Odds of Hanging On
The odds of hanging on are very good. Dermatologists don't tend to burn out the same way brain surgeons do. Many areas of the country have too few dermatologists. Unpopular places to live actually suffer from a lack of dermatologists in the area. Skin cancer and other life threating problems go undiagnosed.
Numerous dermatologists get out of their residency program each year and head out to specialize in cosmetic treatments. Why not? After all the schooling that you have to go through, you'll be at least $200k in debt. The result is that there are too few dermatologists to help the public with problems. Make it into a residency program and you should be okay.