Considerations before Applying
The following pages contain a consolidation of advice from Dermatology Program Directors, Chairs, and Faculty who responded to individual questions posted on our forum. These are general recommendations, which may not apply to your individual situation. It is always best to discuss questions and plans with your school’s advisors and/or dermatology faculty.
What is the impact of a poor performance/remediation in a pre-clinical course?While any blemish to one’s record is a setback, programs look at the big picture in applications. First, the student’s poor performance may easily be missed in the evaluation process by the residency program. Secondly, to prevent “negative thoughts” if the program does take note of the issue, it may be worthwhile to include “a good explanation” in the personal statement as well as the letter of recommendation. Honors grades during the clinical years will also help to dispel any reservations created by a single bad preclinical grade. In addition, it will help to display “functional literacy” in the course that was failed. For example, if it was genetics, a strong performance in a medical genetics elective demonstrates important knowledge has been learned. It may also help to get involved in research following medical school to strengthen your application, but this in no way guarantees you of matching.
“Marginal” USMLE Step 1 Score:
Many programs use “cutoffs” for USMLE scores. These cutoffs may be 220 for some and 230 for others. There is data to suggest that scores below 220 may indicate an increased risk of failure on the American Board of Dermatology Certifying Examination. As many applicants have scores above 230, programs may prefer to avoid this risk. Step 2 scores above 220, 230 may help to overcome low Step 1 scores.
The Step 1 is only one part to your application. It does not measure personal attributes such as creative thinking (research, etc.), humanitarian skills, or leadership ability. High grades, “excellent” Dean’s letter and LOR mentioning personal attributes, and high step 2 are great remedies. It is advisable to discuss one’s application with the school’s dermatology faculty. Completing a rotation at programs you are particularly interested may help. These “try-outs” assure dermatology programs that you have what it takes to be a great resident.
Do I need my USMLE Step 2 score available in my application?
The Step 2 is not required in one’s application. To our knowledge, programs do not refuse to interview or rank applicants based on availability of the Step 2. About half of all Dermatology applicants do not have Step 2 scores available by interview season. Some program directors believe that Step 2 scores are better predictors of residency and future performance than Step 1 scores. Candidates with lower Step 1 may prefer to take the Step 2 early for reasons stated above under the heading “Marginal USMLE Step 1 score”.
Would a MPH strengthen my application?
While few applicants have a MPH, it is likely to make one stand out positively. However, the title itself is less important than the achievements that accompany an MPH such as presentations and publications that show a specific area of expertise. It is also important for the applicant to clearly state how the expertise gained during the MPH process will benefit the program or the field of dermatology in general. In other words, it is a minor part of the application which should reflect the strengths in the rest of one’s application (Grades, AOA status, board scores, research activities, and goals).
Rotating at programs of interest is generally a good idea. Try to arrange 1-2 away rotations in July/August/September especially at schools in your region and/or where previous graduates have matched. Also, if a major city has multiple dermatology programs it may be possible to network with residents from multiple programs during monthly Dermatology Society meeting.
During the externship, try to pursue scholastic activity with faculty. It is very hard to accomplish much research during a 1-2 month rotation. Working on a case report may fit better into this timeframe. This demonstrates the ability to synthesize the literature and write well. Working with a good mentor, who can write a strong LOR when you are done, is also important.
If other students from your school have matched in dermatology, contact your medical school to determine where they matched. Ask the former students for advice. If one of your predecessors made a favorable impression somewhere, then consider applying for an away rotation at that program.
How can I show interest in a program?
Contacting a program may be okay, but it is critical that you are not perceived as “pushy” or “overbearing.”. A better way of communicating one’s interest is by crafting a personal statement to include experiences that demonstrate a keen interest in dermatology and specifically in their specific program. Completing a dermatology externship is another great way to show additional interest and allow formation of personal relationships with faculty/residents.
Backup plan: Preliminary medicine program or defer graduation and complete a year of research?
Despite being superb applicants, each year many candidate fail to match. Therefore, each medical student should have a backup plan. In addition, applicants should be prepared to discuss these plans in dermatology interviews. Most research fellowships prefer or require full medical licensure before starting the program. Though highly variable, Fellowships that do not require a medical license, may be more likely to result in an increased number of projects/papers/publications/networking opportunities rather than an emphasis on income producing service.
Early completion of an internship, however, offers the benefit of immediate availability for a candidate if an unexpected opening occurs in dermatology residency programs.
The back-up plan for some applicants may include a plan to apply for a residency in another field. It should be noted that later reapplication to a dermatology residency is complicated by funding issues if additional years of residency training are completed in another field.