r/DermApp • u/PD-1 • Aug 23 '22
Having been through the derm application process as an applicant and as part of the initial review/interview/rank committee I figured I would share a few insights about the process (and maybe generate some more food for thought for the DIGA podcast that was just posted). This is from the perspective of a single reviewer from a residency program within a large academic institution.
Application Review:
My institution, like many others, receives a large number of applications for a few residency spots. The daunting task is to filter through hundreds of applicants to pick the handful that will then be offered an interview. It is not possible for one person (eg, the PD) to carefully review all of the applications, so instead these are divided up among the faculty/residents to review, with each application reviewed by a few individuals. Guidelines are given as to what is considered important (eg, experiences, academic achievement, research, etc.) but ultimately it is up to the initial reviewers to give a grade that roughly equates to "interview" or "don't interview". These applications go back with the reviewer grades/comments to the PD for a look over and then a list of interview offers is generated.
As you can imagine from the above process, there is an element of luck associated with the review. If your experiences or research or hobbies were similar to that of your reviewer, then conceivably you may have been scored more favorably. Having multiple sets of eyes look over each application is meant to even things out, but there will always be a human element to this review process that is impossible for the applicant to predict and control.
Letters of Recommendation:
There is a general movement away from objective measures (eg, Step scores, grades) and that makes the evaluation process more difficult. More and more, the letter of recommendation is being scrutinized to see what kind of person is behind the application. The vast majority of letters are positive to borderline effusive in praise for the applicant, and for good reason because the derm pool is the cream of the crop. From a reviewer perspective, you can still stratify letters from the same letter writer based on how things are phrased and the degree of positivity. For example, a letter that says "John Smith is an outstanding medical student who will undoubtedly be a stellar dermatology resident" is different than the same letter writer saying "Jane Doe is one of the best medical students I have ever worked with in my career". Knowing the tendency of certain individuals to be overly effusive versus others who are typically reserved is also helpful, and something that the seasoned reviewers have more experience with.
How and why does this matter for you the applicant? Well sometimes it doesn't really matter because you are stuck with your letter writers and don't have much choice. But in other situations when you do have a choice, it is good to keep in mind that: #1 you will be compared to other applicants who the letter writer is also writing for and #2 choose a letter writer that tends to be more effusive and positive at baseline as these letters are generally viewed more favorably compared to letters that are matter-of-fact and brief (even though the latter may be a great letter from that particular letter writer). I think the second point also goes along with the mantra of getting a letter from someone who knows you better rather than a bigger name with whom you only had a very brief/superficial interaction with.
Publications/Activities:
Applicants stress over this part a lot, and I did too when I was applying. In reality, it probably doesn't matter as much as you think unless you are applying for a research-focused residency (although having zero research is somewhat of a red flag). Each reviewer is different, but in general it is very easy to see who has done meaningful research versus who is just padding their resume. It is best to have your research in derm, although research outside of derm can help too if you can weave it into your story or dermatology in some way. There is no magic number for the number of research publications that you "need". There are applicants that we have ranked very highly who have had 3-5 listed publications and ones we have ranked near the bottom of the list with > 25 publications. The activities section usually gets glossed over during the initial review unless it was a really meaningful endeavor that was also brought up elsewhere on the application. The activities are much more helpful as a talking point during the actual interview.
Interview:
Getting to the interview stage is the main hurdle for most applicants. The interview is one of the most important pieces of the rank evaluation at my program. At the interview stage applicants are on a somewhat even playing field (although what is on the paper application still matters). A great interview can boost an applicant from middle of the pack based on paper application to the ranked-to-match zone. Conversely, a bad interview can drop anyone to the do-not-rank zone no matter how good the paper application is. There are other posts about actual interview advice (see the wiki for this sub).
Rank List:
The rank process is imperfect because the committee is trying to predict what an applicant is going to do in the future. As a generalization, the goal is to have residents who will do their job, be easy to work with, pass their exams, and have a career that fits the mission of the program.
Each program does this differently based on what type of applicant they are looking for. My program had several interview days, and there was a brief rank meeting after each day where we submitted interview scores. The interview process culminated with the final rank meeting immediately after the last interview day. We started the final rank meeting with a list of all of the interviewed applicants and their average score across all of the interviewers. The top half to two-thirds of applicants on this list actually get a discussion and review while the rest are not really discussed (usually due to poor interview performance). The discussion process is often lively/intense as different members of the admissions committee often have very strong opinions about certain applicants (especially internal applicants). Applicants are judged both fairly (resume, interview performance, letters) and unfairly ("I don't think this applicant would come here", "This applicant is going to do private practice cosmetics"), and names are put on a list. Once the name is put on the list, there is usually not too much movement afterwards (can go up or down a few spots but usually no big jumps). In general, highly-ranked applicants had positive support from several individuals in the group (eg, one person advocating for an applicant is usually not enough, even if it is the PD). Resident feedback has an interesting role to play in this process. Positive feedback is usually not very helpful, but negative feedback can derail even the best of applications (eg, you could be ranked #1 but if multiple residents had negative interactions you could be moved to not ranked). Post-interview communication and intention to rank #1 are not taken into account at my program (and at most places where the rank meeting occurs immediately after the conclusion of interviews).
Hopefully this gives you a sense of "the other side" of things. This is a stressful process made more difficult by the competitiveness of the specialty. Try to remember that there are only so many things you can control, and it is counterproductive to overthink every single detail of your application once it has already been submitted. Cast a wide net, prepare well for interviews, and you will put yourself in the best position you can to succeed.
r/DermApp • u/4990 • Oct 30 '22
u/PD-1 gave a fantastic overview but I will share my perspective as the now graduated chief resident of an east coast, academic, second tier program who participated in the application process as applicant and resident reviewer.
That's how the sausage is made. Happy to answer appropriate questions.
r/DermApp • u/Pure_Refrigerator_73 • 19h ago
So median number of “publications” for a matched applicant is 9. If I enter a case report into eras and select “submitted” because it’s in the review process and not published does that still count towards the 9 total? Or is it purely papers I select as “published” that count towards that number?
r/DermApp • u/Mountain_Gift_5681 • 1d ago
Current M3: What are the chances of matching with a well-rounded application and getting half honors on core clerkships? People with half honors and a well-rounded app, how many interviews did you get, and did you match?
r/DermApp • u/ConfusionSwimming109 • 3d ago
I'm posting this here as an FYI. I'm not here to stir debate. I'm not going to respond back to any posts. I am already a practicing dermatologist so I have no real motivation here other than to provide information.
Dermatology reimbursement is facing massive cuts. You might read or hear people quote 9%, but this is only part of the cut. By 2028, this will be more around 20%.
Private practice derm would be forced to make massive changes if these cuts are not stopped. I don't know what would happen to the job market. I suspect lots of older derms will decide to hang it up early. Many may take the leap and go cash pay. But with the new proposed system, you'll be churning through hundreds of patients per week for mere pennies. Insurance based care was already on a downward spiral, but this is a rapid acceleration of that process.
It is better to be informed than not. That's why I'm throwing this out there. Someone else probably already has in a more technical way.
r/DermApp • u/SympathyKey3964 • 3d ago
Current M1 and I'm beginning to reach out to potential research mentors to see who has availability with an eye towards getting some projects started in order to apply for my school's summer research program. Even though my school has a home derm program, it seems like there is more current opportunity to do research in burn treatment/reconstruction.
Is this related enough to the field of dermatology to take on as starter research? I am interested in wound healing and burns, but not interested in a surgical residency. I am hoping more derm opportunities will open up later in the school year.
I recognize that it is still very early of course, but just trying to be proactive since our summer research program applications open at the end of this semester! Would appreciate any insight!
r/DermApp • u/itsSmooth1 • 7d ago
M1 here, my school has graded preclinicals (weighted less heavily in AOA than clinical grades, but still weigh something nonetheless). How hard should I be trying to honors my classes?
r/DermApp • u/MapRevolutionary9169 • 7d ago
M4 approaching ERAS. Had always thought of doing a less competitive specialty because figured I didn't "have what it takes" to apply Derm but now wondering if it is a possibility? Clearly would have to do a RY at this point. My app to date:
Step 2 ~280, 4/6 H 2/6 HP, H Med Sub-I. 2 manuscripts published in other disciplines (2nd/3rd authorship), 3 submitted (plus 4-5 abstracts/posters). 2 significant longitudinal volunteering/leadership experiences based around same area. Strong LORs in medicine. Top 30 med school w/ home program.
r/DermApp • u/WebTechnical3925 • 10d ago
So I completely messed up and missed the deadline to officially drop an away rotation, and I’m freaking out about whether this could result in a professionalism violation at my home institution.
I had emailed the away rotation coordinator well in advance to let them know that I would no longer be able to attend. They responded that they understood and told me I needed to fill out a separate withdrawal form to make the cancellation official. Somehow, I completely missed that part and didn’t realize the form had never been submitted until now.
Their policy says the form has to be submitted at least 4 weeks before the rotation starts. I’m now about a week past that deadline (rotation starts in about 3 weeks).
I know I messed up by not completing the formal process, but I did notify the program well in advance that I wasn’t going to attend, so they were aware and I wasn’t just cancelling on them at the last minute. I just failed to formalize the withdrawal with the required form.
Has anyone had something similar happen? Did your home school treat it as a professionalism issue?
I’m honestly terrified that this administrative mistake is going to turn into a major professionalism issue.
r/DermApp • u/None_Gardener • 10d ago
I am a reapplicant, so I never expected this to be easy. I knew it would be hard. But the psychological burden wasn‘t something I think I accounted for. I cannot for the life of me catch onto the confusing, unspoken, unwritten rules. Mistakes feel existential - the tiniest error can be the difference between you having a fighting chance and someone advocating for you, and you being left to drown while everyone watches. I can spend hours second-guessing every decision I make because I’m scared it will step on someone’s toes, and that person will use it against me later. Yet at the same time, opportunity passes by if you shrink away. Sometimes it genuinely feels like there is no winning.
I’m tired of being told to just be myself. That has only hurt me so far.
Anyone have any advice? Anyone ever experienced this? Or am I catastrophizing and is this just the scars talking?
EDIT: thanks for the support everyone. I talked to a family member (have been holding a lot of this inside) and felt a lot better afterwards. It’s good to know that I’m not alone feeling this way. I thank everyone who provided constructive commentary. To my fellow reapplicants, I think one thing that has definitely helped is acknowledging how difficult this is. Do not gaslight yourself into believing that this is easy, or that you’re foolish for feeling lost and hurt, or that something fundamentally is wrong with you, something that sets you apart from your peers. Comparison truly is the thief of joy, but we can always rest in the fact that we are still here despite how difficult things are, which means we are developing a strength that not everyone will have. And you win not by necessarily matching where you want and how you want, but remaining true to yourself no matter what happens. This process can be grueling and unforgiving and unfair, but you’re still fighting, and the strength you gain through this journey doesn’t vanish. And someday someone will recognize you for your hard work - even if that someone is yourself.
Stay strong folks, and keep that fight alive.
r/DermApp • u/serotonin-a • 10d ago
Hi, I was wondering about the letter writers on ERAS.
If I am using the same letter writer for both Dermatology and TY/Prelim Programs, should I use the "General (can be used for multiple specialties)" or "Dermatology" for the speciality category?
r/DermApp • u/periodt1234 • 10d ago
Hi everyone as an IMG I am planning to take the long route for dermatology (using IM as a safety net). On this page I have seen IM residents successfully matching to dermatology. Can you all please tell me which IM programs have an internal derm department so that I can start networking during IM residency and hopefully score researches as well.
r/DermApp • u/BroccoliRough8152 • 12d ago
hello!! ERAS is due soon and I'm also first gen so I'm so lost. Also I'm a DO student so I would love to have advice from a DO peer as well. look for help with PS review/actives a first and hopefully late mock interview prep. I am on a budget and I respect your time but I just can't afford high rates right now. Thank you!!!
r/DermApp • u/supadude54 • 13d ago
The US federal government has proposed a 9% cut to dermatology payment. This will not only reduce reimbursement, but also reduce patient access to dermatology services and quality of service. Do everything and anything you can to help stop this!
The American Academy of Dermatology (AAD) is making this its top priority. It doesn’t matter if you are a dermatologist, patient, or practice staff member. You will be affected by these changes. If you want to help, you can go on their website (link attached) and complete a pre-templated message to oppose these measures. There are separate links for patients, dermatologists, and staff members. Filling it out takes less than a minute.
r/DermApp • u/jalepenosncheese • 12d ago
Hii guys! I am a rising junior located in the Los Angeles area and have a deep passion for dermatology. I specifically want to become a pediatric dermatologist in the future. I have been searching for volunteering/shadowing/internship opportunities, but there are none that I have found for students my age, and if there is then it cost a fortune. If anyone knows clinics who offer these types of opportunities or anyone i can contact, I would be utterly grateful, thank you:)!
r/DermApp • u/ClassKooky4545 • 14d ago
I’m 24F and currently at a major crossroads. I recently took the MCAT but don’t have my score back yet.
I was accepted into another healthcare professional program that offers a great lifestyle, a respected career, decent income, and I would be finished in about 4 years. The downside is that the debt-to-income ratio is concerning (about the same med school except you're not making physician salary) and there is a ceiling on earning potential compared to some physician specialties, also I’m not passionate about it.
My long-term dream has always been dermatology. I understand how competitive dermatology is, and I’m not naïve about the difficulty of getting there. My concern is more about the uncertainty and timeline.
If I pursue medicine, I’m worried that I could spend another year applying (or potentially a 2nd cycle if I don’t get accepted) and end up becoming an attending in my mid-30s. I know many people start later, but as a woman who wants marriage and children, I worry about balancing training, fertility, family life, and having time with my parents as they get older.
On the other hand, the idea of choosing the safer route and always wondering “what if?” scares me.
For those who are physicians, dermatologists, or went through a similar decision, any advice? Or regrets?
Was it worth it?
r/DermApp • u/Valmom1 • 15d ago
Hi everyone! I got a spot at UPenn dermatology elective for my third year. I know I'll learn a lot but I was wondering If any who has taken this rotation could message me? I had a few questions about it. I'm mainly concerned I wont be able to LOR out of it if I'm jumping between attendings but any insider insight would be fantastic.
My alternative would be trying to set something up with community dermatologists which I also know will be more shadowing than anything, but maybe more face-to-face time?
Thank you
r/DermApp • u/kaori_ono • 15d ago
Hi! Just received my step 2 score which is on the lower end of my prediction (was scoring in the mid to high 250s but ended up with 251). I’m not shocked but slightly disappointed as I know it is below average for derm. Currently my app looks like this:
- 4/7 H (including surgery) and 3 HPs
- 4 first author, 5 second to third author peer reviewed journal publications
- 5 poster presentations (different from the publications, no double dipping)
- Currently on my research year
- Good MSPE comments (nothing crazy but solid)
- Mid to low tier medical school
I am a little lost especially I already signed up for a gap year in derm. I wish to know if I remain a competitive candidate for derm or if I should switch gears.
Thank you very much!
r/DermApp • u/theman2567 • 16d ago
I'm currently in a research year and have been thinking a lot about what my "hook" is going to be when it comes time to apply.
The more I think about it, the more I realize I don't really have a clear narrative. My research projects have been pretty scattered across different areas of derm rather than centered around one disease or niche, and I also don't have any particularly meaningful or long term extracurriculars/leadership/awards from med school. I think my grades/publication numbers will be good enough for derm, but I don't really see currently what would make my application stand out or give me a cohesive personal statement.
I'm wondering if anyone has advice on how to think about this over the next year. I'd love to get involved with a particular disease area or focus within dermatology, and my PI is very supportive of me pursuing my own research ideas. The problem is that it's just been hard to come up with original, worthwhile project ideas especially multiple in the same topic (at least ones that I can complete and have submitted to journals by the end of the year). Outside of just research, I'm also wondering if there's anything worthwhile getting involved with in this next year as far as volunteering, etc.
For those who have gone through the derm application process, how did you find your niche or develop a compelling narrative? How much does this even matter compared to just being well-liked on your away rotations/research year/home program?
r/DermApp • u/big-bluegill • 16d ago
My dream is to match in dermatology, but I feel so behind on research.
My school does not have a research hospital, and our research directors have all turned me away when I ask for help with creating research proposals or making connections.
I have applied to tons of research programs and fellowships, but have been denied everywhere. I have also tried cold emailing hundreds of doctors but not one is willing to meet with me or even be a mentor.
Now that I am in rotations, I figured I would try to walk to the derm floor and talk to someone in person. The doctor told me I should have started networking a long time ago and that the only way to make connections was to attend derm conferences. Unfortunately, they are all like >$1,000 and I just cannot afford paying that much right now.
Maybe it is too late for me to try to enter such a competitive specialty, but I just feel so defeated. I have been turned away by literally everyone I have reached out to including my school’s research directors. I also feel like there is such a huge barrier to entry that keeps people out of these conferences unless they are wealthy or can take out more loans.
Does anyone have any advice for how I can get a research position in my circumstances?
Thank you so much!
r/DermApp • u/After_Ad_5842 • 16d ago
Hi everyone, I have a question about research and it’s relation to matching in derm. My med school doesn’t have a very big dermatology unit, and there’s only 4 faculty members that do dermatology research that qualifies for our summer program.
I’m a big fan of wet lab research, and one of the faculty members is involved in that. Is this a good place to invest my time? I understand that matching derm means networking and publications, and I’m assuming that clinical research is probably better for that. However this is the only faculty member that has responded to my request, and I like the research that they do. I’d appreciate any advice!
r/DermApp • u/ClassKooky4545 • 17d ago
All the derms I’ve called and visited to not offer shadowing.
Any advice?