Jeffrey J. Miller, MD, MBA

Have you ever heard of the American Dermatological Association (ADA)? While many residents may not yet be familiar with this group, its members are among the most respected leaders in dermatology. They serve as current and past presidents of influential organizations including the American Academy of Dermatology (Susan C. Taylor, MD [Philadelphia, Pennsylvania]), the American Society for Dermatologic Surgery (M. Laurin Council, MD, MBA [Creve Coeur, Missouri]), and the Association of Professors of Dermatology (Sewon Kang, MD [Baltimore, Maryland]). Others lead certification boards or serve as editors of key journals like the Journal of the American Academy of Dermatology (Dirk Elston, MD [Charleston, South Carolina]), JAMA Dermatology (Kanade Shinkai, MD [San Francisco, California], and Cutis (Vincent A. DeLeo, MD [Los Angeles, California]).

The ADA is celebrating its 150th anniversary in 2026. What makes the organization so enduring is not just its history, but its culture. The members of the ADA foster deep, long-lasting relationships, and its meetings are purposefully designed to balance structured scientific sessions with unscheduled time for reflection, conversation, and connection. That intentional design cultivates learning, innovation, and wellness.

Steven Covey’s The 7 Habits of Highly Effective People¹ highlights the importance of renewal and relationship building, as does the Harvard Study of Adult Development, one of the longest-running research projects on well-being.^2-4 The key conclusion? Relationships are the strongest predictors of long, healthy, and fulfilling lives, not wealth or achievement. Medical training is intense, and the emphasis often falls squarely on achievement. But the friendships you form in medical school, residency, and early career are just as formative. Membership with the ADA continues this spirit of connection throughout one’s professional life, with meetings that welcome spouses and partners and encourage engagement across generations.

A hallmark of ADA culture is its commitment to mentoring and mutual support. Need advice about transitioning from private practice to academia? Navigating department leadership? Applying for a grant? Considering industry, editorial, or global health roles? Within the ADA, there’s someone who has done it and is eager to help. Recent meetings have addressed future-facing topics such as artificial intelligence, bedside diagnostics, workforce advocacy, and global health while also carving out time for rejuvenating activities: book clubs with best-selling authors, sessions on the arts, storytelling, wellness, and travel. This holistic programming reflects the ADA’s belief in supporting the whole physician.³ Members understand the value of relationships and appreciate these opportunities to learn about the passions and interests of their colleagues (Table).

Candidates are nominated by current members and must be board certified and at least 10 years beyond completion of their training. Members vote upon candidates in a rank voting system each year. If someone is nominated and not selected, they did not fail—they may be nominated again. The idea behind this membership process is to keep the organization small enough that members can get to know one another—there are currently 552 active members. Importantly, the ADA has embraced diversity and inclusion. While historically male- and White-dominated, recent inductee classes now reflect gender parity and a broader range of backgrounds, enriching the organization with fresh perspectives.^5-8

For residents and fellows, the lesson is clear: friendships, mentorship, and time for reflection are not luxuries—they are essential. Burnout stems from relentless output in isolation; however, in cultures that prioritize renewal, authenticity, and community, physicians can flourish.⁹ Membership in small professional organizations is an important step towards avoiding isolation. We encourage you to be active in your local, state, and national organizations.

The ADA stands as a powerful example of how professional societies can help you build the kind of life and career you want, not just a résumé. From informal beachside conversations to high-level scientific discussions, its enduring strength is this: leaders helping others lead.

Have you ever heard of the American Dermatological Association (ADA)? While many residents may not yet be familiar with this group, its members are among the most respected leaders in dermatology. They serve as current and past presidents of influential organizations including the American Academy of Dermatology (Susan C. Taylor, MD [Philadelphia, Pennsylvania]), the American Society for Dermatologic Surgery (M. Laurin Council, MD, MBA [Creve Coeur, Missouri]), and the Association of Professors of Dermatology (Sewon Kang, MD [Baltimore, Maryland]). Others lead certification boards or serve as editors of key journals like the Journal of the American Academy of Dermatology (Dirk Elston, MD [Charleston, South Carolina]), JAMA Dermatology (Kanade Shinkai, MD [San Francisco, California], and Cutis (Vincent A. DeLeo, MD [Los Angeles, California]).

The ADA is celebrating its 150th anniversary in 2026. What makes the organization so enduring is not just its history, but its culture. The members of the ADA foster deep, long-lasting relationships, and its meetings are purposefully designed to balance structured scientific sessions with unscheduled time for reflection, conversation, and connection. That intentional design cultivates learning, innovation, and wellness.

Steven Covey’s The 7 Habits of Highly Effective People¹ highlights the importance of renewal and relationship building, as does the Harvard Study of Adult Development, one of the longest-running research projects on well-being.^2-4 The key conclusion? Relationships are the strongest predictors of long, healthy, and fulfilling lives, not wealth or achievement. Medical training is intense, and the emphasis often falls squarely on achievement. But the friendships you form in medical school, residency, and early career are just as formative. Membership with the ADA continues this spirit of connection throughout one’s professional life, with meetings that welcome spouses and partners and encourage engagement across generations.

A hallmark of ADA culture is its commitment to mentoring and mutual support. Need advice about transitioning from private practice to academia? Navigating department leadership? Applying for a grant? Considering industry, editorial, or global health roles? Within the ADA, there’s someone who has done it and is eager to help. Recent meetings have addressed future-facing topics such as artificial intelligence, bedside diagnostics, workforce advocacy, and global health while also carving out time for rejuvenating activities: book clubs with best-selling authors, sessions on the arts, storytelling, wellness, and travel. This holistic programming reflects the ADA’s belief in supporting the whole physician.³ Members understand the value of relationships and appreciate these opportunities to learn about the passions and interests of their colleagues (Table).

Candidates are nominated by current members and must be board certified and at least 10 years beyond completion of their training. Members vote upon candidates in a rank voting system each year. If someone is nominated and not selected, they did not fail—they may be nominated again. The idea behind this membership process is to keep the organization small enough that members can get to know one another—there are currently 552 active members. Importantly, the ADA has embraced diversity and inclusion. While historically male- and White-dominated, recent inductee classes now reflect gender parity and a broader range of backgrounds, enriching the organization with fresh perspectives.^5-8

For residents and fellows, the lesson is clear: friendships, mentorship, and time for reflection are not luxuries—they are essential. Burnout stems from relentless output in isolation; however, in cultures that prioritize renewal, authenticity, and community, physicians can flourish.⁹ Membership in small professional organizations is an important step towards avoiding isolation. We encourage you to be active in your local, state, and national organizations.

The ADA stands as a powerful example of how professional societies can help you build the kind of life and career you want, not just a résumé. From informal beachside conversations to high-level scientific discussions, its enduring strength is this: leaders helping others lead.

Have you ever heard of the American Dermatological Association (ADA)? While many residents may not yet be familiar with this group, its members are among the most respected leaders in dermatology. They serve as current and past presidents of influential organizations including the American Academy of Dermatology (Susan C. Taylor, MD [Philadelphia, Pennsylvania]), the American Society for Dermatologic Surgery (M. Laurin Council, MD, MBA [Creve Coeur, Missouri]), and the Association of Professors of Dermatology (Sewon Kang, MD [Baltimore, Maryland]). Others lead certification boards or serve as editors of key journals like the Journal of the American Academy of Dermatology (Dirk Elston, MD [Charleston, South Carolina]), JAMA Dermatology (Kanade Shinkai, MD [San Francisco, California], and Cutis (Vincent A. DeLeo, MD [Los Angeles, California]).

The ADA is celebrating its 150th anniversary in 2026. What makes the organization so enduring is not just its history, but its culture. The members of the ADA foster deep, long-lasting relationships, and its meetings are purposefully designed to balance structured scientific sessions with unscheduled time for reflection, conversation, and connection. That intentional design cultivates learning, innovation, and wellness.

Steven Covey’s The 7 Habits of Highly Effective People¹ highlights the importance of renewal and relationship building, as does the Harvard Study of Adult Development, one of the longest-running research projects on well-being.^2-4 The key conclusion? Relationships are the strongest predictors of long, healthy, and fulfilling lives, not wealth or achievement. Medical training is intense, and the emphasis often falls squarely on achievement. But the friendships you form in medical school, residency, and early career are just as formative. Membership with the ADA continues this spirit of connection throughout one’s professional life, with meetings that welcome spouses and partners and encourage engagement across generations.

A hallmark of ADA culture is its commitment to mentoring and mutual support. Need advice about transitioning from private practice to academia? Navigating department leadership? Applying for a grant? Considering industry, editorial, or global health roles? Within the ADA, there’s someone who has done it and is eager to help. Recent meetings have addressed future-facing topics such as artificial intelligence, bedside diagnostics, workforce advocacy, and global health while also carving out time for rejuvenating activities: book clubs with best-selling authors, sessions on the arts, storytelling, wellness, and travel. This holistic programming reflects the ADA’s belief in supporting the whole physician.³ Members understand the value of relationships and appreciate these opportunities to learn about the passions and interests of their colleagues (Table).

Candidates are nominated by current members and must be board certified and at least 10 years beyond completion of their training. Members vote upon candidates in a rank voting system each year. If someone is nominated and not selected, they did not fail—they may be nominated again. The idea behind this membership process is to keep the organization small enough that members can get to know one another—there are currently 552 active members. Importantly, the ADA has embraced diversity and inclusion. While historically male- and White-dominated, recent inductee classes now reflect gender parity and a broader range of backgrounds, enriching the organization with fresh perspectives.^5-8

For residents and fellows, the lesson is clear: friendships, mentorship, and time for reflection are not luxuries—they are essential. Burnout stems from relentless output in isolation; however, in cultures that prioritize renewal, authenticity, and community, physicians can flourish.⁹ Membership in small professional organizations is an important step towards avoiding isolation. We encourage you to be active in your local, state, and national organizations.

The ADA stands as a powerful example of how professional societies can help you build the kind of life and career you want, not just a résumé. From informal beachside conversations to high-level scientific discussions, its enduring strength is this: leaders helping others lead.

The Diagnosis: “Pseudonits”

Dreadlocks are matted hairs formed into thick ropelike strands (Figure 1). As a chosen hairstyle dreadlocks are worn by individuals of many different ethnic groups but are most commonly associated with members of the Rastafarian movement, or Rastas. Various techniques are used to form dreadlocks including backcombing (also known as teasing) in which the hair is combed toward the scalp to facilitate tangles and knotting or the neglect method in which the hair is not combed, brushed, or cut, becoming tangled and twisted as it grows long. Manicuring and perming techniques may be used to create the starting point for dreadlocks.

Figure 1. Dreadlocks are matted hairs formed into thick ropelike strands.

Telogen hairs are the hairs shed as part of normal hair cycling. The average person is estimated to lose 50 telogen hairs per day.¹ With dreadlocks, the hairs are entangled distally, so when telogen hairs are released from scalp follicles, the shed hairs remain part of the locks. These “club” hairs have a bulbous white tip situated at the proximal end of the hair shaft (Figure 2) and should not be mistaken for the eggs of Pediculus humanus var capitis, hence the designation pseudonits.² Hair casts, keratinous material surrounding the hair shafts when there is infundibular or perifollicular hyperkeratosis, also may resemble nits.³ Hair cast pseudonits can be distinguished from true nits by one’s ability to slide the hair casts freely along the hair shaft, whereas lice ova are cemented to the hair shaft and fixed in place.

The Diagnosis: “Pseudonits”

Dreadlocks are matted hairs formed into thick ropelike strands (Figure 1). As a chosen hairstyle dreadlocks are worn by individuals of many different ethnic groups but are most commonly associated with members of the Rastafarian movement, or Rastas. Various techniques are used to form dreadlocks including backcombing (also known as teasing) in which the hair is combed toward the scalp to facilitate tangles and knotting or the neglect method in which the hair is not combed, brushed, or cut, becoming tangled and twisted as it grows long. Manicuring and perming techniques may be used to create the starting point for dreadlocks.

Figure 1. Dreadlocks are matted hairs formed into thick ropelike strands.

Telogen hairs are the hairs shed as part of normal hair cycling. The average person is estimated to lose 50 telogen hairs per day.¹ With dreadlocks, the hairs are entangled distally, so when telogen hairs are released from scalp follicles, the shed hairs remain part of the locks. These “club” hairs have a bulbous white tip situated at the proximal end of the hair shaft (Figure 2) and should not be mistaken for the eggs of Pediculus humanus var capitis, hence the designation pseudonits.² Hair casts, keratinous material surrounding the hair shafts when there is infundibular or perifollicular hyperkeratosis, also may resemble nits.³ Hair cast pseudonits can be distinguished from true nits by one’s ability to slide the hair casts freely along the hair shaft, whereas lice ova are cemented to the hair shaft and fixed in place.

The Diagnosis: “Pseudonits”

Dreadlocks are matted hairs formed into thick ropelike strands (Figure 1). As a chosen hairstyle dreadlocks are worn by individuals of many different ethnic groups but are most commonly associated with members of the Rastafarian movement, or Rastas. Various techniques are used to form dreadlocks including backcombing (also known as teasing) in which the hair is combed toward the scalp to facilitate tangles and knotting or the neglect method in which the hair is not combed, brushed, or cut, becoming tangled and twisted as it grows long. Manicuring and perming techniques may be used to create the starting point for dreadlocks.

Figure 1. Dreadlocks are matted hairs formed into thick ropelike strands.

Telogen hairs are the hairs shed as part of normal hair cycling. The average person is estimated to lose 50 telogen hairs per day.¹ With dreadlocks, the hairs are entangled distally, so when telogen hairs are released from scalp follicles, the shed hairs remain part of the locks. These “club” hairs have a bulbous white tip situated at the proximal end of the hair shaft (Figure 2) and should not be mistaken for the eggs of Pediculus humanus var capitis, hence the designation pseudonits.² Hair casts, keratinous material surrounding the hair shafts when there is infundibular or perifollicular hyperkeratosis, also may resemble nits.³ Hair cast pseudonits can be distinguished from true nits by one’s ability to slide the hair casts freely along the hair shaft, whereas lice ova are cemented to the hair shaft and fixed in place.