Dermatology

Dermatologists care for patients of all ages and specialize in treating diseases of the skin, hair, nails, sweat and sebaceous glands, and mucous membranes. Most residency programs offer a broad range of experiences in outpatient clinics, surgical clinics, specialty clinics, and inpatient/consult services. Sub-specialty clinics include those for pediatrics and cutaneous T-cell Lymphoma and other complex dermatologic disease. As a dermatology resident, you will be trained to provide both medical and surgical therapies. Clinicopathological correlation is strongly emphasized in this field and dermatopathology is typically reviewed each week.

Programs provide training in a variety of subspecialties within the field including Dermatopathology, Mohs surgery, Phototherapy, Allergy and Immunology, Pediatric Dermatology, Laser surgery, and Cosmetic Dermatologic Surgery. Some programs require or highly recommend independent resident research, case report publication, papers, and presentations at local and national conferences. Most programs have a broad range of didactic sessions (lectures, text review, dermatopathology review, unknown slide conference, journal club, grand rounds).

• Typical dermatology residency program: 4 years (Preliminary Year (PGY-1)/Transitional Year + 3 Advanced Years in Dermatology)
  1. Most applicants complete a preliminary year in Internal Medicine (preferred!)
  2. Other preliminary year specialties are also acceptable: Pediatrics, Family Medicine, General Surgery
  3. In contrast to preliminary year programs, Transitional Year Programs offer one year of rotations through multiple specialties (Medicine, Surgery, etc)
  4. In most cases, the application process to your Preliminary/Transitional year is completely separate from your Dermatology applications. There are only about 6 programs which have a “linked” preliminary year -- in other words, if you match at that program, you will be going to that institution for your preliminary medicine year as well.
• Med-Derm: 5 years (2 years of Internal Medicine + 3 years of Dermatology/Medicine)
  1. Only 5 programs in the country
• Research Track: varies, typically 4-5 years
• Fellowships (each 1 year): Residents may choose to pursue further training in Mohs Surgery, Dermatopathology, Cosmetic Dermatologic Surgery, and Pediatric dermatology

You should be a competitive candidate. Competitive clinical grades, a good step 1 score, and research are all important aspects of your application. Talk with Dr. Thom, Dr. Allen, Dr. Lamos, or your advisor. Dr. Hornyak, the Chairman of the Department of Dermatology, is an important person to talk to. E-mail Dr. Hornyak and set up a meeting as soon as you decide Dermatology might be a good fit for you. Dr. Driscoll the Residency Program Director, is also very friendly and helpful to meet with. The Maryland Dermatology residents are also a great source of information.

All dermatology programs now participate in ERAS. It is also important to check the program’s website as well as their information on ERAS because a number of programs require essays in addition to what you submit to ERAS.

Most applicants apply to anywhere between 50 and 100 dermatology programs. You will also need to apply to preliminary medicine and/or transitional year programs separately (for PGY-1), for which most applicants apply to anywhere between 10 and 20 programs.

Dermatology continues to be one of the most competitive residencies to obtain. There are, however, various opportunities to strengthen your application and demonstrate an interest in dermatology: 

1. Dermatology elective at Maryland: The sooner you are able to decide if you would like to pursue the field, the easier it is to put together a competitive application and perform research, attend conferences, get to know your home department, and apply for away electives. Therefore, if you are not sure about dermatology, take the Maryland dermatology elective early in theird year and/or try to shadow in clinic to decide if it is right for you. If you know for sure that you want to do dermatology, you may take the Maryland dermatology elective anytime in third year. You may even take it in July of fourth year if you do not get a spot initially or do not have the prerequisites met in time. During this elective, it is highly recommended to attend Dr. Hornyak's evening clinics, as this is the only opportunity you will get to work with him one on one. Be prepared to ask for LORs toward the end of the elective or right after it ends.
2. Away electives: Consider doing 2 or 3 away electives between the months of July and November of fourth year (the earlier the better). Choose programs you might be interested in going to as you will likely receive interviews from them. Some places even interview you while you are on your away elective in late summer/early fall so you do not need to travel back during interview season. Do not assume you will get an interview invitation just because you did the away rotation. Although this is true in many cases, it is not always the case (particularly for very competitive programs). Continue to show your interest in the program after your rotation ends, and keep in touch with residents or faculty you were particularly close with.
   
   1. Apply early to these away electives through VSLO (most applications open between February and April) as they fill up fast! Immunization forms are required for all away electives and most have their own unique form. These can take a couple of weeks to complete so get them done early. Try to get this taken care of in early January if possible as these electives fill up very fast!
   2. Non-VSLO away electives are also available; if you do not see an institution listed on VSLO, check their website or contact their residency coordinator or administrative assistant to inquire about the availability of away electives.
   3. Email program coordinators of programs that you are most interested in for away rotations in January of your 3rd year to show early interest and let them know that you will be applying for an away rotation through VSLO when it opens.
   4. If the elective dates do not line up with Maryland’s schedule, just ask the program coordinator nicely if they can accommodate your requested rotation dates. Usually this is not a problem, and they can make the dates work with your schedule.
   5. Study the AAD modules (link below) for medical students to be prepared for common diseases you will see in dermatology clinic. This will make your experience more fulfilling and allow you to show your interest in dermatology. Furthermore, most rotations have a cumulative test at the end that these modules are excellent for.
   6. Most away rotations are mainly shadowing, but if you are given the opportunity to present to the attendings and perform procedures, take them! You can make a great impression just by being nice, enthusiastic, and having a good attitude.
3. Research: 
   1. Case Reports: While on your home or away dermatology rotations, ask your residents if they have any interesting cases waiting to be written up. With their help, you can submit these to a journal in less than one month.
   2. Review Articles: Putting together an article synthesizing a body of literature on a specific topic is also a good opportunity for you to work closely with a faculty mentor while trying to add a publication. Some faculty may be more receptive to this than others, and you will have to be proactive in suggesting a topic to them. Be sure to do some background research ahead of time to ensure a similar review article has not been published recently. This project is likely more time intensive than a case report.
   3. Formal Research: It is a good idea to do dermatology research in addition to your home and away electives. Ask a resident or your faculty mentor about opportunities to become involved in dermatology research. There are a number of local and national conferences that are good to attend.
   4. Research Year: More than one half of dermatology applicants typically participate in a research year between 3rd and 4th year to make their application more competitive. This may be clinical or laboratory-based research. If you are interested in this, applications to research years should be submitted by December or January of third year to maximize the chance of securing a position. Many research years are unpaid which can be difficult so give yourself time to look into research grants. Some research opportunities will be paid, but these positions are highly sought after so an early application is crucial.

A research year is by no means necessary to match into dermatology, but may help you stand out as an applicant. Besides strengthening the research aspect of your application, key beneficial aspects of this experience include additional mentorship, professional networking, and gaining more LORs from faculty who know you well. If you are able to participate in research during third year or have a strong prior research background, it is not necessary to take a year off to do it.

1. Presentations: 
   1. Maryland Dermatologic Society: This society typically has two academic meetings (Spring, Fall) during which interesting cases are briefly presented. This offers an excellent opportunity for students to research a specific topic and gain experience in giving an oral presentation to local dermatologists. Let your residents know that you are interested in participating, and confirm the dates with the residency coordinator, Betsy Satosky.
   2. Away Rotations: most institutions ask visiting students to give a presentation at the end of the month. This can range from a case presentation to a lesson on a specific topic. Pick something that is interesting to you and confirm with a resident or attending before deciding on a topic. Other institutions will have a test at the end of the month that is usually based off of the AAD online modules.
2. Letters of Recommendation: 
   1. Most programs request 3-4 LORs. Make sure at least 2 are from dermatologists (most people do 3 derm + 1 medicine). One of your LORs should be from the Chair of the Dermatology Department, Dr. Hornyak. For your other dermatology letters, consider choosing an attending that worked with you throughout the month and can write about your specific qualities. Also consider faculty who are particularly well-known in the field (active in professional societies, well-published, and/or who have been practicing for a while). You have the opportunity to strengthen your application by obtaining LORs from attendings at other institutions by participating in away rotations. Try to choose one who knows you well. If you need an extra letter, consider using one from a medicine attending or non-dermatology research mentor.
   2. For your separate PGY-1 year applications, keep in mind that you should ideally have at least 1 letter from an attending in that field (i.e. medicine, surgery, etc.). You do not need to send this letter to dermatology programs, but you may if you wish to.

Interviews range from November (rare) to early February, although most programs interview during December and January. Dermatology programs typically send out invitations to interview much later than most specialties. You may receive your first invitation to interview as late as December. Schedule your interviews as soon as you hear from a program since the interview spots tend to fill up quickly! Additionally, programs usually offer only one or two interview dates and many interview dates overlap, therefore scheduling them can be very tricky. Most dermatology interviews occur in January.

Interview at as many places as you can due to the competitiveness of the specialty. Keep in mind dermatology applicants tend to get fewer invitations, so do not be discouraged if you get fewer invitations than you expected. Currently, the "magic number" of interviews to match is 9, but it is definately still possible to match with less!

Most dermatology interviews are structured in a “speed dating” style, where you interview with multiple people in one day. A typical interview day can last anywhere between 4-8 hours and include six to thirteen, 8-15 minute interviews back to back or with small breaks in between.

Be prepared to describe your interest in Dermatology, your future career goals, and any clinical or research interests at your interview. Also be prepared to answer behavioral questions as some programs seem to heavily ask these types of questions. Ask about where recent graduates are practicing! This simple question will provide some clarity as to whether the program supports careers in both academia and private practice or whether one is heavily favored.

Dermatology participates in the regular Match. This enables you to apply to more than one type of residency program in case you do not match for Dermatology. In past years, about 1/3 of those who applied did not match, so you must have a backup plan (research fellowship versus another specialty)! You may also choose to complete a preliminary year and re-apply for an advanced position during the next Match cycle.

2018 NRMP Match Statistics: U.S. Allopathic Seniors

• Total number of US Senior applicants: 651
• Number of positions in the main match: 472
• Number of positions filled by US Seniors: 368
• Mean USMLE Step I Score: 249
• Mean USMLE Step II Score: 256
• Percentage AOA: 49.1%
• Mean # of abstracts, presentations, publications: 14.7
• Mean# of volunteer experiences: 9.1
• Mean # of work experiences: 3.1

Charting Outcomes - 2020 

Alikhan, Ali; Sivamani, Raja K; Mutizwa, Misha M; & Aldabagh, Bishr. (2009). Advice for medical students interested in dermatology: Perspectives from fourth-year students who matched. Dermatology Online Journal, 15(7). Advice for medical students interested in dermatology

AAD Modules for Medical Students 

Contact:

Paola Aldana (MS4) 

Emily Nesbitt (MS4)