Dying To Be A Derm

[DrDivaLenz]

Hi Kids:


Alright, Here is the lowdown. I have been dreaming and working for a dermatology career for about 5 years now. I am a 3rd year medical student and before medical school worked for a NYC derm for 2 years.

I worked my butt off in med school and unfortunately wound up a High Pass student with only 60 points above the national mean on the Comlex (DO) boards and a 200 on the USLME step one.

I have 5 publications, a summer bench project, a poster presentation, as well as the 2 years work experience. I have great letters of rec from reputable staff at NYU.

Can i achieve my lifetime goal if I do more research or keep persistently working at contacts? Am i completely out of teh game because of my step one scores or can I work some majic with my program director friends ?

I WNAT THIS BAD BC ITS THE ONLY THING I ENJOY.

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[tripleJ]

You best become friends with cindy hoffman, DO. And, no; don't think about allopathic programs. Go to AOCD.org and go to all the meetings, etc...

 

[dermpathdoc]

This will be difficult for you. I know of a former student who so badly wanted to be a derm that she tried to make a residency position for herself at a local program(D.O.) after she did not get into the program of her choice. Do not try that route. All it does is engender a lot of bad feelings in not only programs that might consider you but also in your future colleagues.
You certainly have a good background and a lot of stellar recommendations. I would do as many rotations in D.O. Dermatology programs as you can. Do not restrict yourself to one area of the country. Make yourself known to the Osteopathic college of Dermatology ( AOCD.org), go to thier functions at the AOA convention and network, ALOT.
Also if you are considering trying for an ACGME Derm program, do NOT let the D.O. programs know.....

 

[PathOne]

While your work/research experience seems solid, it's honestly probably not worth the time and effort to try working towards an allo derm spot. Obviously, almost anything can be accomplished by dedication, but there's simply too many other applicants with similar or better resume AND USMLE scores far above the national average. I really have no knowledge of DO programs, but would imagine that they too have a very strong applicant pool.

It might seem harsh and unfair, but Derm PD's have an almost unlimited pick, including AOA grads from major universities with strong research and sky-high USMLE scores. Competing against such types is simply an uphill battle.

However, try to contact som DO derm residents and perhaps PD's, and have them look at your resume. They can provide much better input than anybody here.

Best of luck.

 

[DrQuinn]

You can also consider some of the unfunded DO Derm residencies....

Q

 

[alfonsito]

Listen, you're on the right track. It sounds like you are definitely competative. Keep doing what you're doing. All you can do is try your best, rotate smartly, and at the end of the day...pray. Like others have said, there are tons of applicants just like you, and sometimes it can be the luck of the draw...but just remember that they're all in the same boat as you, too.
I got interviews at programs that I had never rotated through, and no response from some programs that I had rotated at....makes no sense (and no, I don't think I offended them in some way while there). I know people that have done full residencies and then years of research before getting in...and then many people who get in on their first try. Don't try to predict, just do the best you can....go to the meetings, rotate through as many programs as possible, and it sounds like you are doing great publication-wise. And its too early in the game to already resolve yourself to unfunded programs....you apply to all of them and see who bites. And, although I am not in an unfunded program, I don't like the tone (I dont think DrQuinn meant it here) but on other forums where people are reminded "not to forget about the unfunded programs" as if they are any less competative than the funded ones. My opinion, you rotate at as many places as possible, don't piss anyone off (this actually happens often), and APPLY EVERYWHERE. It's a pain because there is no centralized app process....but in July you call everyone over and over and over until you get an application in the mail and send it back. My rant is over. Good luck.

 

[dermpathdoc]

You can also consider some of the unfunded DO Derm residencies....

Q

Can you give more info on those please? Such as where they are??? As a mentor to my students who go into pathology and Dermatology, I know NOTHING about such programs and would definitely like to know about them.

 

[DrQuinn]

I actually don't know THAT much about them, but when I graduated NSUCOM in 2003, there was one of my fellow students who went to one, I believe it was somewhere in S. FL. I also heard of another DO at Suncoast who did his internship year and then did an unfunded program. Not sure where that one was.

Q

 

[dermpathdoc]

I actually don't know THAT much about them, but when I graduated NSUCOM in 2003, there was one of my fellow students who went to one, I believe it was somewhere in S. FL. I also heard of another DO at Suncoast who did his internship year and then did an unfunded program. Not sure where that one was.

Q

Sounds more like those things you have to lobby for, like the student of my acquaintance who tried to create a position for herself...and an unfunded position is that sort of ilk. Of course if you are willing and have the wherewithal to support yourself in an unfunded position in a program with ACGME or AOA approval....then all the best to you

 

[alfonsito]

Whether you're MD or DO, derm is a small world, and everyone knows everyone somehow....its like the Kevin Bacon game. DO derm is even smaller overall, and the residencies in general have less residents in them (mine has only one each year)......
That being said, there is an element of "lobbying" that has to be done....not in the sense of necessarily kissing *ss, but in the sense of behaving yourself on your rotations and getting along with everyone, because the programs are smaller and it is very important that people get along.
As far as being related to someone....we've all heard stories of people who get in because they know someone or are related to someone....that happens in every medical specialty, and moreover in every single field outside of medicine, so........
It is true that MD's do not necessarily have to rotate at a program to get a spot there....there is a centralized application process and applying to programs I a matter of a simple mouse click, although the downside is that you have to pay of every single one of those applications $$$$$ On top of that you have to have an almost impecable resume (generalization, i know)
For DO derm, the other hassle is that there is no centralized app process, you still, generally, have to look ridiculously great on paper, you are judged on you personality because most programs favor you if you've rotated there (generalization again, i know) because again, the DO derm world is small, and personality disorders become apparent much quicker (I've heard that people don't get in to other programs based on poor performance during rotations at other sites!)
All in all, derm is hard to get, if you really want it, go for it, but you really have to go for it.....do the things you're supposed to do (grades, boards, research, rotations) and that's it. MD or DO, its hard to get and I dont think anyone will argue with that.

 

[daelroy]

The unfunded osteopathic programs are as competitive as the funded ones. There is no real difference in competition. People want derm bad and will do anything to get it. Even the osteopathic residencies have plenty of top 10% candidates and 700+ COMLEX score applicants that have research.

Your best chance is to do an osteopathic family medicine residency or a traditional rotating internship at a program that is affiliated with a dermatology program. Then you should get to know the people in those programs on a personal level. Even then you probably won't get a spot. Realistically, you will probably have to be willing to do research for them or work for them in some capacity after you graduate. You might have to spend 2-4 years doing this while reapplying until they take your or you can get letters from them and another program accepts you.

The sad truth is you probably won't get one regardless of how nice or how hard you are willing to work now. Remember, the people who got a spot worked incredibly hard to be in the top of their class and have great board scores. They know what it's like to be one of those top students. They will relate and empathize with the top students more than they will with you. Why should they pity you because you have low scores? Do you think the top people want it less than you? Just wanting it is not a good enough reason for them.

You can still practice dermatology as a family medicine doctor or any other primary care physician. They even have non-accredited fellowships that you can pursue. You can't claim to be a dermatologist or a board certified dermatologist. But you can claim to specialize in dermatology or focus on dermatology or write "dermatology" under your shingle without mentioning the word "Family Practice". A lot of physicians do this. Contrary to popular belief, you don't get reimbursed less per procedure because you aren't a dermatologist. You get paid the same from insurance companies. A lot of these pseudo dermatologists actually earn more money than many accredited dermatologists because they advertise better. The general public doesn't know the difference either. They will just assume you are a dermatologist. Do a google search and you will see there are many physicians who practice as dermatologists but are not true dermatologists.

If that's not good enough for you then consider reapplying and starting over with a American allopathic program. Finish with AOA and score over 240+. That's not easy but if derm is the only thing you can see yourself doing then it may be worth it.

 

[daelroy]

Can you give more info on those please? Such as where they are??? As a mentor to my students who go into pathology and Dermatology, I know NOTHING about such programs and would definitely like to know about them.

Don't get your hopes up. Among the DO derm residencies, a few them are unfunded meaning they don't pay their residents. You won't be given a stipend for training there. However, derm is so competitive that students are willing to do this if it means they can become a dermatologist. Unfunded doesn't mean less competitive. I believe one of them is located in Mesa, AZ and is associated with COMP. People just assume "unfunded" means it's some backdoor route to derm and it's not. They are accredited DO derm residencies but they lack the appropriate funding to provide students with a stipend; they have an apprentice-ship type of quality to them as opposed to a formal fellowship type of setting. It's usually some DO dermatologist that teaches and starts a fellowship out of his practice. The "program director" is the director of that particular clinic.

 

[doctalaughs]

Of course they are less competitive. Why would any of the top candidates pick those unfunded programs if they can get into a funded one? Sure, they are still probably somewhat competitive, since there are enough people who want derm, but everyone will pick a funded program over an unfunded one. So once all the funded programs are filled, the less stellar applicants will try for those spots.

Personally, I dont know why anyone would take an unfunded spot... just to call themselves a dermatologist after going more deeply in debt? Just do family and open a skin practice... I think those programs should not be allowed.

 

[tripleJ]

"less competitive"- no such thing; there is likely a pool of about 50 well qualified Do applicants per year who are currently pursuing other training in the process or re-applying. This is in addition to the new applicant intern pool. The fact that you don't realize this, though, seems to be commonplace- even among students supposedly interested in derm. I used to hear " I'm only applying to allopathic programs" or " I think I will go to Penn to do Med/Derm because that interests me" type statements all the time. If a potential applicant has not done the basic research about the process (talked to current and past residents, etc) how can they be sincere about their "true interest in derm despite the money and lifestyle"

 

[daelroy]

Of course they are less competitive. Why would any of the top candidates pick those unfunded programs if they can get into a funded one? Sure, they are still probably somewhat competitive, since there are enough people who want derm, but everyone will pick a funded program over an unfunded one. So once all the funded programs are filled, the less stellar applicants will try for those spots.

Personally, I dont know why anyone would take an unfunded spot... just to call themselves a dermatologist after going more deeply in debt? Just do family and open a skin practice... I think those programs should not be allowed.

Of course, they are less competitive much like Yale's admission process is less competitive than Harvard's. There are far more top candidates than there are funded positions so they will accept the unfunded spots if they have to. Everyone will pick a funded program over an unfunded one but every serious DO derm applicant applies to ALL the programs especially since there aren't many AOA derm programs to begin with. You obviously don't know anything about the application process because every serious DO derm applicant knows this already and will gladly accept a chance to become a dermatologist. I know of one program in particular that received over 50 applications from students who were top 5%/99 boards/Research which includes reapplicants and interns. Doing family and opening a skin practice will not command the prestige associated with becoming a full fledged dermatologist. Remember that in dentistry, many of their fellowships are not only unfunded but require fees to actually complete them such as orthodontistry. Ask any dental student if having to pay for an orthodontist fellowship lowers the competitiveness for those postions; the answer will be a resounding NO! I personally know medicine residents who have told cardiology fellowship directors that they were willing to fund their fellowship spot if given a chance. You have no clue as to what students are willing to do to enter a particular field. Please do some research before sharing an uninformed opinion next time especially since you aren't even a DO.

 

[doctalaughs]

True, I'm not a DO but it's simple logic- if a spot is unfunded, it is LESS competitive. I didnt say NOT competitive. And, no its not yale vs harvard. If harvard paid you 40k per year and was slightly better training, and yale you had to go into an additional 150k of debt then it would be a good comparison. Sure, lots of people will still be going to the unfunded spots but the top 50% of the applicant pool- the best applicants - will have matched to a funded spot.

I know there are a few unfunded MD allo spots too (like 5 total). The only people who go there are very, very rich because not many are willing to go into so much additional debt when you can try to reapply for a funded spot. I don't see why it would be any different for the DOs unless there is some loophole that has allowed greedy PDs to create a lot of unfunded programs for free slave labor.

 

[daelroy]

True, I'm not a DO but it's simple logic- if a spot is unfunded, it is LESS competitive. I didnt say NOT competitive. And, no its not yale vs harvard. If harvard paid you 40k per year and was slightly better training, and yale you had to go into an additional 150k of debt then it would be a good comparison. Sure, lots of people will still be going to the unfunded spots but the top 50% of the applicant pool- the best applicants - will have matched to a funded spot.

I know there are a few unfunded MD allo spots too (like 5 total). The only people who go there are very, very rich because not many are willing to go into so much additional debt when you can try to reapply for a funded spot. I don't see why it would be any different for the DOs unless there is some loophole that has allowed greedy PDs to create a lot of unfunded programs for free slave labor.

What's also simple logic is understanding the meaning behind the word "relative". Of course, some programs will be less competitive but the degree to the discrepancy in competitiveness of the admissions of osteopathic derm programs is the point of the discussion. You obviously think there is a significant difference and that's what you were arguing so don't start debating semantics. The difference in competition between the unfunded and funded programs is hardly anything due to the demand. There are not enough funded spots to satisfy the top 50% of the osteopathic derm applicant pool which is an assumption you are making. There are only 20 osteopathic derm programs in existence. It's also simple logic to recognize the high earning potential in derm would convince many to pursue derm even if they have to add to their debt. Furthermore, we have an actual osteopathic dermatology resident(triple j) who refuted what you said so you might consider that when responding. The derm applicant pool is so strong that it's truly splitting hairs when trying to distinguish between derm applicants. I don't know how you can arbitrarily designate who is in the the top 50% when nearly all of the candidates have high numbers.

And I would be interested to learn what the identitify of these so-called 5 unfunded allopathic derm programs that only rich people apply to. Frankly, I don't believe you and I think you just made that up to recover from the unsound logic you proposed in this thread. Please list them, their program directors and contact numbers if you want any of us to take you seriously because at this point, I'm not taking you seriously and I don't think anyone else is either. I personally know 2 derm applicants that would be willing to fund their residency if given a chance to do derm. Don't bother responding if you can't provide the identities and contact information of those 5 allopathic derm residencies that are unfunded and supposedly far less competitive. Again, if you want us to take you seriously, provide some data instead of your assumptions.

 

[gryffindor]

Remember that in dentistry, many of their fellowships are not only unfunded but require fees to actually complete them such as orthodontistry. Ask any dental student if having to pay for an orthodontist fellowship lowers the competitiveness for those postions; the answer will be a resounding NO!

As an unpaid orthodontic resident, I will attest to this. This specialty is as competitive to match into for dental students as derm is for medical students, except the dental student will pay upto $75K x 3 years to get that orthodontic certificate while the med student will likely get paid for his training. Every orthodontic spot fills regardless of how much it costs, and there are nearly half of the applicants left over without a position. It is a good thing that medical residents get paid, however, I'm almost surprised there aren't more unscrupulous hospitals and clinics with unfunded positions trying to take advantage of desperate derm candidates.

 

[DrDivaLenz]

I havent been on here in like a year ! and i just got all your messages. OMG outcome looks bad, though im battling away with applications and rotations and still trying ! !

One comment though, to assume a person did not work hard because their USMLE or COMLEX score is average is a mistake. There are plenty of people that score high once because of 4 or 5 weeks of intense studying, but otherwise are quite lazy. And more, there are some that study hours daily and still just got an average score, so the score is not a measure of work-ethic for some. Furthermore, many times people score high boards and then just decide to do dermatology.

So how do you measure a true passion for something over just wanting to do something ? ? And who will perform better than, one with a true passion or one wiht a high board score. ? ?

 

[dermpathdoc]

I havent been on here in like a year ! and i just got all your messages. OMG outcome looks bad, though im battling away with applications and rotations and still trying ! !

One comment though, to assume a person did not work hard because their USMLE or COMLEX score is average is a mistake. There are plenty of people that score high once because of 4 or 5 weeks of intense studying, but otherwise are quite lazy. And more, there are some that study hours daily and still just got an average score, so the score is not a measure of work-ethic for some. Furthermore, many times people score high boards and then just decide to do dermatology.

So how do you measure a true passion for something over just wanting to do something ? ? And who will perform better than, one with a true passion or one wiht a high board score. ? ?

Well said Diva!!! and you are right it is very subjective. Which is why many programs prefer having prospective residents actually rotate or do research at thier institution as a way to know how that person "fits".
As for all the stuff about unfunded programs. While I am a pathologist I did an unfunded Dermatopathology reisdency after trying for 4 years to get into a funded one. Frankly it was really hard to get into that program and hellaciously expensive. I had to not only pay a fee for the privilege of attedning that program but also had to find a way to support myself during the fellowship. So if I were you, at least try for a couple of years to get into a funded program before tryign for unfunded programs and do have a fall back position you can live with.

 

[HenryH]

The unfunded osteopathic programs are as competitive as the funded ones. There is no real difference in competition. People want derm bad and will do anything to get it. Even the osteopathic residencies have plenty of top 10% candidates and 700+ COMLEX score applicants that have research.

Your best chance is to do an osteopathic family medicine residency or a traditional rotating internship at a program that is affiliated with a dermatology program. Then you should get to know the people in those programs on a personal level. Even then you probably won't get a spot. Realistically, you will probably have to be willing to do research for them or work for them in some capacity after you graduate. You might have to spend 2-4 years doing this while reapplying until they take your or you can get letters from them and another program accepts you.

The sad truth is you probably won't get one regardless of how nice or how hard you are willing to work now. Remember, the people who got a spot worked incredibly hard to be in the top of their class and have great board scores. They know what it's like to be one of those top students. They will relate and empathize with the top students more than they will with you. Why should they pity you because you have low scores? Do you think the top people want it less than you? Just wanting it is not a good enough reason for them.

You can still practice dermatology as a family medicine doctor or any other primary care physician. They even have non-accredited fellowships that you can pursue. You can't claim to be a dermatologist or a board certified dermatologist. But you can claim to specialize in dermatology or focus on dermatology or write "dermatology" under your shingle without mentioning the word "Family Practice". A lot of physicians do this. Contrary to popular belief, you don't get reimbursed less per procedure because you aren't a dermatologist. You get paid the same from insurance companies. A lot of these pseudo dermatologists actually earn more money than many accredited dermatologists because they advertise better. The general public doesn't know the difference either. They will just assume you are a dermatologist. Do a google search and you will see there are many physicians who practice as dermatologists but are not true dermatologists.

If that's not good enough for you then consider reapplying and starting over with a American allopathic program. Finish with AOA and score over 240+. That's not easy but if derm is the only thing you can see yourself doing then it may be worth it.

Daelroy, this is interesting to read.

Is this the same thing as a family med. doctor advertising herself as a "bariatrics specialist?" There is a lady in my town who, as far as I know, is a general/family practitioner, but she advertises herself on TV and billboards as a weight-loss/bariatrics doc. From what I have heard, she does pretty well for herself, despite not even practicing the medicine they learned during residency (for the most part).

What are some other areas of specialization that family med. doctors can advertise themselves for?