I can only share from my experience. I matched into derm in my last year of IM residency training. I do feel there is a difference (and have been told by other dermatologists this is true) in someone applying while in another residency vs someone who has been out in practice for a period of time. Whether right or wrong, they are put in different categories when applying. So, that being said, my situation was different from that of the OP. However, funding was a big issue I encountered with many programs. For me, the hard part was getting interviews. Many programs excluded me because I had been through a prior residency (If you contact programs, they will be honest about this). Once I got interviews, each program expressed that my IM background was a big asset and thought I would add a unique perspective to their program. I received interviews at top tier and community based, smaller programs. I did absolutely no research (and had no pubs in IM either). However, I had some unique life experiences and had competitive board score (250+ Step 1). I also had to ask for LOR after only 2-3 weeks of working with academic dermatologist. This was all I was able to do. Of course, the question you will get asked is why dermatology after having completed IM, so have good answers for that. Anyway, this was my experience. This might not be the normal experience, but I wanted to share what I went through a few years ago. I knew there was a chance I would not match, but I was older and was not willing to go through a fellowship given my family situation. I still liked IM and saw derm as an extension of IM just like allergy or ID or rheum. I was content that if I didn't match, I could be happy in life and already had a pretty good job. I know our situations are a little different but I hope this might help in some way.