What Should I do if I don’t Match into Dermatology Next Week?

On Monday, March 12th MS4s and independent applicants will find out if they matched into a dermatology residency program (successfully matched applicants will have to wait until Friday, March 16th to find out where they are going). Predictably, every year competitive applicants who had multiple dermatology interviews fail to match. While this is a big disappointment, in the following weeks many applicants wonder if they should re-apply. They may wonder if it is worth the effort taking a one or two year dermatology research fellowship following their PGY1 year in the hope of improving their dermatology application and achieving their goal of obtaining a residency position. Here are some considerations regarding re-application:

-Currently, medical students are not able to retake Step 1 once it is passed. The Step 1 score is a major factor in determining how many interviews an applicant will receive. If an applicant has previously failed Step 1 or if the score is lower than 211, it is rare to be offered interviews because so many other applicants have much higher scores. Not impossible, but it certainly will be a struggle.

-Not being a member of AOA hurts an applicant’s chances for interviews. This is also an application variable that cannot be changed in the short term. Not being in AOA and having a Step 1 score lower than 221 will make interviews hard to come by.

-Having an impressive away rotation may open a door for a residency position with an away program. Students still in medical school should consider additional away dermatology rotations prior to graduation if their schedule permits. Once graduated, the opportunity to take rotations at outside institutions is typically difficult and may not be possible.

-Serious applicants who are not AOA and do not have a Step 1 score of at least 230 need to have significant research on their ERAS application. This could include quantity (at least 5 published case reports), quality (authorship on high quality research papers published in highly regarded dermatology journals), or sophisticated research skills usually acquired during a PhD program. Effort should be made to complete any previous research projects with the goal of getting them published before the next application cycle. There is no doubt that most dermatology research fellowships offer re-applicants an opportunity to engage in serious, productive research with leading dermatology investigators. This activity can results in numerous high quality research publications by a motivated fellow. That is why the match rate for dermatology research fellows is impressively high, even without a high Step 1 score and AOA membership.

-Many primary care fields and some specialties (rheumatology, allergy) have lots of patients with skin diseases. Consider if it is possible to satisfy your interest in dermatology through specializing in family medicine, pediatrics, or internal medicine (or one of its specialties)? Such residencies and clinical fellowships may offer the opportunity to do clinical electives with a dermatologist.

Of course, these observations and suggestions don’t apply to everyone. There are exceptions to everything. Some re-applicants don’t change anything on their next ERAS application and match in the next cycle! Only you can decide whether to re-apply or not, and whether to gain additional research experience first. If you decide to re-apply, good luck! Every year some re-applicants get the dermatology residency position they want.