UTMB Dermatology encourages our medical students
to learn about dermatology throughout medical school, starting in the
first year. Here is the outline of the available opportunities currently
available and the timeline for those who are
seriously thinking about a dermatology career:
First Year
1. Sign up for the
UTMB Dermatology Interest Group (DIG) during orientation. Joining this
student organization will put you in contact with other
dermatology-minded medical students in your own class and upper
level students. You will learn more about dermatology research
opportunities, dermatology-related community service, and leadership
positions in the DIG. Early during the first year the DIG conducts a
meeting to discuss dermatology opportunities at UTMB and
the Dermatology Program Director is available to answer questions. The
DIG also conducts a suture workshop in the second half of the first
year, and DIG members have priority (space is limited). The UTMB DIG has
a blog that has been continuously published
since 2004 and is a treasure trove about UTMB Dermatology activities (
digutmb.blogspot.com )
2. Sign
up for the St. Vincent’s dermatology clinic that is held the first
Thursday of every month. You will take care of unfunded patients with
skin diseases and be supervised by current UTMB dermatology
residents and faculty. It is a good way to learn more about the UTMB
Dermatology Department.
3.There
are unfunded preclinical dermatology preceptorship rotations
(DERU-1050) of 4 week duration for first year medical students during
the months of May and June. Four students may participate each month.
UTMB holds a meeting in January each year to let first year medical
students know about summer clinical and research opportunities, and
immediately after the meeting you will be able to sign up for what
interests you. All students interested in the preclinical
dermatology preceptorship will be randomly selected for preceptorship
positions. During this preclinical rotation you work in the UTMB
dermatology clinics along with the dermatology residents and faculty,
and attend dermatology conferences. You will also receive
graduation credit for this elective. This is where most first year
medical students have the first opportunity to collaborate with
dermatology residents and faculty on poster presentations for the fall
meeting of the Texas Dermatological Society and other
conferences. This is an early start for your dermatology research
experiences.
5. If you have a
dermatology research project in mind and have identified a faculty
mentor, you should consider participating in the UTMB Dermatology Honors
Research Program. Successful completion of the program
(thesis defense) will result in Latin research honors at graduation.
You also receive BSHS Selective credit upon successful completion of the
program if you register for DERU-4004 during your MS4 year. Most
students who participated in this program published
their thesis in a peer-reviewed dermatology journal as the first author
and they are dermatologists now. For more information see
https://escholarship.org/uc/item/6471z2jq The new faculty in charge of this UTMB program is Bret T. Howrey, PhD (Family Medicine).
6. Medical
students also have the chance to help current dermatology residents
with their scholarly project, a graduation requirement for the UTMB
Dermatology Residency Program (see
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3726645/ ). Completed
projects are usually presented at the spring Texas Dermatological
Society meeting, and some are published. You be given credit as a author
of this work if you contribute to this work.
7. Work hard in
all of your courses. Even though UTMB is now pass/fail, your
performance will still be considered for Alpha Omega Alpha (AOA)
membership in the MS3 and MS4 years. The more you learn during
the first year of medical school, the better you will do on Step 1 at
the end of your second year.
Second Year
1. Continue
participating in DIG meetings and activities (it is never too late to
join if you have just become interested in dermatology)
2. Continue to attend St. Vincent’s dermatology clinic on the first Thursday of each month (it is never too late to start going)
3. Continue
working with residents and faculty on presentations for the Texas
Dermatological Society fall and spring meetings (and other dermatology
meetings)
4. During
POM2, all second year medical students will be assigned to one
dermatology clinic. If your POM2 faculty is a dermatologist, you will
have a second chance to go to dermatology clinic as your “wild
card” clinical experience.
5. Continue helping current dermatology residents with their scholarly projects.
6. Consider
taking a research year at the end of MS2. A dermatology research year
should improve your application due to additional research activity that
lead to presentations at national meetings and peer-reviewed
publications, making your dermatology residency application more
competitive. Downsides are that they are not usually paid, not offered
at all medical schools, do not guarantee a dermatology residency match,
and delay graduation.
7. Take Step 1 preparation seriously and study hard to do the best you can.
Third Year
1. Continue
participating in DIG meetings and activities (it is never too late to
join if you have just become interested in dermatology)
2. Continue to attend St. Vincent’s dermatology clinic on the first Thursday of each month (it is never too late to start going)
3. Continue
working with residents and faculty on presentations for the Texas
Dermatological Society fall and spring meetings (and other dermatology
meetings)
4. During the 3
rd
year, you will have two opportunities to take dermatology electives.
UTMB Dermatology offers more dermatology electives than most other
programs. In your third year schedule, you
will have the opportunity to take a 4 week dermatology elective. In
addition, you may also take a 4 week dermatology electives during Period
13 (holiday period). Period 13 dermatology electives fill up fast, so
if the student quota is full, ask to be placed
on the waiting list. Electives offered are described here:
http://ar.utmb.edu/SOM/Electives/blist.asp?dc=der
5. Start planning your away dermatology rotations through VSAS (
https://apps.aamc.org/vsas/public.html#/find-electives ) . An
application is required and away rotation spots fill up fast, so you
should consider applying to several programs for each Period that you
want to be away from Galveston. Away rotations are very
important for successful matching in dermatology. Over half of
dermatology matches occur at the applicant’s home program or at a
program where the applicant has rotated. The best times to rotate are
from the end of MS3 until the end of October. Good places
to rotate are institutions where students from your school have matched
in the recent past. It is also better if the away rotation takes 4 or
more residents each year. If you have a legitimate geographic or
personal ties to the away rotation site that is a
plus (programs think you may be more interested in going there).
Beware of programs that accept lots of rotators but do not interview all
of them (you still may want to rotate there for a variety of reasons,
but don’t go there if you are counting on an interview
with them). It is debatable if a 2 week rotation (some of these are
available) is as valuable as a 4 week rotation in terms of chances for a
match at that program. If you are accepted to more than one program, be
courteous and decline the rotation right away.
6. Consider
taking a research year at the end of MS3. This may be a serious
consideration if the applicant has just recently become interested in
dermatology but has no dermatology research. A dermatology
research year should improve your application due to additional
research activity that lead to presentations at national meetings and
peer-reviewed publications. Downsides are that they are not usually
paid, not offered at all medical schools, do not guarantee
a dermatology match, and delay graduation.
7. Although
it is not absolutely necessary to take Step 2 CK and CS at the end of
the second year, a growing trend is for institutions to require these
tests in order to place you on the NRMP match list. It
is better to study hard for these exams and get them out of the way
early (Step 2 CK is usually higher than Step 1, so it also helps the
applicant)
Fourth Year
1. Continue participating in
DIG meetings and activities (it is never too late to join if you have
just become interested in dermatology)
2. Continue to attend St.
Vincent’s dermatology clinic on the first Thursday of each month (it is
never too late to start going)
3. Continue working with residents and faculty on presentations for the
Texas Dermatological Society fall and spring meetings (and other
dermatology meetings)
4. UTMB requires an Acting Internship (AI) for graduation, and
fortunately UTMB Dermatology offers one of the few dermatology AIs in
the country (see
https://escholarship.org/uc/item/63d8j499 ) It is best to take this
early in the MS4 year so that you already have the skills and knowledge
to impress faculty at your away rotations!
5. ERAS opens in September of your senior year. Everything
should be ready to go on the first day (including letters of
recommendation from dermatology faculty). That is because
most dermatology positions are offered as advanced positions
(dermatology residency does not begin until the applicant has completed a
PGY1 year in an accepted clinical specialty such as pediatrics,
internal medicine, family medicine, surgery, obstetrics/gynecology,
emergency medicine, or a transitional year. Taking a PGY1 year in any
of these programs starts the Medicare Funding Clock. This often becomes
a funding issue if the dermatology applicant does not match into a
dermatology advanced position at the time of the
PGY1 match. Dermatology requires 4 years of residency (PGY1 + PGY2, 3,
and 4 in dermatology), and Medicare starts the residency funding clock
running at the time of the initial match. Since Medicare funding is only
3 years for pediatrics, internal medicine,
family medicine, and emergency medicine, if an advanced dermatology
position match does not occur at the same time, those reapplying to
dermatology have one year of residency that is not completely funded by
Medicare. Some institutions are unable to fund this
additional year, and are not able to consider taking an applicant under
these circumstances. However, if the applicant takes a PGY1 year in
surgery (5 years of funding) or in obstetrics/gynecology (4 years of
funding), complete Medicare funding is available
if the surgery resident did not spend more than 2 years in the surgery
residency or if the obstetrics/gynecology resident did not spend more
than 1 year in the program. If the applicant matches into a transitional
PGY1 year and does not match into dermatology
right away, there is no Medicare penalty since the transitional year
does not start the funding clock. Transitional and preliminary program
interviews in all of these residency programs fill fast, so early
application is advantageous. Applicants will usually
start going to these interviews as early as September. Dermatology
residency applications typically occur much later, with some as early as
November. However, the vast majority of dermatology interviews occur in
January, so it is wise to take vacation that
month or take a didactic elective or BSHS Selective where presence on
campus is not required. UTMB Dermatology offers 4 didactic electives
(DERU-4007, DERU-4008, DERU-4011, DERU-4017; see
http://ar.utmb.edu/SOM/Electives/blist.asp?dc=der ) and 3 didactic
Selectives (DERU-4012, DERU-4051, and DERU-4402), that include the
option of teleconferencing or make-up written assignments for each class
meeting if you are away for interviews (see
http://ar.utmb.edu/BSHSselectives/brochure.asp?dc=der ) . A BSHS
Selective, a writing requirement is required by UTMB for graduation. Try
not to be in a situation when you cannot go to interviews because you
are on a rotation that only permits two absences!
The more interviews you go to , the better your chances for a
dermatology match.
- As mentioned,
advanced residency positions are the most common type of dermatology
residencies. There are also a few categorical dermatology residency
programs where the applicant spends 4 years training
at a dermatology residency in the same institution that includes the
PGY1 year. In addition there are combined dermatology/internal medicine
and combined dermatology/pediatric residency programs that are 5 years
long (2.5 years of dermatology and 2.5 years
of internal medicine or pediatrics with completing residents eligible
for board certification in both specialties) which also includes the
PGY1 year.
6. Some applicants who like dermatology and a different
specialty make dual applications to both. This can be difficult due to
time restraints for several audition rotations
in two different specialties. Other issues are obtaining letters of
recommendation from two sets of physicians. Some of these applicants do
not to apply to both departments in the same institution. If discovered,
applying to two different specialties may indicate
lack of applicant commitment to both of them. Sadly, some applicants
who match into their backup specialty still want to become
dermatologists and are later unhappy with this choice.
7. Match day is held in mid-March. That is when you find out if
you matched into a dermatology residency and where you will be going
for the PGY1 year. Dermatology has some
categorical dermatology programs (where you do the PGY1, 2, 3, and 4
years at the same institution), but they are relatively rare. If you
have not matched into dermatology (it is a very competitive match), it
is still possible to become a dermatologist, but
it is a path best taken by applicants who are very committed to a
dermatology career, because success is not a guarantee. There are three
main ways this is accomplished:
- At the end of
the PGY1 year and successful completion of Step 3, begin a dermatology
clinical fellowship. These are not accredited by the ACGME and do not
count toward the required 3 years of dermatology
residency. Typically the fellow conducts clinical research under the
supervision of the clinical investigator, resulting in meeting
presentations and publications. Quality of these fellowships and
reapplication success vary. It is bests to work with a mentor
who has a good track record of helping the fellow successfully match at
that institution or other dermatology departments. There are no
guarantees of a dermatology residency match. Fellows may stay at the
same institution for several years before matching,
or may try switching to different clinical dermatology fellowships at
different places. Fellows often work with dermatology residents, and
learn lots about dermatology while in the fellowship, often becoming
expert in clinical research and new drug therapy
for skin diseases.
- Stay at medical
school another year (“super senior”) if you have not matched into a
PGY1 program and have not yet completed all graduation requirements
(Some applicants send in their NRMP match list with
the contingency that they don’t want to match into a PGY1 position if
they fail to match into dermatology, although matching into a PGY1
transitional year in this circumstance will allow the applicant to apply
for a dermatology clinical fellowship since a
medical license is needed for most of these. In addition, if the
re-applicant is a PGY1 transitional physician, there is always the
chance that additional positions will open during the current academic
year in the “Physician Only” track that the PGY1 transitional
could obtain). Some schools permit you to stay for an additional degree
(MS, MBA) and you can use that time to take additional away rotations
and conduct dermatology research. This could increase the quality of
your application, although it will only be about
5 months before you will need to submit another ERAS application.
- Another
strategy is to become board certified in a different specialty first
before reapplying to dermatology. This strategy relies on the future
needs of specific dermatology residency programs. Even
though Medicare funding has been exhausted, new departments may be in
need of physicians who will be able to immediately provided needed
clinical skills to care for dermatology patients. High demand physicians
are board-certified in pediatrics, internal medicine,
surgery, or dermatopathology (initial pathology residency). The
pathology trained dermatopathologist will also need to take a PGY1 year
in one of the required clinical specialties before starting dermatology
residency, because the pathology residency does
not meet the clinical requirement for dermatology.
8. UTMB still requires all students take neurology and emergency
department electives prior to graduation. The best time to take these is during Periods 8, 9, 10, or 11.
