Planning Ahead for 2010 Dermatology Applications

Matching into a dermatology residency program continues to be very difficult because there are so few positions available nationally and lots of applicants. What are the trends in dermatology applications, and what can be done to improve an application for next year?

Step 1: The average dermatology applicant score for those who match into a dermatology residency is above 240. Some residency programs use the Step 1 score as a cutoff to decrease the overwhelming number of applications to review.

Step 2: Currently, most dermatology programs do not expect to have Step 2 scores, but some do. Step 2 scores are usually higher than Step 1. Applicants should consider taking Step 2 in June, at the end of their core MS3 rotations in order to be considered at every program.

AOA: Half of dermatology matches are AOA members. It is a big advantage to be in AOA for dermatology applicants, because some programs use AOA membership as a screen for applicants.

School: Yes, it matters. Some schools never interview applicants from XYZ. Some programs have regional or state preferences. Students from medical schools without dermatology residency programs seem to be a a disadvantage in this process.

Multiple applicants from the same school: Yes, programs will compare students from the same school during the application process. Higher Step 1 scores and AOA membership are advantages, as are a PhD. An outstanding away rotation may also result in an invitation to interview.

Advanced degrees: A PhD will help at a handful of programs that do bench research, but there are not many of these (although they tend to be the larger programs). Other graduate higher education (MS, MA, MBA, MPH, JD, etc may also interest some programs especially if there are academic publications).

Away rotations: Statistics seem to indicate this can help some applicants. However, at many programs, an interview is not automatic. Some away rotations require an application far in advance of the elective date, so planning is required. Applicants who are not AOA or have below average Step 1 scores for dermatology applicants have the opportunity to make a positive impression during aways, especially at smaller programs with fewer visiting students.

Research: Almost every applicant has dermatology research now. High quality research takes time (IRB, data collection, data analysis, manuscript preparation, etc), and usually cannot be completed in the first half of the MS4 academic year (June to November 1), when most applications are due. The earlier substantive research is started, the better is the chance it will be completed by the application deadline. UTMB sponsors the Dermatology Honors Research Program, in which the participating medical student acts as the PI on an original investigation. It can be started as early as the MS1 year and may be completed before the ERAS application is due. Number of publications count, because it is rare for MS4 applicants to have more than 5 peer-reviewed publications (but those in their 2nd year of post-internship dermatology fellowship frequently do).

Awards: Always adds to an application. UTMB students sponsors many campus activities that may lead to student award, such as the MSSRP (Medical Student Summer Research Program between the first and second year of medical school) and the annual Forum on Aging. In addition, UTMB sponsors The National Student Research Forum each year, that awards for medical students and residents for dermatology in the categories of poster and presentation. Getting a dermatology award as an MS3 or earlier will get on your ERAS application. Included in this is the American Academy of Dermatology Diversity Medical Student Mentorship Awardees (about a quarter of them have been successful in obtaining dermatology residencies, including some UTMB students).

Letters: The sooner dermatology faculty at your school know about your dermatology career interest and become involved in your academic program, the better. Programs will look for letters from the dermatology chair at your school and your research project faculty. Your research mentor's letter is very important because this faculty has great insight into student academic potential and productivity, areas of interest to many dermatology residency programs.

Essay: Not too short or longer than one page. Try to make it interesting. Avoid spelling or grammatical errors. If you have any ties to the geographical location of the program, this is a chance to make it known.

Delayed graduation to do research: This can improve application quality if the additional research year has been productive with national presentations, publications and a strong faculty letter of recommendation.

Previous residency: Limits residency positions available for a dermatology match, but can be very desirable to programs if special clinical skills are involved (dermatopathology, plastic surgery, ent, internal medicine, pediatrics, rheumatology, allergy, infectious diseases, psychiatry) and a strong academic publication record was established during the prior residency. It also helps if there if a dermatology job is waiting for you at your previous residency institution or if a sponsoring institution is willing to provide funding.

Switching residencies: Often viewed skeptically by programs, because they may be next. Essay should have a very good reason for not completing the residency that was started, and letters from former chair and program director should support new professional goal.

Internship (PGY1): For those not matching into dermatology while a MS4, the quality of the PGY1 year will be considered by many programs. A strong preliminary internal medicine internship at a University Hospital with strong support letters from the Chair and Program Director should help generate interest.

Clinical Dermatology Fellowships: The best ones for applicants have a strong track record of taking their former fellows for dermatology residency positions after one or more years of fellowship work with them or those that have a strong historical record of fellow placements into dermatology residency programs. These fellowships usually involve clinical trails. During the fellowship, pre-dermatology fellows need to be presenting and publishing lots of research. Sometimes it is necessary to do several fellowships at different institutions before finally matching into dermatology.

ERAS: Saves lots of time but difficult to update programs about additional accomplishments after the ERAS application is submitted. Since many programs have a November 1 deadline and many try to offer interviews by late November or early December, non-ERAS supplemental information sent by applicants after the program deadline may have little impact on the decision process. However, once invited for an interview, supplementation of your application is generally considered.

Interview: Be yourself. Your application is under serious consideration. Don't get flustered. Don't be late. This is the one chance to make a great first impression. Read about the program and faculty research ahead of the interview. Try to have fun learning about a new program and a new city. Make the pre-interview dinner if there is one, because face time counts in this process.

Good luck with the application process!