How to Switch from Categorical IM to Derm after PGY-1 year?

[Venom]

I have become increasingly interested in pursuing a career in dermatology. The prob is I am already matched in a Categorical IM program on the west coast and I just started my PGY1 yr. I know I could get credit of the 1st year of IM as derm residents need a prelim year anyway.

Has anyone heard of anyone switching programs after the 1st year of a categorical program? To make things worse, my hospital doesn't have a derm program just acts as clinical derm site for another academic hospital. What should my plan of action be? 1 year of full-time research, mentors etc.? I would be prepared to go anywhere to do derm instead(even leave the beautiful sunny west coast). HELP!!!

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[porokeratosis]

I have become increasingly interested in pursuing a career in dermatology. The prob is I am already matched in a Categorical IM program on the west coast and I just started my PGY1 yr. I know I could get credit of the 1st year of IM as derm residents need a prelim year anyway.

Has anyone heard of anyone switching programs after the 1st year of a categorical program? To make things worse, my hospital doesn't have a derm program just acts as clinical derm site for another academic hospital. What should my plan of action be? 1 year of full-time research, mentors etc.? I would be prepared to go anywhere to do derm instead(even leave the beautiful sunny west coast). HELP!!!

How do you know Derm is for you? Have you ever done a Derm elective? Do you have Derm mentors who will write you strong letters of recommendation? Or do you want Derm for easy lifestyle reasons and you are now realizing that IM is quite demanding? I'm sorry...but your post sounds suspicious and fishy.

If you truly enjoy Derm and you're committed to the field, then I recommend you apply for a 1 or 2 year Derm research fellowship during your intern year. If accepted, you will start your Derm research fellowship after your intern year. Research fellowships show your commitment to the field and increases your chances of getting into a Derm residency. Remember the competition to get into a Derm residency is fierce so even a fellowship does NOT guarantee that you will ever get in. To increase your chances of acceptance in Derm, you should have great grades (AOA would be awesome!), outstanding USMLE scores (230 and above), do research in the specialty, publish, work hard and impress attendings on elective Derm rotations, and get excellent letters of recommendations from Derm attendings. A research fellowship will cover the research, publishing, and letters of recommendation, but not your past academic performance (med school grades and board scores). I recommend applying to Derm research fellowships with a successful history of getting their fellows into residency, such as Wake Forest and Case Western.

http://www.derminterest.org/phpBB2/index.php
- click on "Fellowship Opportunities"

http://p220.ezboard.com/fdermatologyfrm9

You will likely face a hard road if you decide to go for Derm...Your categorical IM residency program and fellow residents will not like the fact that you will be leaving them. Do not expect a supportive staff for your career change endeavors. It also really hurts that your hospital does not have an affiliated Derm residency program.

In any case, good luck ...because you will need it!

 

[ny skindoc]

How do you know Derm is for you? Have you ever done a Derm elective? Do you have Derm mentors who will write you strong letters of recommendation? Or do you want Derm for easy lifestyle reasons and you are now realizing that IM is quite demanding? I'm sorry...but your post sounds suspicious and fishy.

If you truly enjoy Derm and you're committed to the field, then I recommend you apply for a 1 or 2 year Derm research fellowship during your intern year. If accepted, you will start your Derm research fellowship after your intern year. Research fellowships show your commitment to the field and increases your chances of getting into a Derm residency. Remember the competition to get into a Derm residency is fierce so even a fellowship does NOT guarantee that you will ever get in. To increase your chances of acceptance in Derm, you should have great grades (AOA would be awesome!), outstanding USMLE scores (230 and above), do research in the specialty, publish, work hard and impress attendings on elective Derm rotations, and get excellent letters of recommendations from Derm attendings. A research fellowship will cover the research, publishing, and letters of recommendation, but not your past academic performance (med school grades and board scores). I recommend applying to Derm research fellowships with a successful history of getting their fellows into residency, such as Wake Forest and Case Western.

http://www.derminterest.org/phpBB2/index.php
- click on "Fellowship Opportunities"

http://p220.ezboard.com/fdermatologyfrm9

You will likely face a hard road if you decide to go for Derm...Your categorical IM residency program and fellow residents will not like the fact that you will be leaving them. Do not expect a supportive staff for your career change endeavors. It also really hurts that your hospital does not have an affiliated Derm residency program.

In any case, good luck ...because you will need it!

I agree with this post for the most part.
A great performance at Derm fellowship is what it will take to get you in to a program.People have succeeded this way without being stellar candidates in other respects but it will take an all out effort as others are trying the same approach with no guarantees..

 

[Venom]

If I could potentially need a 1 or 2 yr research fellowship after my PGY-1 yr then do you think it might be better to hang on and complete by IM residency and apply for derm afterwards? Does a previous residency with derm electives, good recs and IM residency perfomance have any bearing on getting a derm spot?

 

[Venom]

I am interested in switching to derm not because I'm too lazy for IM (since my post sounds "fishy"), but because I want to spend my life doing something I love. I went into IM thinking I would find a specialty I adore and pursue that. But, after taking several med electives, I still haven't found one so I began rethinking about my previous interest in derm. I don't really see myself being happy doing general IM for the next 30-40 yrs. I'm really agonizing over my future at this point.

 

[ny skindoc]

If I could potentially need a 1 or 2 yr research fellowship after my PGY-1 yr then do you think it might be better to hang on and complete by IM residency and apply for derm afterwards? Does a previous residency with derm electives, good recs and IM residency perfomance have any bearing on getting a derm spot?

Doing IM residency is unlikely to help much with Derm.A few people do it but its uncommon and better to do a fellowship and make the right contacts ASAP.If you hang on in IM then plan on practicing that.There is too much competition to rely on old electives and recs several years out of med school. If you really want Derm you will have to go all out for it.Otherwise finish IM and focus on a fellowship like Allergy-Immunology or Rheum.

 

[03Doc]

If I could potentially need a 1 or 2 yr research fellowship after my PGY-1 yr then do you think it might be better to hang on and complete by IM residency and apply for derm afterwards? Does a previous residency with derm electives, good recs and IM residency perfomance have any bearing on getting a derm spot?

Derm electives? Maybe, if it's a high-powered place or you get solid recs out of it - hard if it's only a couple weeks.

Good recs? From IM, not much. From Derm, yes.

IM residency performance? Not really a factor (unless it was bad, of course) - maybe if you are a super-stud at like a MGH or something.

IM before derm used to be the norm, but is the rare exception nowadays. People get in all sorts of ways, but finishing IM will likely not be as fruitful as leaving IM and doing a research fellowship. Basically, this shows you are committed to getting into derm... if you're willing to leave a categorical program to face the "unknown" of the research fellow circuit, programs know you're serious.

All that aside, you still have nothing derm going for you if you apply during IM residency... you are jumping ship and the "numbers" you would need (boards, etc.) will be at least that of the average derm match (Step I >230, etc...) or even more. Derm programs get tons of apps from people who re-think their specialty choice all the time. You need to stand out, have derm experience, derm letters, etc., and it's near impossible from IM residency. A lot of research fellowships show some preference to their fellows when selecting residents as well.

Even if you do this, remember it's not guaranteed. Do yourself a favor and only do this if you are SURE derm is your calling.