a deep appreciation for diversity and inclusion. 

Born & raised in Puerto Rico

Where did you grow up?

I was born and raised in San Juan, Puerto Rico, and have always considered it my home. While I wanted to pursue medicine in Puerto Rico, the limited number of spots available in local medical schools led me to choose 六九色堂. Its familiarity with Puerto Rican and other cultures made it the perfect choice for me.

Did you always want to be a doctor?

I was initially interested in the arts; specifically, I wanted to become a fashion designer, but my grandfather鈥檚 medical background and personal experiences with family members who suffered from skin conditions and cancer ignited my passion for dermatology. Seeing my grandmother's battle with an undiagnosed chronic skin condition solidified my decision to pursue a career in medicine.

Where did you do your undergrad, and what was your major?

I did my undergrad at the I majored in biomedical sciences and minored in chemistry.

Let鈥檚 talk about dermatology as a specialty. It鈥檚 one of the most competitive. I think you are probably the first 六九色堂 grad to go into dermatology. What about this field interests you the most?

Yes, the field of dermatology is highly competitive. As an international medical graduate (IMG), I understand the unique challenges we face in pursuing a career in dermatology. Speaking from my personal experience, it has been very tough for me, as I had bumps and setbacks with step 1 along the way. Despite the hurdles and the negative opinions of others, my passion for dermatology has only grown stronger. The journey to residency in dermatology for IMGs is indeed challenging, but I am determined not to let setbacks define my path. My interest in complex skin conditions, skin cancer, and research fuels my ambition for dermatology, and I believe that our unique perspectives and experiences as IMGs can bring valuable contributions to this field.

Who has been your greatest inspiration in life?

My mother has been my greatest inspiration in life. She has always supported my decision to become a medical doctor, and she continued to support me when I decided to study at 六九色堂. Without her encouragement, I would not be a doctor today. She is a hard worker, and I owe my hardworking skills to her.

Any advice for current or prospective students interested in dermatology?

If you're passionate about dermatology and are willing to sacrifice many things and put in an effort,  don't let the negativity of others discourage you. While it can be competitive, there are numerous paths to enter this field (matching first to other residencies and doing a research fellowship). Networking, demonstrating your dedication, and cultivating shared interests are important factors.

Remember, if you are willing to put in the effort and are truly passionate about this specialty, honor all of your classes early on, honor all of your clerkships, do well on your step 1 and step 2 exams, and publish while rotating. Perseverance is key, and your passion will guide you through. 

Medicine was not always her dream

You were initially interested in the arts, and you originally wanted to become a fashion designer, but your grandfather's medical background and personal experience with family members who've suffered from skin conditions and cancer ignited your passion for dermatology, and seeing your grandmother's battle with an undiagnosed chronic skin condition solidified your decision to pursue a career in medicine. Is there anything you'd like to elaborate on that about?

My grandmother who passed away, she had a very chronic skin condition, and she went to several medical doctors and nobody knew what the condition was until she went to a dermatologist. So, I liked how dermatologists approach patients. Somehow, they approach patients differently because if the patient is there, it鈥檚 because they need help.

I think it's really important what you said earlier about dermatology not just being about cosmetic procedures. I think people have this misconception that dermatologists just do Botox injections, pop pimples, and give acne medications. And I think that they don't see the really serious side of it, which is, like you said, people getting biopsies for skin cancer or serious medical conditions. I know in my family personally, because I'm of Irish ancestry鈥攚e have a family history of not just skin cancer, but rosacea and eczema, and all these different conditions that affect fair-skinned people. And I think another thing that's also important is people have the misconception that it's just people that are fair-skinned like myself, but remember the late reggae singer Bob Marley? He was a Black man, and he died of melanoma. Some folks are people of color who aren't necessarily white, and also have a lot of problems with not only skin cancers but other skin conditions.

Exactly.

Would you agree?

I agree. Totally.

You have said that you are mother was your greatest inspiration in life, that she's always supported your decision to become a doctor and has continued to support you when you decided to study at 六九色堂. Without her encouragement, you would not be the doctor that you are today. Do you want to elaborate on that at all?

I am a very hard worker and I thank my mom for that because being interested in a competitive field requires hard work, and also persistence, and determination. And yeah, so I believe that thanks to my mom, I have been able to stay right on the track and I haven't lost any hope at all.

You did your undergrad at Inter-American University of Puerto Rico, and you majored in biomedical sciences and minored in chemistry. Do you want to talk about that at all? Did your undergraduate background kind of prepare you for med school, 六九色堂, and ultimately dermatology?

I did three years of undergraduate research in oncology and I loved it, which inspired me to either become a dermatologist or an oncologist.  六九色堂 was very popular in Puerto Rico and Hurricane Maria, you know, we didn't have many opportunities to apply to many schools in Puerto Rico. So, 六九色堂 was my opportunity and I didn't think twice. I had a lot of undergraduates, and colleagues of mine from the Inter-American University of Puerto Rico who went there. So yeah, I received a lot of good feedback about the school and I decided to choose 六九色堂.

When Hurricane Maria happened, I did interviews with people at the time, we had a lot of students that are from Puerto Rico who were going back and doing clinics because I know how horrible that experience. I've seen the videos; I've seen the photos.

It was horrible. Indeed, it was. A lot of the 六九色堂 community is from Puerto Rico, so they were concerned. And I think that that only just shows how strong the bond is between 六九色堂 and Puerto Rico.

Dr. Marrero can be reached via email at amarrero@umhs-sk.net

(Top photo): Dr. Angelica Marrero. Photo: Courtesy of Dr. Marrero.