How Many Dermatology Residency Programs Should I Apply To?

Opinions vary. Some suggest applying to them all; this is certainly the most expensive strategy. Of interest is the AAMC’s analysis. They suggest that fewer applications may be the best strategy. For additional information, please review https://www.aamc.org/cim/481320/applysmartderm.html

Committed to a Dermatology Career?

Dermatology has certainly changed since its earliest days. Prior to the advent of penicillin, many dermatology patients were treated for syphilis, a highly stigmatizing and chronic disease. Entry into dermatology practice was relatively easy since careers in our specialty were not very competitive or prestigious. After the advent of penicillin (and the cure of many patients with syphilis) dermatology practice became more procedural, first with minor office surgery, and later with the adoption of Mohs surgery, lasers, dermabrasion, sclerotherapy, chemical peels, hair transplantation, fillers, neurotoxins, and new emerging cosmetic technologies. Dermatology has now become one of the most competitive residencies for applicants. It is very attractive profession because it is one of the ROAD (“road to happiness”: radiology, ophthalmology, anesthesia, and dermatology) specialties, with manageable lifestyle and excellent compensation for hours worked. With these 4 specialty choices, there is a chance to have a second life outside of medical practice with a good income!

Career planning is prudent when considering very competitive specialties. The reality is that there are not enough residency positions for all the highly qualified applicants. Why are the majority of dermatology applicants highly qualified? Self-selection is at work, because potential applicants without many academic honors, awards, dermatology research, and high scores don’t apply. Applicants with a PhD, extensive research, taking an additional year of substantive, productive (publications!) research before graduating from medical school, high Step 1 scores, AOA membership, and graduation from a top medical school are favored in this selection. This process results in a pool of applicants with above average credentials. However, this has created another problem--there is no longer any guarantee for dermatology matching, even with a Step 1 score of 250 or higher and AOA membership. Everyone is not able to get the competitive job they want, and if they do, it may be in an undesirable location.

The dermatology match through ERAS and the NRMP is a highly stressful time for many applicants. Stress begins immediately for many applicants, who after receiving a high Step 1 score, make the decision to become a dermatologist. Many have no prior dermatology research and now have one year or less to gain enough research experience to remain competitive before submitting residency applications. Is there enough time to become competitive while taking required MS3 clerkships and doing well on these rotations? Stress continues to build when excellent applicants find themselves not getting enough interviews (or fewer interviews than classmates). Interviews are highly correlated with matching: the more interviews, the greater the chance for a match. Going to interviews is stressful, and may be costly as well. Air travel and hotel is often involved, and once at the interview, the quality of the other applicants is daunting. Everyone is so well qualified and competing for just a few available positions. This is why long-range planning is prudent for anyone considering a dermatology career. Applicants need to know what could happen if they do not match on the first attempt.

Sadly, every year excellent dermatology applicants fail to match. Of all 4 ROAD specialties, dermatology has the fewest residency positions. What is the next step? Some have already planned for this outcome and have matched into back up specialty; they never looking back at dermatology and are happy with their alternative career choice. Others cannot give up the dream of a dermatology career. They consider completing residencies in primary care specialties and plan to reapply for dermatology; this can work, but due to restrictions in Medicare funding for second residencies, only a few programs are able to consider this type of applicant. Some initially match into alternative residencies with longer Medicare funding periods, like the 5 year general surgery residency with the plan to leave the program after one or two years in order to protect 3 years of dermatology residency funding. Some take a 4 year pathology residency with a transitional or preliminary medicine PGY1 year and then take a dermatopathology fellowship, with the plan to identify a dermatology residency that needs a dermatopathologist for ACGME program accreditation and is willing to forgo full Medicare funding. Currently the most efficient strategy for dermatology re-applicants appears to be completing the PGY1 year, obtaining a medical license, and going into a non-accredited dermatology clinical trial research fellowship with the hope of improving research credentials and professional connections during this additional training. It is thought that more than 50% of these paid clinical dermatology fellows eventually match into dermatology residencies, although it may take several years to do so. These dermatology re-applicants may need to move across the country for dermatology training in an unfamiliar city without friends and family. There is some risk to this strategy, because those that fail to match into dermatology after this extra research training may find it hard to find residency positions in other specialties, since it now has been several years since medical school graduation and nondermatology clinical skills and general medical knowledge have faded. Some in this situation will forgo additional postgraduate training and open dermatology practices anyway, relying on dermatology knowledge obtained during medical school, the clinical trial research fellowship, and ongoing CME obtained at dermatology conferences. This career course may not be optimal because due to a lack of ACGME dermatology residency, there is no possibility for board certification in dermatology and some insurance plans may not accept physicians who have not completed a dermatology residency and become board certified.

DIG needs volunteers for Plazapalooza

DIG is looking for members to volunteer at our Plazapalooza booth Tuesday, August 22nd 5:30-8:30. It will be outside of Old Red. There will be food and drinks at the event. Please email Kedwagne@utmb.edu

Volunteers needed for Saturday

UTMB DIG is requesting volunteers for the DIG booth this Saturday. There will be a breakfast served before the fair and lunch will be after. We are also looking for someone to design our poster for the table.  Details below. Email Kedwagne@utmb.edu if you would like to help us this weekend!

Location and Time:

Welcome Weekend will take place at the Moody Gardens Convention Center at 7 Hope Boulevard, Galveston, TX 77554. The Community Fair will occur from 10:00 AM – 12:30 PM in Expo Hall C in the Convention Center. Student Organizations and Community Vendors will be allowed to set up for the fair starting from 9:00 AM – 9:45 AM. All student organization must be at their tables and ready to go at 9:45 AM. Volunteers will be unable to enter the Expo Hall after 9:45 AM, as we will be preparing to transition the first group of students into the fair.

Lots of Medical Students at UTMB

928 allopathic medical students as of last fall, making UTMB the 9^th largest medical school in the US.

UTMB Dermatology Publishes Original Research in August 2017 JAAD

UTMB dermatology research about nephrogenic systemic fibrosis (Wilson J, Gleghorn K, Seigel Q, Kelly B. Nephrogenic systemic fibrosis: A 15-year retrospective study at a single tertiary care center. J Am Acad Dermatol 2017; 77:235-240) was published in the August 2017 issue of JAAD. The first author, Dr. Janice Wilson, recently completed a dermatopathology fellowship at UTMB and will join the dermatology faculty next month. She will be the 9th UTMB faculty member.

Texas Dermatological Society Requesting Posters for Fall 2017 Meeting in Bastrop, Texas

The application deadline for the Texas Dermatological Society (TDS) fall meeting applications for poster presentations is September 1, 2017, with complete abstracts due by September 8th. Only residents are eligible to win awards, but medical students may submit their work. Materials presented must not have been published, but may be already accepted for publication. Winning abstracts are published in The Texas Dermatologist. The meeting is on September 29th and 30th. Please email any questions to sylvia.hall@texmed.org

Living with Melanoma Symposium at MD Anderson Cancer Center, 8/26

Hey DIG members, Register now for the free 2017 Living with Melanoma Symposium at MD Anderson Cancer Center on August 26! Hear stories from survivors of melanoma, as well as lectures by melanoma experts on topics related to melanoma. Click the link below for more information and to register. 

http://mailchi.mp/aimatmelanoma/free-living-with-melanoma-symposium-at-md-anderson-cancer-center-8mlncjat12?e=45f093aa48

St. Vincent Dermatology Night 8/3

Join UTMB Dermatology residents and faculty for the upcoming dermatology night (Thursday, August 3rd) at St. Vincent’s Clinic. Please see the calendar link below to reserve your volunteering spot:

When: Thursday, August 3rd, 5:30-8:30PM (volunteers should arrive at 5:15)

Where: St. Vincent's House, 2817 Post Office Street, Galveston, Texas 77550

Volunteer link: http://ift.tt/25Hmbgd