Grade Inflation During Third Year of Medical School

Harvard researchers have published a 2009 survey of MS3 internal medicine clerkship directors that documented grade inflation during this third year rotation. 55% of respondents felt that there was grade inflation during this required clerkship at their schools. Shockingly, 38% thought that students who should have failed their clerkship still passed! The reference to this article is: Fazio SB, Papp KK, Torre DM, Defer TM. Grade inflation in the internal medicine clerkship: a national survey. Teach Learn Med 2013;25(1):71-77.

UTMB Dermatology Residents Give Residency Program High Marks

The results for UTMB’s annual ACGME Resident Survey conducted earlier this year are back.100% of UTMB’s dermatology residents’ overall evaluation of their program was “very positive.” This was the highest rating possible.

Texas Dermatological Society President offers Practice Advice to Dermatology Residents

UTMB Associate Professor of Dermatology and Texas Dermatological Society (TDS) President Dr. Michael Wilkerson offers some sage advice for dermatology residents entering independent practice in the Winter 2013 TDS Newsletter. The entire editorial is available at: http://texasdermatology.org/wp-content/uploads/2013/03/Winter2013.pdf

Dr. Mara Dacso Set to Perform at St. Vincent's Benefit Concert

Dr. Mara Dacso is performing at the The Grand 1894 Opera House (2020 Post Office Street) on Wednesday, March 6th at 7 pm for the annual St. Vincent’s Clinic Benefit Concert. St. Vincent’s Clinic is a free clinic made possible in part through the voluntary support of UTMB students, residents and faculty. Tickets are $7 (cash) and $7.50 (credit card) in advance, $10 at the door. Dr. Dacso is currently a PGY4 Dermatology resident at UTMB . This is her 8th consecutive year performing at this fundraising event. Please come and enjoy a night out for a very worthy cause. For tickets, please visit www.wepay.com/events/stvbenefitconcert2013. For more information about St. Vincent's, please visit http://acs.etxahec.org/LinkClick.aspx?link=09-Shoemake+Student+Brochure.pdf&tabid=76&mid=423.

Raimers Receive 2013 Community Enrichment Award

Congratulations to Dr. Sharon Raimer (UTMB Dermatology Chair) and her husband, Dr. Ben Raimer for being awarded the 22nd annual Leonora Kempner Thompson Community Enrichment Award. As reported in the Sunday, March 3, 2013 issue of the Galveston Daily News (page C8), the award will be presented o March 16, 2013 at the 1894 Grand Opera House in Galveston, Texas.

UTMB Dermatology Research Honors Project Approved

Congratulations to UTMB Dermatology Interest Group (DIG) President Sheila Jalalat MS3 for gaining UTMB Research Honors Committee approval for her original Dermatology UTMB Research Honors Project, “Dermatology Interest Group Blog: The Impact of Medical School Interest Groups and Web 2.0 Tools as a Resource for Students and Residents.” Ms. Jalalat became interested in learning more about the educational impact of our UTMB DIG blog after completing an in press review article for Clinics in Dermatology (“Medical Student Dermatology Interest Groups,”) with UTMB co-authors Drs. Lindsey Hunter-Ellul and Richard Wagner on this topic. She designed an internet survey to collect information about our DIG blog use, and worked with a UTMB dermatology faculty, resident, and members of the UTMB Honors Research Committee over several months to improve her research design. Due to recently increased UTMB Research Honors Committee standards for medical student participation in this academically prestigious activity, Ms. Jalalat’s is the first dermatology proposal that the UTMB Research Honors Committee has approved for dermatology research in three years! Ms. Jalalat’s ad hoc Dermatology Research Honors Committee for this research are Drs. Richard Wagner (faculty advisor), Sharon Raimer and Brent Kelly. Ms. Jalalat is also scheduled to present her preliminary findings about UTMB’s DIG blog (“Dermatology interest group blog: A valuable tool for students, residents and faculty) on March 4, 2013 at the Dermatology Teachers Exchange Group (DTEG) meeting in Miami, Florida. Her UTMB co-authors on this presentation are UTMB dermatology UTMB PGY2 dermatology resident Dr. Lindsey Hunter-Ellul and faculty Dr. Richard Wagner. Many thanks for UTMB’s Office of Student Life/UTMB Student Government for funding Ms. Jalalat’s travel to this meeting to present her original research to this national group of academic dermatology educators.

"Stay Shady!" Looking for Volunteers

The UTMB DIG is looking for volunteers to present our sun protection presentation, "Stay Shady!," to the students at Central Middle School in Galveston, TX. 

When: Tuesday, March 5, at 10:30am to 12:30pm

Where: Central Middle School, 73014 Sealy Ave, Galveston, TX 77550

 

This is fun teaching experience and a great way to get involved with DIG (especially for first and second year students)! Interested in participating? Please email Alex Acosta at kaacosta@utmb.edu

Waiting for the NRMP Results

NRMP certified match lists were due on 2/20/13 from applicants and programs. Although theoretically a computer "knows" were applicants will be spending the next few years in residency, the official results will not be disclosed to applicants by the NRMP until March 15, 2013 ("match day'). Good luck to all of the applicants and programs participating in the 2013 NRMP. We hope everyone gets their first choice(s) this year!

UTMB $90 Million Victory Lake Expansion Reported in Galveston Daily News

Galveston Daily News reporter Laura Elder, in her "Biz Buzz" biweekly column, reported on 2/21/13 (pages B1 and B3) that UTMB will hold a groundbreaking ceremony at 4 pm, on Tuesday, February 26th. There will be 39 new patient beds allowing for 72 hour stays and 17 emergency/urgent care treatment rooms. UTMB will also build a central plant that will provide electricity, hot and cold water for 72 hours in the event of an emergency. UTMB's new clinical facilities are scheduled for completion in February 2015, while the central plant should be completed by August 2014. 

UTMB Dermatology Resident and Faculty Co-author New Amyloid Study about Cancer

Congratulations to UTMB PGY2 dermatology resident Dr. Audra Clos and her UTMB dermatology faculty, Drs. Brent Kelly and Richard Wagner, for their recent publication about the role of amyloid in cancer. The full citation is: Lasagna-Reeves CA, Clos AL, Castillo-Carranza D, Sengupta U, Guerro-Munoz M, Kelly B, Wagner R, Kayed R. Dual role of p53 amyloid formation in cancer; loss of function and gain of toxicity. Biochem Biophys Res Commun. 2013 Jan 18;430(3):963-8. doi: 10.1016/j.bbrc.2012.11.130. Epub 2012 Dec 19.

Good Luck on 2013 In-Service Dermatology Examination!

Most dermatology residents will take the “practice boards” sponsored by the American Academy of Dermatology on Thursday, February 21, 2013. Many hours of preparation have gone toward preparing for this competitive examination that provides current residents with standardized information about how well they score in reference to their PGY level.

"Stay Shady!" Goes to Early Childhood University

On Tuesday, February 12, UTMB DIG member Dung Mac (MS1) taught approximately 40 second graders about the importance of sun safety at Galveston's Early Childhood University.  This fun, interactive presentation is aimed at making kids aware that the sun can damage their skin and inform them how to protect themselves. Thank you to the students of ECU for being such a great audience, and thanks to our volunteer!

Annual UTMB Dermatopathology Review Scheduled for Saturday, May 4, 2013

UTMB’s highly rated dermatopathology review course will be held on Saturday, May 4, 2013 in Galveston, Texas. It is free to all residents. 

Additional information for this course is on Facebook: https://www.facebook.com/UtmbDermatopathologyBoardReviewCourse

Plan on spending the day in Galveston and learning more about dermatopathology!

Camp Discovery Volunteer Opportunity

Applications to volunteer one week this summer at Camp Discovery are now available (deadline April 8, 2013)

Camp Discovery is a program supported by the American Academy of Dermatology. It is a one week summer camp experience, where young people ages 8-16 with a chronic skin condition come together to participate in fun camp activities. It also offers volunteers to learn more about the effects of dermatological conditions as you interact and work with these patients. For more information, please email Janine Meuller, jmueller@aad.org

http://www.aad.org/forms/CampDiscoveryVolunteerApplication/Default.aspx

Woman Dermatologists

According to Richard Nelson’s article in Dermatology World (February 2013, page 52), a publication of the American Academy of Dermatology, women are emerging as the majority of US dermatologists. He predicts that women will be the majority of dermatologists within 10 years.

UTMB DIG in Austin: Stay Shady!

The UTMB DIG in Austin will be having their first "Stay Shady!" presentation for the children of St. Ignatius Martyr Catholic School

UTMB DIG in Austin is looking for volunteers to help present our sun protection presentation

When: Wednesday, February 20th at 8am

Where: St. Ignatius Martyr Catholic School: 120 West Oltorf Street | Austin, TX 78704

Interested in participating? Please email Sarah Pritchard at sepritch@utmb.edu

Two Physicians Assert Importance of Patient Service During Residency

Drs. Kesselheim and Cassel recently published their perspective about the important role of patient service in medical education (“Service: An Essential Component of Graduate Medical Education.” New England Journal of Medicine, 2013;368:500-501). The authors observe that the role of “…service is being harmfully undermined within the medical profession and within graduate medical education (GME) in particular.” They cited an ACGME resident annual survey from 2007-2008 that identified “…excessive service obligations” as the most frequent indicator of program noncompliance. “Scut work” (transporting patient, phlebotomy, telephone delays while scheduling diagnostic tests) is distinguished from educational service functions that permit residents to employ their professional knowledge to clinical patient care and its documentation. They suggest that the later types of service to patients should be considered for inclusion in the ongoing ACGME “Milestone Project”, a new educational tool to assess resident progression through residency with the final goal of professional autonomy.

Hektoen Essay Contest Deadline Approaching

Send your original 1000 to 2500 word essay about medicine and culture to contest@hektoeninternational.org by March 1, 2013 for consideration in the current Hektoen Grand Prix Essay Competition. Their announcement requests essay topics related to medicine and "...art or literature, history of medicine, ethics, music, philosophy, anthropology, linguistics, etc..." They will award $1000 for first prize and $800 for second place. Winners will be announced on May 1, 2013. Both winning essays will be published, and other submitted essays will be considered for publication as well. Their publication, Hektoen International is available online.

Austin to Get New Medical School

A $50 million gift from the Dell Foundation will establish a new medical school in Austin, Texas. It is projected that its first class of 50 students will enroll in 2016. Additional details from last week’s Houston Chronicle report are available at: http://www.chron.com/news/houston-texas/houston/article/Gift-from-Dell-Foundation-will-help-launch-4240073.php

Stay Shady is looking for volunteers!

The UTMB DIG is looking for volunteers to present our sun protection presentation, "Stay Shady!," to the students at Early Childhood University in Galveston, TX. 

When: Tuesday, February 12, at 1pm

Where: Early Childhood University, 7100 Stewart Rd, Galveston, TX 77551

 

This is fun teaching experience and a great way to get involved with DIG (especially for first and second year students)! Interested in participating? Please email Alex Acosta at kaacosta@utmb.edu

Houston Chronicle Article Highlights MD Anderson Financial Woes

According to a front page article by reporters Todd Ackerman and Eric Berger on February 3, 2013 (New blow to cancer center is at budget: MD Anderson costs have risen faster than revenue, pages A1, A21) in the Sunday, February 3, 2013 edition of the Houston Chronicle, MD Anderson, Texas' premier cancer hospital, is facing financial issues related to decreased patient visits (13% since 2011), a situation that may become worse in the quickly evolving healthcare environment of lower governmental support and cost cutting initiatives by private insurance companies. In addition, the article highlights poor faculty morale (30% plan on leaving the institution within 3 years), and internal criticism about the $710 million cost of 6000 administrative employees.

Ackerman Academy Accepts UTMB Dermatology Resident for Dermatopathology Fellowship

Congratulations to Dr. Mara Dacso, a current PGY4 UTMB Chief Dermatology Resident and former editor of the DIG Blog on her recent selection for a dermatopathology residency at the world famous Ackerman Academy in New York.

Is a Dermatology Career Still a Good Choice?

Dr. Noah Scheinfeld, an Assistant Clinical Professor of Dermatology at Columbia University, has published a sophisticated, thought provoking article about the future of dermatology practice in the United States in his Legal Ease feature of the January 2013 issue of The Dermatologist (“Quo Vadis, Dermatology”?, pp. 20-21). In the future, private dermatology practice may not continue to be a viable option for many. This excellent article is currently available online at http://www.the-dermatologist.com/content/quo-vadis-dermatology

What PGY1 Does the American Board of Dermatology Approve?

The American Board of Dermatology (ABD) approves PGY1 years in Transitional, Internal Medicine, Emergency Medicine, Family Medicine, General Surgery, Obstetrics & Gynecology, or Pediatrics for residents prior to Dermatology Residency. Those taking PGY1 in other disciplines must have permission from the ABD before starting dermatology residency.

Yale Dermatology Professor Predicts Major Changes in Medical Practice

Dr. David Leffell, in a Wall Street Journal Opinion column on Wednesday, January 30, 2013 (“The Doctor’s Office As Union Shop,”, page A11), highlights the potential acceleration of our national trend for physicians to become employees rather than employers due to implementation of the Affordable Care Act in 2014. This transition could result in doctors forming unions with the right to collective bargaining and creates the possibility of future physician strikes, as has been historically seen with other types of unions.

American Academy of Dermatology Diversity Mentorship Program Applications are now open

The American Academy of Dermatology is now accepting applications for its diversity mentorship program. Any medical student from an underrepresented background is able to apply. In this program, a student selects a volunteer mentor to complete a one month, 160 hour mentorship between June 1st and Dec 1st 2013. For their work, the student will receive a grant of $1500. To apply, please submit an application at https://www.aad.org/apps/mentorship/student/default.aspx along with a Résumé or curriculum vitae and two professional letters of recommendation. If you have any questions, please contact Nikki Haton at nhaton@aad.org or visit the website below http://www.aad.org/diversitymentorship.

UTMB MS1 Dermatology Preclinical Preceptorship Registration Completed

Four UTMB MS1s registered for the available dermatology preclinical preceptorships during Periods 11 and 12. Some students inquired about research opportunities in the dermatology department as well. Six MS1s requested subscriptions to the UTMB DIG Blog, so they will be receive new blog posts. MS3 Will Tausend, UTMB DIG Vice President (and former dermatology MS1 preclinical preceptorship student), assisted UTMB Dermatology Program Director, Dr. Richard Wagner, during student registration in Levin Hall. 

American Board of 2013 Dermatology Certification Examination

The American Board of Dermatology will hold its dermatology certification exams from July 15-18 and July 22-25 this year in Tampa, Florida. The completed electronic application and $2500 fee must be received by March 1.

UTMB Dermatology Offers 4 Preclinical Preceptorships to UTMB MS1s

This spring, the UTMB Department of Dermatology will once again offer clinical preceptorship to UTMB first year medical students. Two positions are available from 5/6/13 to 5/31/13 (Period 11), and another two positions are available from 6/3/13 to 6/28/13 (Period 12). Registration for these positions will be on a “first come, first serve” basis in Levin Hall on Thursday, January 17 starting at 5 pm. The first 4 students who want these dermatology preceptorships will be required to complete an application that will be available at the time of the meeting (PID number needed). A small alternative list will also be compiled. Students taking this preceptorship will rotate at UTMB dermatology clinics in Galveston and in League City. Feedback from DIG members who have taken this preceptorship have been very positive. It is a great way to meet UTMB dermatology residents and faculty, and learn more about clinical dermatology.

Inside versus Outside Dermatology Residency Matches

Applicants often analyze dermatology residency programs based on the current number of residents who graduated from its sponsoring institution. If programs seem to fill most of their available match positions with graduates from their own school, these programs may discourage outside applicants from doing away rotations, applying and interviewing. Why do inside applicants have a higher match rate at their own schools, and at schools where they have done away rotations? Parallels may be found in the business community, where data suggests that inside hires are initially more successful at adapting to the job demands of their own institutional culture, resulting in better job performance. Dermatology departments are more familiar with the relative strengths and weakness of their own students, since there has usually been an extended opportunity to see them work in a variety of departmental settings. Why wouldn’t the home program want to retain their own excellent students who are already known to be a good fit for the program? Currently at UTMB, 40% of the dermatology residents graduated from the UTMB SOM. In July 2013, the percentage of UTMB graduates in the program will shrink to 27%.

Texas Medical School Graduates Exceed Available PGY1 Positions in Texas

According to a report from the Texas Medical Association (TMA) in the January 2013 issue of It’s Academic (Volume 12, Number 1), Texas medical schools recently graduated 50 more medical students than there were available residency programs in our state. The TMA plans on requesting additional funding from the Texas State Legislature to increase the number of residency positions to accommodate future Texas medical school graduates.

How Does Dermatology Research Collaboration Strengthen Dermatology Residency Applications?

Medical students interested in dermatology careers may have an opportunity to work with dermatology residents and faculty on research projects, especially if they attend institutions with dermatology departments or divisions. How does involvement in such research improve an applicant’s chance for a dermatology match? If a presentation or a publication results from the work, it increases the student’s professional exposure in a positive way. More importantly, however are the professional ties developed to others in the specialty as a result of the collaboration. Your supervisors recognize the ability of medical student collaborators who are professional, are able to meet research deadlines, and are able produce high quality work. Your collaborators will enthusiastically share their experiences working with excellent medical students to others in the field through strong letters of recommendation that could result in additional residency interviews and the opportunity to match at other dermatology programs. Of course, if all student collaborative and clinical interactions are stellar, they might want to retain you as a future dermatology resident in their own program! Maybe that explains why in many cases, applicants have the best chance of matching at their home program.

Indoor Tanning Industry Pushes Back

According to an article published in the January 7-January 13, 2013 issue of Bloomberg Businessweek (page 29) by John Tozzi, the indoor tanning industry is planning to lobby against business regulation that could adversely impact their industry this year. Tozzi wrote that 28 million Americans currently tan in salons annually, generating approximately $5 billion each year. He reports that there are about 19,000 tanning facilities currently in the US.

Texas Dermatologic Society Editorial

UTMB Associate Professor of Dermatology and President of the Texas Dermatological Society (TDS), Dr. Michael Wilkerson, published an editorial in the Summer 2012 issue of The Texas Dermatologist. In his analysis of evolving dermatology clinical practice, he noted that, “We will soon have as many midlevel providers as board certified Dermatologists, if current trends continue.” Since most midlevel providers do not have an opportunity for a one year fellowship in dermatology prior to clinical practice, Dr. Wilkerson emphasized the need for continuing dermatology education for midlevel providers. Fortunately, TDS and American Academy of Dermatology meetings are open to midlevel providers if they are employed by a dermatologist.

Dr. Ashley Group Publishes Article About Cosmetic Dermatology

Congratulations to Dr. Ashley Group, the newest dermatology faculty member at UTMB. Dr. Group graduated from medical school at UTMB and also completed dermatology residency last year at UTMB. Her article, “Cosmetic Dermatology Training in Residency: Results of a Survey from the Residents’ Perspective,” was published in the December 2012 issue of Dermatologic Surgery (38:1975-1980). Her research was performed as part of the required dermatology program requirement for dermatology residents at UTMB. Her co-authors on this research were Drs. Rebecca Philips and Erica Kelly. Dr. Philips will begin her PGY2 year of dermatology residency at UTMB in July 2013, and Dr. E. Kelly is  dermatology faculty at UTMB.

UTMB DIG Members Polled About UTMB Dermatology Department Interviews

UTMB currently has medical students located in Austin and other Texas cities during their third year required clinical rotations. Some of these students do not return to Galveston for their MS4 year. Recently, some UTMB MS4 applicants and dermatology faculty reconsidered UTMB's current practice of interviewing all UTMB MS4 applicants at their convenience during December and January. Since it is recommended that applicants meet with all of UTMB's dermatology residents and faculty, more than one trip may be required of UTMB medical students, and this aspect is more inconvenient for applicants who do not reside in Galveston because of the additional travel involved. An alternative way to interview UTMB MS4 students applying for dermatology residency at UTMB is to schedule all applicants to interview on the same day. However, the later method could result in some students having interview conflicts with outside programs and missing the opportunity to interview at an additional program.

 

UTMB DIG officers recently surveyed MS4 DIG members about their opinions on this. The vast majority of UTMB MS4 students applying for dermatology residency prefer the current process because it provides more flexibility for scheduling outside interviews. UTMB MS4 students residing outside of Galveston should be aware the UTMB's dermatology program coordinator will be happy to assist with an interview schedule on a day when most of the UTMB dermatology residents and faculty are in Galveston.

National DIGA Officer Opportunity

The national Dermatology Interest Group Association (DIGA) is now accepting 2013-2014 officer applications.  

To apply, simply download, complete, and email your DIGA officer application, which can be found at: http://www.derminterest.org/Blog/tabid/121/EntryId/20/DIGA-Officer-Applications-are-NOW-OPEN.aspx

The deadline for applying is January 25th, 2013. 

Lindsey Hunter, current UTMB Dermatology PGY-2, and Rebecca Phillips, PGY-2 starting 2013 have represented as DIGA committee chairs.  

Positions available include:

Vice President,
Webmaster,
Treasurer,
Secretary,
Community Service Director,
Professional Societies Liaison,
Residency Interviews Database Director,
Southern Regional Director,
Northeastern Regional Director,
Midwestern Regional Director,
Western Regional Director,
Public Relations/Fundraising Chair,
Curriculum Development Chair,
Sun Protection Chair,
Melanoma Fundraising Chair,
Allied Health Outreach Chair,
Psoriasis Awareness Chair.

Contact Sheila Jalalat at szjalala@utmb.edu with any questions. 

What Should I Do About Conflicting Dermatology Residency Interviews? A Primer on Match Math

Competitive dermatology applicants often find themselves invited for two or more interviews on the same day. Sadly, some of these applicants don't cancel the interview(s) that they are unable to attend until the day before. Late cancellation makes it difficult for "wait list" applicants to interview due to travel logistics and high cost. Late cancellation may ironically result in matching at a less desired program on their match list!  Remember that in the small universe of applicants receiving conflicting invitations to interview, applicants will typically employ different strategies for creating their rank list. Some will rank programs based on prestige, others will rank programs based on their sense of "fit", and many will base their decision entirely on geographic considerations. Applicants unable to attend an interview who promptly notifiy the program about it in time for that program to invite another applicant may move a competitor away from blocking the path to matching at their first ranked program!

DIG Meeting Recap: Guest Speaker 12-10-12

Ms. Kimberly Cooper, UTMB dermatology residency program coordinator, volunteered to meet with DIG members for a Q&A session last week and provided very helpful information in regards to applying and interviewing for a dermatology residency position.

She stressed the importance of UTMB’s November 1^st ERAS deadline because the dermatology residency committee starts reviewing applications the following day. She displayed a computer application that residency programs use to filter out specific application components such as Step 1 scores, AOA status, number of publications, etc. Currently, due to an overwhelming number of applicants, the UTMB cut off score for USMLE Step 1 is 225; however, she mentioned that many scores in their application pool are in the 250-260 range.  UTMB medical students and students from other institutions who take dermatology rotations at UTMB are currently exempted from a specific cutoff score.

Step1 scores and grades are not the only important factors in reviewing dermatology residency applications. Letters of recommendation and research experience are also taken into consideration. Most applicants have an average of 2-3 publications. Although research experience is not required for UTMB dermatology residency, it is highly encouraged because third year residents are required to complete a scholarly project before they complete their residency.

Personal statements do not make or break an application, but provide a way for the applicant to be unique and interesting. Ms. Cooper pointed out that the personal statement could also be used to mention any ties, such as family, to certain geographic regions.

UTMB students have the opportunity to work with faculty members and current residents by taking one of the several dermatology electives and/or an acting internship. This gives students a chance to portray their work ethic, professionalism, and enthusiasm for dermatology.  Students are encouraged to be on time, helpful, enthusiastic and interested.

When reviewing applications, an important factor for faculty and, most importantly, the residents is if the student will “fit” in the program based on their “whole package”. This year UTMB received 350 applications.  Of those, 10 MS4 students from UTMB, 2 current residents from UTMB’s internal medicine program, and 32 applicants from outside institutions were invited for an interview.  There are currently four PGY-2 slots to be filled each year through the NRMP.

At UTMB, each interviewer will have 16 individual interviews with each faculty and resident. Each interview lasts approximately 11-15 minutes. After all of the interview sessions, the faculty and residents meet to create a ranking list for the NRMP.

Thank you Ms. Cooper for your very informative talk and to all of the students that attended!

Disclosing Away Interview Conflicts to Home Program Faculty

UTMB medical students applying for dermatology residencies often have one or more of UTMB’s dermatology faculty mentoring and supporting them through this stressful process. Should medical students voluntarily initiate disclosure about interview conflicts to their home dermatology faculty? Experienced faculty can offer excellent insight and perspective into the interview process, and may be able to offer valuable professional advice. However, do students want their faculty to know where they are receiving interview offers from outside institutions? Interview conflicts typically arise with excellent applicants who are overwhelmed by the positive response they receive from outside dermatology programs. It is not possible to be in three or four places at the same time (or in a constricted time sequence) when competing programs may be thousands of miles apart. Most of our faculty at UTMB are familiar with this type of situation, and are happy to help students make the best scheduling choices. It is unlikely that students diminish their chances for a match at UTMB by disclosing this information to their advisors. The fact that the applicant’s academic potential has been recognized by multiple outside programs is usually a strong indication that the applicant will be successful in the upcoming dermatology match.