The man speaks the truth, especially for folks who specialize in derm, radiology, or some of the other "lifestyle" residencies. Sure, you chose derm because you are "fascinated by the skin." Give me a break....I defy any current doctor to deny that mixed in amongst the more altruistic reasons, there were a lot of more superficial/shallow reasons too.
Having worked in an interventional radiology practice for 10 years at a major clinical research hospital, some of those guys really do go into it because they are fascinated by the potential of the technology for changing human lives.