Yes, the 2014 dermatology residency match appears to have been the most competitive one yet. Many qualified applicants failed to match this year. Applicants are often interested about their chance to match in the next cycle. What have we learned from the dermatology residency match this year?
1. Dermatology residency programs are still looking for the best qualified academic students to fill their positions. This currently seems to be defined as having a Step 1 of at least 240 and being a member of AOA. Applicants with these high academic credentials get the most interview offers, increasing their chance to match. They almost always match if they do well at the interviews.
a) Applicants with advanced degrees and published research, especially those with Ph.D.s are favored at some top dermatology research programs, and with excellent past research productivity and future potential, will still be able to match despite lower Step 1 scores and without AOA membership. Extremely high research productivity may also help other applicants without a Ph.D. get a residency position, especially if the specific dermatology program needs to boost their research productivity as a result of insider or outsider criticism that their recent dermatology research (publications) is lacking.
b) Even though applicants with 240/AOA almost always match, they still may not match high on their rank list. That is because dermatology is still a highly competitive match, and there are relatively few positions available. These applicants need to remember that if they list a program on their rank list, they may match there! Think it through before you certify your match list. Would I be willing to live anywhere for three years in order to become a dermatologist? If the answer is “no” for any reason, don’t rank those programs, but realize that you are increasing the risk of not matching into a dermatology program. Every year dermatology applicants match at their last choice program and are not happy about it.
2. Applicants not elected to AOA may need much higher Step 1 scores to get enough interviews needed to match (about 7 last year). Think 260 and higher. Some dermatology residency programs understand that there is occasional subjectivity in AOA elections, and that sometimes excellent academic students are not included because of other selection criteria such as research, leadership roles, and community service.
3. Applicants with Step 1 less than 240 and not AOA: Yes, there is still a chance that you could match. Maybe you have demonstrated to your home program or an away program where you rotated what a superb dermatology resident you would be. However, still be prepared not to match. Other applicants to these programs may have 240/AOA and interview well. If you plan on reapplying, plan to spend an additional 1-2 years in a clinical dermatology fellowship gaining additional national exposure through multiple research presentations, posters and publications. This path is only for the most stalwart because even after doing this, there is no guarantee for a dermatology residency position, and your chances to resume another residency may be limited. Consider if there is an alternative career to dermatology that you would enjoy. There are other ROAD specialties, and other lifestyle shortage area specialties where you will have great geographic flexibility. There is also primary care and primary care specialties that have some overlap with dermatology, such as infectious diseases, rheumatology, and allergy.